Vertigo and Dizziness

The Vestibular System

The vestibular system is a sensory organ that helps keep your gaze and balance stable whenever you move your head. It does this by interacting with other body systems like vision and body position awareness.

 

The vestibular system consists of two organs, within our inner ear on either side, and our brain. These vestibular organs are motion sensors. They detect movement, which is then relayed on to our brain. Our brain then interprets that information and responds accordingly to maintain our balance whilst we are moving.

 

If there is an issue with the vestibular system, people can commonly experience one or more of the following symptoms:

  • Vertigo

  • Dizziness

  • Vision disturbances

  • Hearing loss

  • Tinnitus

  • Motion sensitivity

  • Imbalance and Unsteadiness

  • Falls

How Physiotherapy Can Help

Vestibular issues are common and are often easily treated. Physiotherapists trained in Vestibular Rehabilitation are able to improve dizziness, balance and blurred vision, when it is related to an issue within the Vestibular system. In order to treat vestibular issues, our Physiotherapist must first accurately diagnose the condition. This requires knowledge surrounding the history of the condition, followed by diagnostic physical assessments. These assessment may include tests of your visual system, balance and walking. Some issues such as Benign Paroxsymal Positional Vertigo (BPPV) (see below for details) can be resolved quickly with specific hands-on treatments, whereas other conditions require ongoing training of the vestibular system through home exercise.

Vestibular Anatomy

Within the inner ear lays very small structure, called the bony labyrinth. Within this structure sits the vestibular system (responsible for balance) and the cochlea (responsible for our hearing).

 

Our vestibular system is made up of three semicircular canals. Within these canals, suspended in fluid, are several different sensory organs that detect movement. When we move our head, the fluid within the canals moves, in turn moving the organs. The organs detect the movement and relay this information to our brain along the vestibulocochlea nerve.

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Figure 1: Vestibular system within the inner ear

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Figure 2: Semicircular canals and cochlea

Vestibular Conditions

There are a number of conditions that disrupt the normal workings of our vestibular system. Each of these conditions has very specific actions on the vestibular system, each presents with very specific signs and symptoms symptoms. As previously mentioned, these symptoms can include dizziness and loss of balance. Physiotherapy can aid in the rehabilitation of many of these conditions.

Benign Paroxsymal Positional Vertigo (BPPV)

BPPV is the most common cause of vertigo, which is caused by a sensory disturbance within the semicircular canals. BPPV induces movement or position provoked vertigo. People describe that movements such as sitting and standing, rolling and get out bed, or turning their heads too quickly can bring on sudden vertigo, lasting for generally less than a minute. 

Unilateral Vestibular Hypofunction (UVH)

UVH is a caused when the signals from the vestibular apparatus on one of the head is relaying different information than the other side. There is a vestibular system in each inner ear, so unilateral means that only one system is impaired, while the other is working normally. Symptoms can come on suddenly or slowly, can be mild or severe, and may last for a few days to even weeks. People can experience the whole array of symptoms listed previously, but dizziness and unsteadiness are the most common.