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Vestibular Therapy

What is causing Dizziness?

Dizziness is one of the most common complaints that increases with aging.  Dizziness is often related to Vestibular System issues that can result from a variety of problems including inner ear issues, infections or viruses, head trauma, brain-related issues, diseases, medications and more.  Although the causes can be complex there are two main causes that can be referred to a physiotherapist to treat BPPV and PVD. 

What is BPPV?

Benign Paroxysmal Positional Vertigo (BPPV) and Peripheral Vestibular Dysfunction can both cause dizziness complaints, but the cause and treatments for each are very different.   BPPV is the most common cause and typically includes a sensation of brief SPINNING (<1min) and is triggered by moving one’s head position relative to gravity.   With BPPV there is NO hearing loss or tinnitus, but there can be nausea, vomiting, blurred vision, headaches and neck pain.   The SPINNING sensation is caused by little calcium carbonate particles called otoconia that are moving in one of the canals in the inner ear part of the vestibular system.  The particles, often called crystals or ear rocks, trigger your vestibular system which then gets confused with other signals to your brain from your eyes and other ear, and the result is VERTIGO.   The VERTIGO caused by the BPPV is treated by a vestibular trained physiotherapist by performing some maneuvers that move the crystals from the inner ear canal.   An assessment with your physiotherapist will help determine which maneuver you will need as there are 3 different inner ear canals that could have crystals moving in them.  Generally, BPPV can be treated by your Physiotherapist in 1-3 sessions.

What is PVD?

The second big cause of dizziness Peripheral Vestibular Dysfunction (PVD) is caused by damage or degeneration of the vestibular system in the inner ear.   Dizziness is caused when the vestibular system is not able to sense or send signals correctly to the brain which causes confusion in the system.  The confusion usually is felt as Dizziness, visual disturbances, and even loss of balance.  There is no specific test for PVD but testing of the eye coordination can help determine if the problem is a weakness of the eyes and the info from your vestibular system, the inner ear, or if it’s a problem in the brain sending/receiving information from your vestibular system.  Treating a vestibular system loss caused by PVD is more challenging, and requires moving and specifically challenging the inner ear system and provoking dizzy feelings.  It's natural to avoid feeling dizzy but sometimes it’s necessary for your body to adapt to it.  Eye exercises can also play an important part of training your vestibular system to use information from your ears and eyes together more effectively again.     


We can help you determine which type of Dizziness you have and customize a treatment plan to optimize your body’s ability to reduce or eliminate Dizziness symptoms. See your Physiotherapist for a Vestibular Assessment today!

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