Is it Vertigo or Vestibular? Vertigo, Vestibular Disorders, & Physical Therapy Explained

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Vestibular dysfunction and vertigo affect a person’s quality of life and ability to perform daily life activities and work. Vestibular dysfunction often results in symptoms of lightheadedness, dizziness, positional or persistent vertigo, impaired postural control, and imbalance. Vertigo is described as a spinning, tilting, whirling sensation that can occur when standing still, lying down, or changing position. 

Vestibular disorders refer to impairments in the collection of structures of the inner ear that provide your sense of balance and spatial orientation. As you age, the function of the vestibular system declines, which can leave a feeling of underlying dizziness. 

What are causes of vertigo and vestibular disorder?

Vertigo can be caused by inner ear infections, migraines, surgery or injuries to the inner ear, hole in the inner ear, a cervical spine issue, or stroke. BPPV (Benign Paroxysmal Positional Vertigo) is a common cause of vertigo due to mechanical changes in the inner ear that cause periods of spinning sensations when the head is in certain positions. BPPV results when small “crystals” in the inner ear become dislodged and enter the inner ear canals.

There are several vestibular disorders that result in dizziness, imbalance, postural control, and vertigo: 

  •       Vestibular neuritis: inflammation of the inner ear balance structures due to cold or flu

  •       Vestibular migraine: blood flow changes to the brain that result in throbbing head pain, triggered by stress, hormones, weather changes, and lack of sleep

  •       Meniere’s disease: a periodic and recurrent increase of fluid and pressure in the inner ear that causes damage to the inner ear and can result in loss of hearing or ringing in the ears (tinnitus) 

How can physical therapy treat vertigo and vestibular disorders?

Our physical therapist, Jen Kiernan-Story, specializes in vestibular dysfunction and provides vestibular rehabilitation therapy (VRT). First, our therapist performs a visual and vestibular system screen to observe eye movement control and assess sensation, muscle strength, spine range of motion, coordination, posture, and ability to walk. VRT is an exercise-based program  designed to reduce vertigo and dizziness and address gaze instability, imbalance issues, and fall risk. Our therapist customizes the VRT exercises to the patient’s specific needs.

Vestibular rehabilitation therapy involves habituation exercises, gaze stabilization exercises, and balance training exercises.

Habituation Exercises: These exercises are used to treat dizziness that is caused by movement or visual stimuli. The goal of the exercise is to reduce dizziness by repeated exposure to visual stimuli and specific movements that normally provoke dizziness. Over time, the intensity of the dizziness will decrease as the brain learns to ignore the abnormal inner ear signals that create dizziness.

Gaze Stabilization Exercises: These exercises improve eye movement control to improve vision clarity when the head moves. The exercises are used when a patient is experiencing vision issues (e.g. bouncing or jumping when reading). A patient will practice fixating on an object while repeatedly moving the head.

Balance Training Exercises: The goal of these exercises is to improve steadiness to help a patient return to daily activities. These exercises involve coordinated movement, completing dual tasks, and changing from stationary to dynamic positions to reduce fall risk. Balance training exercises aim to improve standing, bending, turning, and walking abilities. Exercises performed when standing on a narrow base are used to promote postural stability.

For those suffering from BPPV-induced vertigo, our physical therapist performs repositioning maneuvers to restore inner ear crystals into place.

Vertigo and other vestibular disorders can impact your ability to perform daily activities and can increase your risk of falling. Call Mangiarelli Rehabilitation today to get started on the road to recovery and experience relief!

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