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Re-Balanced
Physiotherapy

Helping You Find Balance
Rebalanced Vestibular Physiotherapy

Dizziness is often used to describe symptoms including a feeling that you or the room is spinning or moving (vertigo), a loss of balance, giddiness, unsteadiness, light-headedness or weakness. It may also be accompanied by nausea, fatigue, blurred vision and difficulty concentrating. Symptoms may be constant or come and go. Episodes can last from minutes to days.

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An assessment with a trained vestibular physiotherapist is recommended for clients to help with symptom management

THE BALANCE SYSTEM

Your balance is controlled by signals to the brain about body movement and your position in relation to the environment. The brain integrates this information and sends signals back to the muscles on how to maintain balance.

Three sensory systems manage balance:

  • Vision

  • Proprioception: movement sensors in the skin, muscle and joints

  • Inner ears: the organ of balance in the inner ear is called the vestibular system. It includes three fluid-filled loops (semicircular canals) which respond to the rotation of the head. Near the semicircular canals are the utricle and saccule, which detect gravity and back-and-forth motion.

THE VESTIBULAR SYSTEM

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The vestibular system is name for the inner ear balance organs and the brain processing of inner ear balance information.

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Vestibular or inner ear conditions can cause various symptoms, including dizziness, vertigo (usually spinning or rocking/tilting sensations), light-headedness, unsteadiness or imbalance, nausea, vomiting, blurred vision, and fatigue. Anxiety and depression may also feature or be a result of living with vestibular symptoms.

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A range of disorders can impact the vestibular system, resulting in the symptoms described above. These include benign paroxysmal positional vertigo (BPPV), unilateral vestibular loss due to vestibular neuritis or labyrinthitis, vestibular migraine, Meniere’s disease, superior canal dehiscence, peri-lymphatic fistula, bilateral vestibular loss, stroke or transient ischaemic attacks (TIA) or concussion/ head trauma to the labyrinth.

WHAT IS BPPV (Benign Paroxysmal Positional Vertigo)

BPPV is the most common cause of vertigo, especially in the older population (people over 65 years old).

BPPV occurs when crystals (called otoconia), normally located in one part of the vestibular (or balance) system of your inner ear (the utricle), become dislodged and collect in another part of the inner ear balance system (one of the semi-circular canals).

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As your head moves, the dislodged crystals also move and incorrect messages are sent to your brain and then to your eyes. The brain receives the messages that the head is moving although the head has only moved position slightly. This will cause symptoms such as the feeling of movement or spinning with certain movements such as rolling over in bed, getting in/out of bed, or looking or reaching up (for example to the top shelf or to put drops into your eye). 

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BPPV can be diagnosed and is usually effectively treated with simple manoeuvres performed by a vestibular physiotherapist. A range of positions aims to move the crystals out of the semi-circular canal of the inner ear to an area that will not stimulate the wrong messages to be sent by the balance system. 

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