This service is intended for patients who experience balance and/or dizziness problems. It is appropriate for those seeking an initial assessment for their symptoms or those who have been referred by their GP or consultant.
The vestibular system is made up of many components which allow us to balance and orientate ourselves. The inner ear is a vital part of the vestibular system and there are many disorders which may prevent the inner ear from functioning as it should. Vestibular physiotherapists have extensive knowledge of the inner ear and related disorders.
Vestibular physiotherapy can assist with a wide range of conditions, which include, but are not limited to:
- Benign Paroxysmal Positional Vertigo (BPPV): a disorder arising from a problem within your inner ear, caused by loose calcium carbonate crystals. BPPV results in recurring brief episodes of vertigo and nausea, with possible balance impairments. Triggers include lying flat, turning in bed, bending forward, and reaching up high.
- Persistent Postural Perceptual Dizziness (PPPD): a disorder of chronic dizziness, when symptoms have been present for more than 3 months and are not better accounted for by another cause
- Meniere’s Disease: an episodic condition affecting the balance and hearing components of the inner ear
- Vestibular Neuritis: affects the vestibular nerve and can cause a sudden onset of vertigo and balance problems
- Labyrinthitis: affects the vestibular and the hearing nerve and can cause a sudden onset of vertigo and hearing loss
- Vestibular Migraine
- Neurological conditions such as Multiple Sclerosis or dizziness following stroke
Vestibular physiotherapy can help with, but is not limited to, the following problems:
- Feelings of imbalance or unsteadiness
- Falls or fear of falling
- Movement-triggered vertigo and/ or dizziness
- Feelings of panic, anxiety or stress related to dizziness
- Inability to perform daily activities, such as work, driving and exercise
We offer a comprehensive assessment, which may lead to a diagnosis or recommendation for further investigation if required. Our Vestibular Physiotherapist is aware of the many reasons for balance problems which may require alternative management plans.
What to expect at your initial consultation
A comprehensive 60-minute assessment will include:
- A discussion about the history of your symptoms and your current concerns
A detailed history is vital when assessing disorders of balance and dizziness
- Eye movement examination
Your eye movements give us information about how the pathways from both your brain and inner ear are functioning
- Cranial nerve examination
Your cranial nerves control various functions in the body, one of those nerves is your vestibular nerve, but other nerves sit closely to the vestibular nerve so we need to make sure other nerves are functioning as they should as well
- Inner ear reflex testing
The reflex which allows us to keep our gaze steady even when our head is moving is controlled by the inner ears, a test called the ‘head impulse test’ can give us information on how well this reflex is working
- Positional testing
A common cause of vertigo, called BPPV, can be ruled in or out through specific positional testing which involves laying down with your head in different positions
- Co-ordination examination
Co-ordination tasks can give us information on specific parts of the brain which co-ordinate our movements
- Balance function testing
Asking you to perform various balance tests gives us information on how well you can integrate all of the sensory and movement systems involved in balance and orientation
- Lying and standing blood pressure
Another cause of dizziness can be a drop in blood pressure when standing from sitting or lying, hence why we also need to check your blood pressure in clinic
- Formulation of an individualised treatment programme
If appropriate and based on the above findings, we will be able to form a treatment plan for your problems. Treatment may involve hands-on manoeuvres to help with specific causes of vertigo, or the provision of exercises individual to your needs.
- Consultation report
You will receive a consultation report which will outline the findings of the assessment and the agreed action plan. Your GP and/or relevant consultant team will also receive a copy.
The above testing will involve eye, head, and body movements. Part of the assessment will be ‘hands-on’. We will be able to adapt the assessment if you struggle with neck pain.
Follow Up Sessions
Your treatment plan will be completely individual and based on your own needs and expectations. You will be able to discuss follow-up sessions with your physiotherapist following your assessment. Vestibular rehabilitation is appropriate for most people with balance and/ or dizziness problems, whatever the root cause of the problem is. Some causes are more medical and may require other investigations, in which case this would be communicated to your GP and/ or consultant and further physiotherapy at that stage may not be appropriate.
To book, please call us on 02078343700 or email firstname.lastname@example.org.
Please note: if you experience new, sudden onset vertigo or dizziness, please seek urgent medical attention by calling 999 or attending your nearest A&E department. Whilst vestibular physiotherapy can be effective at assessing and treating these conditions, A&E assessment is warranted in the event of acute onset dizziness.