Do you ever feel dizzy or light-headed,or off-balance when walking?
Dizziness is not something you routinely associate with physio but it is something we can help treat. Its a unique speciality called vestibular physiotherapy and vestibular rehabilitation and it is an area I feel very passionate about. Sometimes this can be a problem with the vestibular or labyrinth system located within the inner ear. This system sends sensory messages to the brain as your head moves, via nerves on each side, and co-ordinates this information (in conjunction with feedback from the eyes and receptors in the joints and spine). When there is a problem in the vestibular system on one or both sides, the wrong messages are sent to the brain and it thinks your head is moving when it is not.
The workings of the inner ear
This can cause symptoms of dizziness,being light-headed,feeling off-balance with veering or staggering, spinning ( vertigo), visual disturbance, fatigue/ reduced concentration,and sometimes associated nausea and occasionally vomiting.
You can also have ringing in the ears( tinnitus) and/ or hearing loss as the vestibular nerve is closely associated with the auditory nerve. But don’t worry it is treatable.
The problem can be from inflammation of the vestibular nerve ( neuritis or neuronitis) or the inner ear( labyrinthitis) and is usually viral in nature but can occasionally be bacterial-this is different from the more common middle ear infections. Another problem can be from crystals in the inner ear (part of the vestibular system) becoming dislodged and moving to the wrong place, again giving mis-information to the brain and causing spinning vertigo,especially on turning to one side in bed. This is called positional dizziness or BPPV- Benign Paroxysmal Positional Vertigo.
The symptoms in all cases can be very disabling in the acute phase impacting on all daily activities and medication can be used to alleviate these. However, the symptoms can carry on for a long time after the initial severe period, to a lesser extent, but still have lasting effects on daily life, especially confidence. Coming off prescribed medication from the acute phase is important to allow recovery in the long term.
Other medical problems including stroke, head injury, heart and blood pressure problems, allergies and side effects of prescription medications can cause similar symptoms, therefore it is important to rule out these from a GP or specialist first. If you have been diagnosed with a vestibular problem by your GP or ENT consultant, vestibular rehabilitation may be what you need!
A thorough vestibular examination would work out the problem area, then a tailored exercise programme would be provided with a full explanation on how the treatment works to allow an improvement in symptoms and a return to a more confident, active lifestyle.
If this sounds familiar, maybe I can help you? I am based at Optimal Physio, Largs on a Tuesday. Why not book in for a free 10minute consultation to see if vestibular rehabilitation is something you would benefit from. Call us on 0333 301 0205 or email me at jo@optimalphysio.co.uk to ask me about your symptoms.
Look forward to making you better.
Jo Jamieson
Senior Physiotherapist at Optimal Physio Largs.
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