What is Vestibular Rehabilitation?
Vestibular rehabilitation is a multi-modal form of treatment for balance symptoms, commonly known as âVertigoâ, but includes all symptoms of dizziness, vertigo and/or unsteadiness. Treatment involves specialist exercises, manoeuvres, advice and psychologically informed education, as well as soft tissue manual therapy and Acupuncture specifically around the neck muscles, in order to restore equilibrium within the balance system.
Vestibular treatment promotes recovery from damage arising from the inner ears, the nerves that transmit signals from the inner ears, and disruption within the brain centres themselves that are responsible for processing these signals.
The exercises are progressed to gradually promote compensation within this system, and to strengthen the inner ear balance mechanisms. Which in turn treats the perception of dizziness, vertigo and unsteadiness, and over time symptoms gradually reduce as tolerance to movement improves.
Vestibular Disorders We Can Help With
- BPPV (Benign Paroxysmal Positional Vertigo)
- Vestibular neuritis
- Labyrinthitis (commonly known as âVertigoâ)
- Bilateral vestibular hypofunction or vestibulopathy
- PPPD (Persistent Postural-Perceptual Dizziness)
- Post-Concussion Syndrome
- MeniÊreâs Disease
- Vestibular Migraine â Migraine associated vertigo
- Ongoing dizziness related to Stroke - brainstem or cerebellar stroke
- Mal de Debarquement Syndrome
- Multiple Sclerosis (MS) related dizziness
- Vestibular Schwannoma
- Presbyvestibulopathy (age-related)
- Any other neurological balance disorder
What to expect during your first appointment
Assessment will contain a detailed history, uncovering all the relevant details regarding your symptoms, followed by a comprehensive examination of inner ear reflexes and eye movements which often show tell-tale signs in vestibular conditions. Treatment will consist of appropriate advice, education and specialist exercises customised to your individual condition.
For some conditions there may be manoeuvres which fully resolve the problem in a single session, or within a couple of sessions, such as BPPV. However, most balance disorders require time for the balance centres in the brain to adapt and compensate for the disruption in signals that have occurred.
Treating any neck dysfunction, whether from the joints of the spine or the surrounding muscles, can often help facilitate the rehabilitation of vestibular disorders. Although dizziness very rarely stems from the neck itself, it can be helpful to treat associated issues there.
If further investigation is required, we can write an additional report and make the appropriate recommendations to your GP or medical provider.
Considerations for a Vestibular Assessment
The primary purpose of vestibular assessment is to diagnose the presence, nature, and severity of any vestibular dysfunction. This involves a series of tests designed to evaluate the vestibular system, which includes parts of the inner ear and brain that help control balance and eye movements. These assessments help identify the cause of symptoms of dizziness, vertigo, imbalance, and visual disturbances.
Some assessments involve physical movements under the guidance of your physiotherapist. Please consider wearing clothing which allows you to move comfortably. Some patients may feel sick during or after an assessment. Vestibular physiotherapists are experienced in supporting patients to manage these symptoms and ensure your safety throughout. If you are concerned about side effects after your appointment please consider bringing a trusted person to support your transport arrangements.
What outcome can be expected?
Successful vestibular rehabilitation can lead to a significant reduction or complete elimination of symptoms. Outcomes may include improved balance, decreased sensation of dizziness, reduced risk of falling, improved coordination, and an overall enhanced ability to perform daily activities and tolerate different environments including busy places such as Supermarkets which are often troublesome. Additionally, patients often report an improvement in their quality of life, as they can return to their normal routines with more confidence and control over their symptoms.
Merseyside Health have regular vestibular specialist appointments which can be booked online at selected sites. For more information or for help arranging an appointment please contact us on 0151 433 2459 or email info@merseysidehealth.com
Nick Hill
Clinical Specialist Physiotherapist â Vestibular Rehabilitation
Nick has a keen and personal interest in health, nutrition and fitness and general well-being. He spent 3 years working as a physiotherapist at Crystal Palace Football Club and has over a decade of experience working in musculoskeletal and sports injury physiotherapy within the private sector. He utilises additional strategies and therapies including Acupuncture to complement the management of muscle and sports injuries as well as vestibular rehabilitation and is accredited by the Acupuncture Association of Chartered Physiotherapists (AACP).