Vestibular Rehabilitation

What is Vestibular Therapy?

Vestibular rehabilitation is a conservative treatment approach to impairments regarding your inner ear system when it comes to balance and dizziness symptoms.

Vertigo manipulation

Do I need Vestibular Therapy?

Dizziness, vertigo and balance deficits are the most common reasons for vestibular rehabilitation. Vestibular therapy may help people with conditions such as:

Dizziness characterized by the sensation of spinning or whirling, even when you're stationary. It often feels like the room is moving around you or that you're spinning. Vertigo can be a symptom of a number of different conditions, including inner ear problems, migraines, head injuries, and even certain medications. It can be accompanied by nausea, vomiting, sweating, and difficulty standing or walking. Vertigo can be a temporary or chronic condition, and treatment depends on the underlying cause.

BPPV stands for Benign Paroxysmal Positional Vertigo. It is a type of vertigo caused by a problem in the inner ear. BPPV occurs when tiny crystals of calcium carbonate, known as otoliths or canaliths, become dislodged and migrate into the fluid-filled canals of the inner ear, which are responsible for detecting head movement and sending signals to the brain about balance and spatial orientation.

When these crystals are dislodged, they can cause the inner ear to send false signals to the brain, resulting in dizziness and a spinning sensation. The vertigo caused by BPPV is typically triggered by specific head movements, such as turning over in bed, looking up or bending down.

BPPV is a common condition, and it can be effectively treated with simple maneuvers that involve repositioning the head in a specific way to move the dislodged crystals out of the inner ear canal. Here at Symmetry Physical Therapy, these maneuvers can be performed by our physical therapists and taught to the patient to perform at home.

Meniere's disease is a disorder of the inner ear that causes episodes of vertigo, hearing loss, tinnitus (ringing in the ears), and a feeling of fullness or pressure in the affected ear. The exact cause of Meniere's disease is unknown, but it's believed to be related to a buildup of fluid in the inner ear, which can disrupt the normal balance and hearing mechanisms.

Meniere's disease typically occurs in episodes that can last anywhere from 20 minutes to several hours, and they can be unpredictable in frequency and severity. The vertigo episodes can be so severe that they can cause falls, and the hearing loss can be permanent.

In addition to vertigo, hearing loss, tinnitus, and ear pressure, some people with Meniere's disease may experience nausea, vomiting, and sweating during the episodes. There is no cure for Meniere's disease, but treatment options include medication, dietary changes, and vestibular rehabilitation therapy. In some cases, surgery may be recommended.

Labyrinthitis is an inner ear disorder that causes inflammation of the labyrinth, which is the part of the inner ear responsible for balance and spatial orientation. The condition typically occurs when a viral or bacterial infection spreads to the inner ear, although it can also be caused by injury or trauma to the head.

Symptoms of labyrinthitis include dizziness, vertigo, nausea, vomiting, hearing loss, ringing in the ears (tinnitus), and difficulty with balance and coordination. The severity and duration of symptoms can vary, and in some cases, symptoms may persist for several weeks or months.

Labyrinthitis is typically diagnosed through a physical examination, hearing tests, and other diagnostic tests, such as an MRI or a CT scan. Treatment may include medication to reduce inflammation and alleviate symptoms, such as antihistamines, corticosteroids, and anti-nausea medications. In addition, vestibular rehabilitation therapy is recommended.

Vestibular neuritis is an inner ear disorder that affects the vestibular nerve, which is responsible for sending signals from the inner ear to the brain about balance and spatial orientation. The condition is typically caused by a viral infection that inflames the vestibular nerve, leading to symptoms such as vertigo, dizziness, nausea, vomiting, and difficulty with balance and coordination.

Vestibular neuritis is often confused with labyrinthitis, but the main difference between the two is that labyrinthitis also involves inflammation of the cochlear nerve, which is responsible for hearing, while vestibular neuritis only affects the vestibular nerve.

The symptoms of vestibular neuritis can be quite severe and can last for several days to a few weeks. Treatment may include medication to alleviate symptoms, such as antihistamines, anti-nausea medications, and corticosteroids, as well as vestibular rehabilitation therapy to help improve balance and reduce the severity of vertigo symptoms. In most cases, the symptoms of vestibular neuritis will eventually go away on their own, but it may take several weeks or months for a full recovery.

Headache Miami

How can Vestibular Therapy help?

There are several different types of vestibular rehabilitation exercises, but they can generally be divided into three categories:

These exercises are designed to help the brain adapt to and tolerate movements that typically trigger vertigo or dizziness. The exercises may involve repetitive movements of the head, such as turning or tilting, or movements of the whole body, such as standing up or walking. The goal of habituation exercises is to reduce the sensitivity of the vestibular system to certain movements and stimuli.

These exercises are designed to improve the ability to maintain clear vision during head movements, which can be impaired in people with vestibular disorders. The exercises typically involve focusing on a stationary object while moving the head or body, which helps train the brain to keep the eyes steady despite movement.

These exercises are designed to improve balance and coordination, which can be affected by vestibular disorders. The exercises may involve standing on one leg, walking on uneven surfaces, or performing other activities that challenge balance and coordination. The goal of balance exercises is to improve the ability to maintain balance and prevent falls.

These exercises are typically prescribed and supervised by a physical therapist who specializes in vestibular rehabilitation. The specific exercises chosen will depend on the individual's symptoms and the underlying condition causing the vestibular disorder.

CPG 2017 update from 2008 CPG

Posterior canal BPPV is more common than horizontal canal BPPV, constituting approximately 85% to 95% of BPPV cases

Take a look at the Clinical Practice Guideline

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Symmetry Physical Therapy is a privately owned one-on-one, patient-centered physical therapy clinic in Downtown Miami/Brickell. Every treatment is with the same Doctor of Physical Therapy for the entire hour. Symmetry’s specialized, dedicated, and passionate team of physical therapists is fully committed to each patient’s success.

10+ Years as a Therapist Owned Physical Therapy Practice