What is it?
By Caren Schatz, MSPT |
Contrary to popular opinion, your Vestibular System can become injured or inflamed and Vestibular Rehabilitation Therapy (VRT) may be all that is needed. The vestibular system, or balance system, is the sensory system which provides information about your movement and sense of position. The system consists of the inner ear (small circular canals called the labyrinth), specific nerves, and a portion of the brain called the cerebellum.
A symptom associated with vestibular system dysfunction is the sense of spinning or vertigo; either you have the sense that you or your environment is spinning and you feel dizzy. Signs of injury or vestibular system inflammation may be abnormal eye movements (nystagmus), blurred vision during head movements, and a loss of balance. In addition, movement of your head will often time make the spinning or sense of dizziness worse.
Vestibular Neuritis or Neuronitis (VN) and Benign Paroxysmal Positional Vertigo (BPPM) are the two most common conditions in need of VRT. BPPV occurs when small pieces of calcium break off within the inner ear and begin to move around the circular canals of the labyrinth. These pieces move when the position of the head changes. Often times, this condition can be easily corrected by a trained professional who uses a very specific sequence of head and body positional changes to move the calcium to a place where it no longer causes dizziness. VN is usually viral and causes inflammation which produces nystagmus, nausea, and sometimes vomiting.
Following the effective use of medication, VRT involves balance and movement-coordination training, postural re-education, hands-on soft tissue mobilization, and overall body conditioning. For BPPV, a trained professional can perform the hands-on Epley(2) Maneuver to re-position the small pieces of calcium. Exercise-wise, and early on in therapy for BPPV and VN, the simple Cawthorne-Cooksey Exercises (3,4) are most often performed; these are a progressive series of exercises which combine eye, head, and body movements in a sequence in order to re-train your balance system. When appropriate, more complex exercises involving the eyes while the head and body are moving are used to re-tune the vestibular system. These are necessary in order for you to return to such recreational activities like golf, bowling, tennis, ping-pong, driving, and bike riding.
In order to avoid vestibular system dysfunction or to fully rehabilitate your system after injury or inflammation, you may need to incorporate specific activities and even change your lifestyle. Dance, Tai Chi, Yoga, and the Martial Arts are great ways to keep your vestibular system operating well. VRT is an effective non-surgical intervention which can help you re-gain your sense of balance, restore coordination, and resolve dizziness.
References:
1. The published works of Dr. Timothy C. Hain MD, professor of Neurology, Otolaryngology, and Physical Therapy/Human Movement Science at Northwestern University Medical School, Chicago, IL.
2. Fujino, A. et. al. (1994). Vestibular Training for Benign Paroxysmal Positional Vertigo. Arch Otolaryngol HNS. 120:497-504.
3. Cawthorne, T. (1946). Vestibular Injuries. Proc R Soc Med. 39:270-272.
4. Cooksey, F.S. (1946). Rehabilitation in Vestibular Injuries. Proc R Soc Med. 39:273-275.
For more information call Body Wisdom Physical Therapy 775-827-3777.
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