| The Vestibular Rehabilitation
Program treats dizziness and symptoms of vertigo. The term "vestibular"
refers to the sensory system within the inner ear, which helps you
to maintain your balance and stability within the environment. There
are a variety of problems which can affect this system, including:
Benign Paroxysmal Positional
Vertigo (BPPV): This is the most common cause of vertigo.
What causes it? The most
common theory of the cause of BPPV is that "debris"
becomes free-floating within the semi-circular canals of the
inner-ear. This "debris" can cause dizziness and unsteadiness
with movement.
Can Physical Therapy help with
BPPV? Absolutely! Once a diagnosis of BPPV has been made
by your doctor, Physical Therapy can perform specialized treatments
designed to free the "debris" and move them back where
they belong, which improves the symptoms. Researchers have shown
a 90 to 100% improvement rate when these techniques are properly
performed and proper aftercare instructions are followed.
Vestibular Neuritis or Labyrinthitis:
This term describes a malfunction or loss of function within the
inner-ear apparatus (Vestibular System,) or of the vestibular
nerve itself.
What causes it? This disorder
is usually caused by a viral infection, and is often preceded
by a cold or upper GI infection. This is the second most common
cause of vertigo in adults.
What are the symptoms? Unlike
BPPV, in which the vertigo tends to be of short duration, vestibular
neuritis vertigo tends to be more severe and prolonged. Nausea,
postural imbalance, and nystagmus is also present. Hearing loss
is usually not present.
Is Physical Therapy indicated
for Vestibular Neuritis? Yes, in most cases. Your doctor
may consider medication and bed rest in the most severe, initial
acute phase; after the first week or two, Physical Therapy can
teach specialized exercises designed to improve symptoms of
vertigo and reduce postural instability. Specific exercises
can help to improve the ability to move around with greater
ease.
Meniere's Disease:
This chronic and debilitating inner-ear disease is characterized
by attacks of severe vertigo, which then slowly resolves, leaving
the patient with nearly normal balance between attacks.
What causes Meniere's Disease?
Currently, the exact cause of Meniere's is unknown.
What are the symptoms? The
classic presentation of an attack of Meniere's is accompanied
by a sensation of fullness in the ear (sometimes, patients will
say their ears feel "full of water," or that it "sounds
like I'm inside a seashell.") Patients will also complain
of reduction of hearing in the affected ear, and tinnitus (ringing
in the ears.) There will usually be quite severe rotational
vertigo, disruption of postural stability, and nausea and vomiting.
In between attacks, balance and postural stability is usually
normal. Over the course of years, hearing usually deteriorates.
Is Physical Therapy indicated
in Meniere's? Usually, Physical Therapy and Vestibular Exercises
are not indicated, due to the episodic nature of the attacks,
and the fact that symptoms of postural imbalance and vertigo
are usually absent between attacks.
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