Part 1: Dizziness, Vertigo and the Vestibular System

What is vertigo?

Have you ever experienced any one or more of these symptoms?

Dizziness: the feeling of light-headedness, giddiness and unsteadiness.
Disequilibrium: the feeling of being imbalanced and is a sensation of being disorientated within your surroundings.
Syncope: losing consciousness and fainting.
Vertigo: a sensation that you, or the room you are in, is in motion and is commonly felt like a spinning sensation.
Headache: is constant pain of aching anywhere within the head or upper neck
Tinnitus: is when an individual hears “ringing” in their ears

In this series of blogs, I will dive into the common causes of dizziness and the associated symptoms experienced by patient presenting to Fighting Fit Physio.

Our ability to remain balanced is determined by information received from our peripheral balance systems such as:

Our eyes (visual system),
Ears (vestibular system) and
The sensory nerves in our muscles, joints, tendons and ligaments (proprioception).

Our central nervous system, the brain, spinal cord and nerves receives this information and then must process it to maintain our balance in all kinds of positions.

Many people do not realise that Physiotherapists are well equipped to assist with diagnosing and treating common forms of dizziness. They mainly think to go to a physio for a torn muscle, a sore back or that niggling injurty that keeps flaring up.

So let’s look at what are causes of dizziness and the conditions we treat.

BPPV or Benign Paroxysmal Positional Vertigo

BPPV is a common disorder of the inner ear or what we call our vestibular system.

‘Benign’ Paroxysmal Positional Vertigo is just that: Benign, which means not life threatening or a progressive condition. Even though for some it can feel like it is not betteror worsening with time

BBPV is the result of a disturbance inside your inner ear.

There are 3 semicircular canals which contain fluid that moves when you move your head. This extremely sensitive area allows us to determine changes in head position relative to the rest of our body and environment.

BBPV develops when small calcium crystals (see above) within your inner ear break free and enter one of the semicircular canals, this results in your brain receiving mixed messages when tilting your head, lying down, rolling over or getting up.

This can occur idiopathically (randomly), with age or can occur following a trauma to the head.

What are the symptoms of Benign Paroxysmal Positional Vertigo?

The symptoms of vertigo include

Dizziness or spinning seconds after a head movement
Light headedness getting up from sitting or lying
Balance disturbances trying to get moving after changes in your position ie: getting out of bed, a chair or even just walking
Nausea and vomiting

How do you fix Benign Paroxysmal Positional Vertigo?

Let’s take a look at how physiotherapy helps BPPV.

“In terms of treatment for BPPV it is individualised depending on which of the semicircular canals has been identified by your clinician”

A thorough assessment including an in depth subjective assessment, or put simply a bunch of questions that well ask you to describe your symptoms ie

When it started?
How long do symptoms last for?
The positions that aggravate you most?
How this is affecting day to day activities and life?

We will then test you, performing a quick movement of the head and body called a Dix-Hallpike test.

If positive, this will reproduce your symptoms and give us information on perform a ‘repositioning’ technique such as the Epley Manouvre.

This seeks to dislodge the calcium crystals from where they shouldn’t be and return them to where they belong promoting a return to normal vestibular function.

This Repositioning technique for BPPV will result in casing those mixed signals sent from the inner ear to the brain and in most cases will have an immediate reduction in dizziness symptoms.

Remember these techniques are individualised for the presentation and just attempting the first exercise could make you feel worse.

As a component of your assessment your therapist will identify the provocative movement patterns for your dizziness, treat it and then teach you some exercise to desensitise the vestibular system so to maintain our treatment effect long term.

Other things to consider with BPPV treatment

Before the dizziness, began to occur did you have poor balance?
If so: We need to implement strategies to reduce the risk of a balance related fall, exercise is a great tool to use help with this.
The “Eppley hangover” is a phenomenon when the day after a successful treatment of BPPV you feel worse, your physiotherapist will warn you of this so you are prepared and it is very normal.
It is important to resume normal activities, as you are able. This allows your body to resume exposure to the normal vestibular demands of day to day life and accelerate your recovery. Your physiotherapist can assist with a graded return to an activity program.

If you experience a sudden onset of dizziness please get in contact with us.

If your symptoms have been ongoing for many months ask your GP for a referral to us under a chronic disease management plan for vertigo.

Kyle Wells

Kyle Wells is a Physiotherapist at Fighting Fit Physio.

He has a special interest in arthritis, neck pain and tendinopathy. Just to name a few.

Kyle loves cross fit and has an exceptional eye for technique and performing exercise correctly.

He use exercise to improve patient results and get them moving better for the long term.

Brenda Samosa

05:52 07 Nov 24

I had a really bad shoulder and had been seeing a different physio for 3 months (from a different place) I got told Tyson was good. After just a few sessions the movement was coming back. I’m 66 and was worried I would have to stop surfing. But with a lot of help from Tyson I’m back in the waves ( thank you so so much)

Cyana Ferguson

08:16 30 Oct 24

Steve Harris

22:33 15 Oct 24

Great team, all friendly, super helpful and first class clinical advice and a big shout out to my Physio Noah with my shoulder issue

Andrea Bell

05:33 19 Sep 24

These guys are the best in the biz 🎉

Ryan Brockett

04:20 18 Sep 24

Shout out to Max from fighting fit physio. He helped me out massively straight after shoulder surgery and back into work and sports in no time. Couldn’t recommend anyone better!

Scotty

08:31 31 Jul 24

Five star service from Max & the team!
Professional & very thorough, you know that patient outcomes are of the highest priority.
I highly recommend this business.

Riley Wilson

08:27 14 Jul 24

Be AWARE they’ll immediately try to commit you to multiple follow up sessions after your initial consultation. This happened to me and then I later found out that as it just so happens, they have a cancellation policy that says you have to pay 100% of the consultation fee for cancelling. They failed to tell me this when they were pushy in committing me to 6 sessions after my consult, so that was a really nice little surprise.

I was already uncomfortable with how pushy they were in having me commit to so many sessions, so when I heard about the policy I just cancelled all together. So, I can’t speak further to the quality of their service throughout therapy phase. FYI this was also a few months ago now, it’s possible (though unlikely) they may have changed the policy. Just ask the question.

Megan Shelley

06:51 03 May 24

Fighting Fit Physiotherapy is hands down the best physio I've encountered. Having tried multiple physios for various injuries, I always find myself coming back to them. Their expertise consistently exceeds expectations, helping me get back to my sport faster than I thought possible. Their personalized approach and attention to detail make all the difference. I could not recommend a better or more exceptional physio team!

Gina Matthews

08:41 24 Mar 23

Can't recommend this place high enough. I was in so much pain with my knee an had been for months through advise an exercises I'm now looking forward to returning to gym an back riding my horses in endurance thank you so much

Courtney Halse

01:36 29 Nov 22

Kyle was knowledgeable, personable and professional. He saw me through my second pregnancy and continued to work with me until 6 months post partum on issues with my back. Would recommend anyone to go and see him.

Also shout out to Georgia on the front desk. She makes you feel welcome and brings a sense of warmth to the place!

Alli Davenport

08:07 04 Nov 22

After hip replacement surgery in February I wanted toget back into weight training legs, I started with Mitch 18 weeks ago and after a lot of hard work and sweat I am able to safely train again, I cannot thank Mitch enough for his support,encouragement and knowledge. The staff are friendly and helpful and I always looked forward to my session's

Robert Parkinson

10:50 15 Aug 22

This is the second time I have been treated by the team at FFP.
As a health professional myself I have been impressed with the level of care I have received from all members of the team.
The personalised treatment and rehabilitation programs have produced excellent results and I have completed both programs pain free and feeling stronger than before my injuries.
During the program there was constant communication and follow up and they were very accommodating with my work schedule.
All in all it was a very holistic experience and I would highly recommend the service.

Kiri Canavan

07:30 08 Jun 22

Tyson was amazing! We came up with an 8 week plan at my first consultation with weekly check ins and updates to exercises. 8 weeks later, I am pain free and able to train harder than ever. Highly recommend and the staff are all fantastic and super accomodating!

What is vertigo?

BPPV or Benign Paroxysmal Positional Vertigo

What are the symptoms of Benign Paroxysmal Positional Vertigo?

How do you fix Benign Paroxysmal Positional Vertigo?

Other things to consider with BPPV treatment

The Desk Worker’s Guide to a Pain-Free Neck

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The #1 Mistake Athletes Make After an Ankle Injury

The Secret to Beating Back Pain? Walk This Way!

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