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Dizziness, Vertigo & Disequilibrium - Is There a Way Out?



It is surpisingly unsurprising to see dizziness, vertigo and disequilibrium as one of the commonest symptoms reported during medical consultations.


Many dizziness complaints can be caused by a large list of potential factors and there is one that is easily overlooked coming from your vestibular system.


So, what is the vestibular system?


Your vestibular system consists of three main component: 1) your two inner ear organs 2) the vestibular centres of your midbrain and cerebellum and 3) your peripheral vestibular nerves.

The vestibular organs act like sensors that measure head movements and gravity. The vestibular nerve connects your inner ear organ to the midbrain and cerebellum which transmits the motion information from the inner ears to your brain for processing.


Your brain also processes information from other sensory organs such as your vision, hearing and somatosensory input throughout your body. It then transmits orders to the muscles in your eyes, trunk and limbs so that you react appropriately to every situation.


Dizziness can result from a peripheral vestibular disorder (inner ear system) or central vestibular disorder (a dysfunction of one or more parts of the central nervous system that help process balance and spatial information).


Although these three symptoms can be linked by a common cause, they have different meanings, and describing them accurately is what leads to a successful diagnosis.


What do you experience when suffering from a vestibular disorder?

People with vestibular disorders usually experience problems with vertigo, dizziness, visual disturbance, and/or imbalance. Dizziness is a sensation of lightheadedness, faintness, or unsteadiness, usually it is related to peripheral vestibular hypofunction.


Unlike dizziness, vertigo has a rotational, spinning component, and is the perception of movement, either of the self or surrounding objects, and it is a typical presentation of benign paroxysmal positional vertigo (BPPV).


Disequilibrium means unsteadiness, and imbalance that is often accompanied by spatial disorientation and frequent fall histories. These are the problems that vestibular physio aims to address. Other problems can also arise that are secondary to the vestibular disorder like nausea, vomiting and reduced ability to focus and concentrate.


Symptoms due to vestibular disorders can influence all aspects of life from economic to social functions as well as can contribute to emotional problems, like anxiety and depression. Additionally, one of the consequences of untreated vestibular disorder is causing people to adopt a sedentary lifestyle to avoid triggering or worsening symptoms that occurs with movement.


As a result, decreased muscle strength and mobility, and reduced stamina can occur from this lifestyle. Treatment strategies used in rehabilitation can also be beneficial for these secondary problems.


Vestibular Rehabilitation Training (VRT)

VRT is a specialized form of physiotherapy which incorporates manual therapy and prescription of exercise targeting both the primary and secondary problems due to vestibular disorders.


VRT begins with a comprehensive clinical assessment that include collecting a detailed history of your symptoms and how these symptoms affecting you. Physiotherapist will screen the visual and vestibular systems to observe how well eye movements are being controlled in related to gravity and head movement.


Testing of your sensation, muscle strength, extremity and spine range of motion, coordination, posture, balance, and walking ability may also be necessary.


You will be benefit from VRT if have been diagnosed with any of the following vestibular conditions:

· Unilateral Vestibular Hypofunction

· Cervicogenic (neck related) Dizziness

· Neurological conditions (i.e. stroke, traumatic brain injury)

· Vestibular deconditioning from aging or inactivity


Every patient’s vestibular rehabilitation exercise program is different from each other. This is not only because there are different types of vestibular impairments, but each type affects everyone differently. Your exercise program should be developed by a vestibular physiotherapist who has identified your specific impairments and the challenges and limitations based on your lifestyle, occupation, and roles.


Are you suffering from Vertigo or related conditions? I specialise in treating people with vestibular dysfunction and related spinning, dizziness and balance problems.



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