By Dominique Wood-Ward
A condition where the inner ear (vestibular system) is giving you unclear or mixed messages about where your head is in space and how it is moving in space. This can lead to persistent dizziness, poor balance and unsteadiness, falls, fatigue and nausea. These symptoms can have a large impact on your quality of life. People often report reduced confidence with leaving the house, navigating uneven ground, crossing roads and reduced coping with motion in a vehicle. In more severe cases it can affect everyday movements such as rolling over in bed and bending forward.
The condition is more likely to occur in older people (>55 years old), people who have had a disease affecting the vestibular system (labyrinthitis, vestibular neuritis), following head injury affecting the inner ear and following the use of certain medications. It can follow on from an episode of BPPV (benign paroxysmal positional vertigo) another inner ear condition causing ‘room spinning’ dizziness.
It is important to have your dizziness assessed to differentiate between the different causes. Other conditions that can produce similar symptoms include cervicogenic dizziness (dizziness caused by dysfunction of the neck), BPPV and disease states affecting the inner ear.
This assessment can guide the rehabilitation plan based on your symptom severity, effect on your daily life and your goals.
Treatment often involves vestibular rehabilitation including eye movement exercises, neck movement exercises and balance exercises. Tailored programme progression is important to increase confidence with balance, reduce dizziness and enable safe return to normal daily activities and outings.
If you’re dealing with dizziness, book with an experienced physio today.
References
Grill E, Heuberger M, Strobl R, Saglam M, Holle R, Linkohr B, Ladwig KH, Peters A, Schneider E, Jahn K, Lehnen N. Prevalence, Determinants, and Consequences of Vestibular Hypofunction. Results From the KORA-FF4 Survey. Front Neurol. 2018 Dec 7;9:1076. doi: 10.3389/fneur.2018.01076. PMID: 30581415; PMCID: PMC6293194.
Hall CD, Herdman SJ, Whitney SL, Anson ER, Carender WJ, Hoppes CW, Cass SP, Christy JB, Cohen HS, Fife TD, Furman JM, Shepard NT, Clendaniel RA, Dishman JD, Goebel JA, Meldrum D, Ryan C, Wallace RL, Woodward NJ. Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association. J Neurol Phys Ther. 2022 Apr 1;46(2):118-177. doi: 10.1097/NPT.0000000000000382. PMID: 34864777; PMCID: PMC8920012.
