Dizzy Day Clinics can help

The vestibular system of the inner ear is made of five sensory organs (see diagram): three semi-circular canals; and two otolith organs.

The purpose of the vestibular system is to monitor the position and motion of your head in space. The semi-circular canals are responsible for detecting rotation, for example when you nod or shake your head. The otolith organs are responsible for detecting motion along a line, for example when your car stops suddenly, or when you lean to one side.

The inner ear structures send signals into areas of the brain, which subsequently are involved in co-ordinating movements of your eyes and your head, and in maintaining balance.

There are a variety of symptoms associated with disorders of the vestibular system. These include:

• dizziness;
• vertigo (an illusion of motion);
• blurred vision;
• nausea;
• impaired balance;
• unsteady walking;
• reduced concentration; and
• increased fatigue.

These types of symptoms may subsequently lead to other problems, such as loss of confidence, frequent falls, work-related issues, headaches, difficulties with driving, depression and feelings of significant anxiety and fear. Commonly people with suspected disorders of the vestibular system are referred for diagnostic testing (also known as vestibular function testing). This type of testing can help to diagnose the cause of your specific vestibular problem.

There are a range of disorders that commonly interfere with the functioning of the vestibular system and which can result in the types of symptoms described previously. These include:

• vestibular neuronitis (a viral infection of the inner ear);
• acoustic neuroma (a benign tumour which grows along the course of the vestibular nerve);
• Menieres Disease (a fluctuating disorder which involves the build-up of fluid in the inner ear);
• Benign Paroxysmal Positional Vertigo (BPPV) (a disorder caused by debris freely floating in the fluid of the inner ear);
• otoxicity (an adverse reaction of inner ear structures to certain medications);
• vestibular migraine (a variant of classic migraine where the main symptom is of dizziness rather than headache);
• stroke (an interference with the blood supply to the inner ear and vestibular areas within the brain); and
• trauma (motor vehicle accidents, significant falls)

These are only a few examples of common disorders involving the vestibular system.

Vestibular rehabilitation is an exercise-based physiotherapy approach to the treatment of vestibular problems.  It was developed originally in the UK, but has gained momentum as a recognised and effective intervention over the past 30 years.

It is now considered to be the most successful management approach for people with dizziness and balance problems associated with disorders of the vestibular system.

Our approach is typically to develop a customised program of vestibular exercises that are designed to re-calibrate the balance system. The vestibular exercises are customised to each individual and are developed based on the initial vestibular assessment findings.

An additional part of our physiotherapy program is the assessment and treatment of Benign Paroxysmal Positional Vertigo (BPPV). This is a very specific vestibular problem that causes symptoms of vertigo that are provoked by rolling over in bed, sitting up in the morning and tilting the head back. We specialise in the assessment of BPPV and use a range of treatment techniques to manage this condition. This type of approach can be enormously successful in treating the symptoms of BPPV.