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What is Vertigo? ... and yes, it's treatable!

Updated: Nov 1, 2023

What is vertigo? You may have heard vertigo used to describe the fear of heights, but it actually isn’t.

Vertigo can be described as a spinning sensation and it affects the ability to balance. Sometimes we might even feel like we are falling to one particular side.

Vertigo is often accompanied with a feeling of nausea and may even result in vomiting.

Have you experienced vertigo before? The answer is probably yes!

Everyone has experienced some form of vertigo in their lives before. Think back to your experience at the local carnival. Remember the spinning cup ride where you would sit in a teacup and it would spin while all the other cups rotated around you?

How did you feel? I’m guessing that you may have felt a sense of giddiness which normally increased as you speed faster..

What happened when the ride stopped and you got off? Were you able to walk in a straight line?

What you felt in that moment of dizziness is vertigo!

The feeling created by the spinning cup is vertigo due to the triggering of our inner ear system!

What creates this feeling of Vertigo?

We have 3 systems to help keep us in check and give us spatial awareness and keep us balance:

  1. Visual System: Our eyes help us to see where we are relative to space

  2. Somatosensory System: Our touch and joint senses for us to feel where we are relative to space

  3. Vestibular System: Has our semicircular canals (loops), which react when we turn our head, and otolith organs that react to gravity and movement i.en i.e the sensation of moving up or down when we are taking the lift

Thus, any insult to the brain (central vestibular giddiness) or the vestibular system (peripheral vestibular system), can result in vertigo!

What are some common causes for vertigo?

There are many potential causes for vertigo, but it is important to understand how you can resolve issues related to vertigo and when you should seek professional help.

Peripheral causes:

  • BPPV

  • Vestibular neuronitis

  • Labrynitis

  • Superior semicircular canal dehiscence syndrome

  • Perilymph fistula

  • Labyrinthitis

Central causes:

  • Head injuries

  • Strokes

  • Migraines

  • Brain tumours

How is vertigo and its associated symptoms treated by vestibular rehabilitation?

Vestibular rehabilitation starts with in-depth history taking to identify the root cause of the problem as well as symptoms affecting your activities of daily living. An assessment is then carried to identify impairments.

The choice of treatment is determined by the cause of the impairment, potential recovery of the vestibular function as well as the identifications of any maladaptive compensation.

The treatment of vertigo is than broken down into 4 categories:

  1. Canalith Repositioning Maneuver: Main treatment for BPPV. To reposition the otolith that is causing hypersensitivity to head positional changes like getting out of the bed and bending down.

  2. Adaptation exercises: For the brain to learn the incorrect signal and recalibrate itself back. This exercise is most useful for those recovering from an acute vestibular episode.

  3. Habituation exercises: Assist to desensitization to the vestibular movement and stimulation through repeated exposure. These exercises are useful for individuals with visual vertigo

  4. Substitution exercises: Using the visual and somatosensory system to replace the missing vestibular function, useful for conditions that are unlikely to have full recovery of the vestibular function.

Why do I need to see a Vestibular Physiotherapist?

The physiotherapist does not only treat vertigo but treats other conditions that may affect your balance.

Vertigo occasionally manifests with other symptoms due to the maladaptive ability of the body to compensate to maintain equilibrium. These maladaptation can be due to the lack of function of the vestibular system to keep our balance or an increase in our reliance on visual input.

These are other associated symptoms that can be treated by a vestibular physiotherapist:

  • Motion sickness (feeling of giddiness after car ride)

  • Supermarket syndrome (Giddiness in crowded in area with large amount of visual stimulus)

  • Sensation of objects bouncing when walking (oscillopsia)

  • Disequilibrium upon head movement

  • Unsteadiness especially at night

  • Feeling unsteady when walking on certain surfaces (like on sand at the beach) or on turns

  • Frequent falls

Can I self-manage my vestibular condition?

Vestibular rehabilitation requires tailored exercises to treat different types of impairments. Grading of exercise exposure is important as too much or too little will result in minimal improvement.

Whilst the treatment for vertigo requires a holistic approach, there are certain basic exercises that are likely to be beneficial for most include balance exercises to train the vestibular system.

Here is one that will help you train your vestibular system!

Try this out!

A general rule of thumb when performing the exercises is selecting the correct intensity. The exercises should provoke giddiness during exercises but do not last to affect your activities thereafter.

When should I seek help from a Vestibular Physiotherapist?

Delayed treatment for vestibular rehabilitation can result in persistent issues and a decrease in quality of life in the long run. So, if the symptoms are not improving, make an appointment for a detailed assessment and a targeted treatment!

Written by Amelia Lim

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