The vestibular system includes the parts of the inner ear and brain that process sensory information involved with balance. Vestibular disorders can be caused by disease, injury, poisoning by drugs or chemicals, autoimmune causes, traumatic brain injury, or ageing. Many vestibular disorders occur from unexplained causes.
Symptoms of vestibular disorders include dizziness, vertigo (a spinning sensation), loss of balance, tinnitus (ringing in the ears), fatigue, jumping vision, nausea/vomiting, hearing loss, anxiety, and cognitive difficulties.
Vestibular disorders impact patients and their families physically, mentally, and emotionally. In addition to physical symptoms such as dizziness and vertigo, vestibular patients can experience poor concentration, memory, and mental fatigue.
Many vestibular patients suffer from anxiety and depression due to fear of falling and the loss of their independence.
Size of the problem
- Almost 1 in 4 adults under 65 years report dizziness or vertigo, often causing occupational difficulties or preventing employment but less than 25 per cent had received treatment
- About 20 per cent with vestibular vertigo avoid leaving the house and 41 per cent require sick leave
- Over 38 per cent of those aged over 85 years fall annually; half in combination with dizziness or blackouts
- 2.4 per cent lifetime prevalence of BPPV (Benign Paroxysmal Positional Vertigo) alone, with only 8 per cent receiving effective treatment.
What is vestibular rehabilitation (VR)?
VR is an exercise-based programme to encourage the central nervous system to compensate for problems in the inner ear. Following thorough examination, a management plan may include:
- Eye and head movement exercises
- Exercises to improve standing balance and walking
- Specific techniques to reposition fragments in the inner ear which cause dizziness in BPPV (not carried out at the Centre)
- Education and advice on activities of daily living to improve confidence & function
- Advice on falls reduction/prevention.
- Significant improvement is achieved in:
- 80 per cent of patients with unilateral vestibular loss (e.g. labyrinthitis, acoustic neuroma surgery)
- 80 per cent of patients with BPPV after one treatment session
- Patients with a central cause (e.g. stroke) may show some improvement
- Use of VR in concussion, migraine, and nonspecific balance loss of the elderly may be helpful.
Manual therapists such as Physiotherapists/Osteopaths are ideally placed to provide early screening and intervention to minimise the impact on daily life of balance and dizziness disorders.
Lessons in The Alexander Technique can also help improve balance and movement for all, and greater functional reach (a clinical measure of balance) in elderly women to reduce the risk of falls.
If you would like some help contact us at the Centre for the best approach.