Featured Treatment – Vestibular

Some people just love a thrill. Let us consider my 4 year old for a moment. He loves to be spun around and swung to and fro – while upside down. I suppose roller coasters were invented for people like him. On the other hand, some folks like their feet firmly planted on the solid earth – you won’t likely find those people on a small sailboat rocking and rolling on the sea’s waves. What am I talking about? I am discussing the widely popular (in name only) and poorly understood vestibular system. 

The Vestibular system is a complex and amazing mechanism that keeps us upright. Come to think of it, it keeps us sideways too – or any position we choose to be in. The vestibular system is named for the word “Vestibule” which according to the Oxford dictionary means “hall, antechamber”. This vestibule in particular is located deep inside the inner ear and is an incredible organ that is filled with fluid. When you are resting the fluid remains at a standstill. However, when you move your head or your body, the fluid flows through the maze, or labyrinth, and in the process it pushes these little otoliths (stones) one way or another which then stimulates these specialized nerve cells which transmit that information to the brain which then determines which way you are moving and weather you are speeding up or slowing down. Take a look at the structure for a moment (Courtesy of https://upload.wikimedia.org/wikipedia/commons/1/14/Blausen_0329_EarAnatomy_InternalEar.png)

When your vestibular system is working correctly, you may not notice much of anything when moving about normally in your day to day activities. The vestibular and the auditory system are innervated by the 8th cranial nerve, and a loss of healing AND dizziness could indicate a problem with the nerve which is not uncommon in older adults. There are also temporary conditions that can affect your nerves resulting in hearing loss and dizziness, such as vestibular neuritis. However, when you experience a sense of dizziness without hearing loss, and this dizziness is brought on with positional changes (such as moving from sitting to lying down or vice versa) then you are almost certainly dealing with a vestibular dysfunction that can be diagnosed and treated by a doctor of physical therapy. There are a number of diagnoses that can cause dizziness, and a well-qualified physical therapist should be able to rule out or rule in those conditions at your evaluation.

The most common diagnosis for positional dizziness is Benign Paroxismal Positional Vertigo (BPPV) of the posterior canal. This occurs when the otoliths (stones) either fall into the canal. Sometimes the dizziness improves after several seconds, cand sometimes it seems to remain. That symptom by itself does not indicate a more severe condition. When BPPV is the cause of your dizziness, your physical therapist can often resolve your issue in 1 to 3 sessions. 

Another very common cause of dizziness is vestibular hypofunction. This occurs when your system one one side is not working correctly due to any number of reasons. This condition is also highly responsive to physical therapy exercises and can usually improve significantly after only one month of balance and vestibular exercise. Unlike BPPV which will typically affect you when you are changing positions, vestibular hypofunction can interfere with your standing and walking activity, leading to impaired gait and even falls. According tot he CDC, mor ethan 95% of hip fractures are caused by falls (https://www.cdc.gov/injury/features/older-adult-falls/index.html).

If you or someone you know is experiencing dizziness of any kind, please consider calling or emailing us at Therapy SPOT – Bellaire (Therapy SPOT – Bellaire – Bellaire) to set up an evaluation with one of our doctors of physical therapy. We proudly offer a thorough examination with the use of Infrared goggles which records your eye movements and allows us to accurately diagnose the cause of your dizziness. You can reach us at 832-588-3552 or email us [email protected]. You can also find us only at www.BellairePT.com. Our address is 6708 Ferris Street, Bellaire, Texas, 77401

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