The vestibular system is often referred to as the inner ear. It provides input about our movement and sense of balance, and is made up of five sensory organs (three semi-circular canals and two otoliths). Within this system there are calcium carbonate crystals which are normally fixed, helping to provide the proper input for balance. When there is a dysfunction in this system, there are often feelings of dizziness and/or vertigo. Vestibular system dysfunctions affect people of all ages; however, it more often affects people age 65 and older.
Vertigo is a specific type of dizziness and has a very distinct sensation with an illusion of movement occurring in the environment, such as the room spinning or objects in the room spinning. This is a very unpleasant experience and usually involves unusual eye movement (nystagmus) and nausea.
There are various causes of vertigo, but one of the most common reasons for it is Benign Paroxysmal Positional Vertigo (BPPV). This is when the calcium carbonate crystals in the inner ear become dislodged and move to another part of the canal, causing the sensation of spinning.
Vestibular rehab is the treatment of these problems in the vestibular system. The assessment is done by taking the patient through a series of positional tests. Treatment for BPPV can be very effective. During the treatment your physiotherapist will ‘float’ the crystals around the canal to reposition them to the proper canal. This is done by a series of movements; the most common is called the Epley maneuver. It can often take 10 minutes or less, and may require one or two follow-up visits. Following the reduction in your symptoms, your physiotherapist may also provide exercises to help retrain your balance and proprioception.
Adam Bernard is a physiotherapist with training in vestibular rehab. If you’re having trouble with vertigo or on-going dizziness, you can book an appointment with him to see if treatment may be helpful. You can reach him at Dynamic Edge Physiotherapy.
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