Vestibular Rehabilitation

Dizziness is the feeling of being off-balance, or feeling that your environment is moving despite everything being still. If you have ever gone on those spinning teacup rides at an amusement park, you have definitely felt this feeling. The challenging part about dizziness is that it can affect every aspect of your life, and limit the activities that you perform during a day. 

Dizziness can come from many different origins, so your medical team (including your family doctor, and physiotherapist) can help to narrow down the causes and contributors to your personal experience with dizziness.

The different types of dizziness are often descriptions of how the dizziness “feels”. It can be tough to describe our dizziness, as it can be an overwhelming feeling. It can be important to try and find some words to describe your dizziness when speaking with medical professionals. Some words that patients have used in the past are spinning, unsteady, feeling faint, the room is moving, feeling like you are on a boat, feeling like you are “drunk”.

You can also get secondary symptoms that follow the same pattern as your dizziness, including nausea, headache, visual or auditory disturbances, or ringing in the ears. Knowing these signs and symptoms can help your therapists treat you more effectively.

It can be useful to do some personal detective work into what activities or movements contribute to your dizziness. For some individuals, the dizziness can be provoked by lying down or rolling in bed, physical activity, or bending down to pick something up.

Dizziness can be caused by many different systems in the body including your blood pressure, use of medication, the vestibular system (inner ear), post-concussion, after a car accident, neck dysfunction, infection, blood sugar levels, anxiety, dehydration, and many more. 

Once your doctor has cleared some of the systems, your physiotherapist can help you to diagnose if your dizziness is related to the vestibular system, a balance deficit, neck dysfunction, or post-accident. This will help your therapist find the proper treatment strategies to help your dizziness resolve.

Vertigo is the common name, for a condition called BPPV for short, or Benign Paroxysmal Positional Vertigo. BPPV usually presents as a feeling of spinning, which occurs with specific movements of the head or the body within space. People often find that this feeling comes on after lying down or getting up out of bed, turning in bed, or lying down flat.

This feeling should last for around 30 seconds to 2 minutes and will resolve on its own. If this occurs with every time that you perform a specific motion, it is a good time to speak with your healthcare team. It is more common after a hit to the head, or with older age. 

BPPV can be treated by doing a specific maneuver, or series of movements, that help to re-align the inner ear system. This maneuver is first performed with the guidance of a physiotherapist, and then can be taught to perform at home if the patient is comfortable.

On your first visit, your physiotherapist will conduct an assessment which may include a health history; evaluation of standing and walking balance; sensation and strength of the lower body; tests to evaluate the co-ordination and communication between the eyes and inner ears about where the body is in space (aka. proprioception); evaluation of dizziness provoking positions; and an examination of the neck (cervical spine) range of motion and strength.

Following the assessment, your physiotherapist will prescribe an exercise program and make recommendations regarding follow-up treatment (frequency, treatment elements, etc.).  Treatment is aimed at compensating for the part of the system which is causing the symptoms.

If you, or someone that you know, is experiencing any form of dizziness, we suggest checking in with your doctor first, and then coming in for a physiotherapy consult. We can help you get your life back into balance, literally and figuratively.