The Vertigo Co
Vestibular Physiotherapy & Vertigo Therapy Melbourne
Recover from dizziness, vertigo and unsteadiness with Vestibular Rehabilitation Therapy.
The Vertigo Co
What Is Vestibular Physiotherapy?
Vestibular Physiotherapy is commonly referred to as Vestibular Rehabilitation Therapy (VRT). This is a type of focused Physiotherapy that may reduce dizziness and balance problems for most people by providing exercises designed to retrain the vestibular system.
Put simply, the vestibular system refers to the link between your inner ear and brain. This system helps to maintain balance in the body and is required to perform many tasks, including standing, walking, and running.
Vestibular disorders or dysfunction occur when a disease, condition or injury causes damage to the vestibular system. At The Vertigo Co we treat a number of vestibular disorders, including but not limited to:
Other Disorders of the Vestibular System
Recover From Dizziness, Vertigo and Balance Problems
Vestibular Rehabilitation Therapy is used to treat a range of vestibular disorders and associated symptoms, including:
Vertigo (the sensation that the world is spinning)
Dizziness (various sensations such as rocking, bobbing, swaying, tilting, floating, feeling like you are on a boat)
Light-headedness
Unsteadiness or "disequilibrium" (a sense of being off-balance)
Veering when walking from side to side
Falls (whereby an individual completely loses their balance and falls to the ground)
Understanding Vestibular Rehabilitation Therapy
To understand how VRT works, let’s consider how the body manages balance through vision, proprioception, and the vestibular system.
Vision
Vision is a sensory system. Your eyes send your brain impulses that show where your body is in relation to other objects.
Proprioception
Proprioception is another form of sensory communication. When your body moves, sensory receptors signal to the brain where your body is in relation to space. For instance, if you lean backwards, the pressure on your feet signals to the brain you are leaning back instead of standing straight.
Vestibular System
This overarching system includes the central vestibular system, located in the brainstem and cerebellum, and the peripheral nervous system in the inner ear, including the semicircular canals and otolith organs. Together, your vision, proprioception and peripheral nervous system send signals to the central vestibular system, which then interprets this information and tells your eyes and muscles to adjust movements or posture.
How Does VRT Work?
Your central nervous system integrates information from your vestibular system and other sensory systems to tell your body how to maintain balance. A vestibular disorder will interfere with these connections, meaning your central nervous system cannot process information correctly. Vestibular rehabilitation therapy helps to restore these connections and reduce symptoms through a range of exercise-based treatments.
Are you experiencing vertigo, dizziness or balance problems?
Support is available from The Vertigo Co.
What are Vestibular Disorders?
BPPV is an inner ear condition that leads to short bursts of vertigo, or a feeling like the world is spinning. The vertigo is triggered by certain head positions caused by lying down, rolling over, looking up or bending over.
Vestibular Neuritis or Labyrinthitis results from an infection in the vestibular (inner ear balance) system, causing an intense bout of vertigo, nausea, vomiting and significant unsteadiness when walking.
Vestibular Migraine is a type of migraine for which dizziness, not headache, is the more prominent feature. Symptoms often include headache, vertigo, imbalance, nausea and vomiting, along with sensitivity to light and sound.
PPPD is a type of chronic non-vertiginous dizziness resulting in persistent sensations of rocking and swaying. These sensations are worse in busy or complex environments such as supermarkets or shopping centres.
Meniere’s Disease is a chronic inner ear disease resulting from abnormally large amounts of fluid (endolymph) collecting in the inner ear. This causes recurrent bouts of vertigo, hearing loss, tinnitus and pressure in the ears.
There are multiple other balance disorders including Acoustic Neuroma (a tumour in the inner ear); Ototoxicity (drug-induced vestibular damage); Mal de Debarquement Syndrome (MdDS); Vestibular Paroxysmia; Superior Semicircular Canal Dehiscence (SSCD); Motion Sickness; and neurological conditions such as Stroke, Traumatic Brain Injury (TBI) and Cerebellar Ataxia.
What Happens During a Vestibular Physiotherapy Assessment?
If you are undertaking Vestibular Rehabilitation Therapy, you will have an initial assessment with a physiotherapist lasting for around an hour. Your assessment will involve one or more of the below steps.
Your physiotherapist will undertake a comprehensive assessment of symptoms including your vertigo, dizziness and balance. This will involve a range of tests including eye movement tests, ear function tests, motion sensitivity tests, a full assessment of your balance, and testing for Benign Paroxysmal Positional Vertigo (BPPV).
BPPV can generally be diagnosed during this initial assessment. If you are diagnosed with BPPV, you will be provided with education and treatment, including repositioning manoeuvres, home exercise programs and, if appropriate, recommendations for supplements.
If your physiotherapist believes further investigation of your symptoms is required, you may be referred to a Neuro-Otologist or for Vestibular Function Testing (VFTs) with a Vestibular Audiologist.
Following your initial assessment, a follow-up appointment may be scheduled for the week or fortnight following. These review appointments typically last for between 30 and 45 minutes.
Next Steps
Once a cause for your symptoms has been determined, we will tailor a specific treatment program for your needs. The length and scope of this treatment is determined by factors including any diagnoses you receive.
For those with BPPV, on average two sessions are required, however on occasion this condition can be resistant to treatment and will require several sessions. For conditions such as Vestibular Migraine and Vestibular Neuritis, on average treatment is 6 to 12 weeks. Persistent Postural Perceptual Dizziness (PPPD) or conditions like Mal de Debarbarquement (MdDS) may require longer intervention of up to 6 months or more.
Frequently Asked Questions
Every person is different. The number of sessions required depends on the cause of the symptoms and how you respond to treatment. Your physiotherapist will inform you of the expected number of sessions required and their frequency during your first consultation. This may change according to how you respond to treatment.
We do not require a referral from a GP or other medical practitioner for private patients. If you are a Workcover or TAC patient, we require a referral, and request that you please contact the clinic before booking your appointment. If you have been given a referral, please bring it along to your appointment along with any other relevant test results or reports.
If you have a referral from a doctor, please bring this with you. Also bring other relevant information including:
- Hearing test results
- Vestibular function test results
- X-rays, CT/Ultrasound/MRI scans and reports
- Specialist letters or reports
- Medication list
Please wear flat shoes (or have socks) and comfortable clothing to your appointment.
Our physiotherapists try to minimise discomfort for their clients wherever possible. However, you may be required to move into positions during the assessment and treatment that provoke dizziness and sometimes nausea. If you are concerned about or have a history of motion sickness and vomiting, we recommend taking anti-nausea medication about 30 minutes before your appointment. You may also choose to bring anti-nausea medication to use if needed after the session.
An Initial Vestibular Physiotherapy Assessment is $180, or if conducted via Telehealth, $160. Please view our FAQs page for further fee information and our policies regarding private health insurance claims, Enhanced Primary Care Plan (EPC)/Chronic Disease Management Plans, and Medicare claims.
What Are the Likely Outcomes of Vestibular Rehabilitation Therapy (VRT)?
Vestibular Physiotherapy has been shown to be significantly beneficial for patients with BPPV (1), Vestibular Neuritis (2), Vestibular Migraine (3), Persistent Postural Perceptual Dizziness (PPPD) (4), Meniere’s Disease (5) and Mal de Debarquement Syndrome (MdDS) (6) along with other Vestibular and Balance Disorders.
Why The Vertigo Co?
We Know Vestibular Disorders and Dysfunction
The Vertigo Co is a specialist physiotherapy service treating adults and children (aged 8 and up) affected by symptoms including vertigo, dizziness and balance-related problems.
Expect Tailored Support and Attention to Detail
Our highly experienced physiotherapists will perform a full physical assessment of your symptoms and discuss with you in detail the likely cause of your symptoms.
In-Person and Telehealth Appointments Available
We offer flexibility, with in-person consultations at our clinic in Murrumbeena and video telehealth appointments available Australia wide and internationally.
The Vertigo Co
Book a VRT Appointment
If you are suffering from frustrating symptoms like dizziness, vertigo and unsteadiness, Vestibular Rehabilitation Therapy may be the answer. Our friendly and highly experienced physiotherapists will provide quality care using the latest assessments, technology, and techniques.
For more information or to book an appointment, contact us today.
the Vertigo Co
References:
- Chen X, Mao J, Ye H, Fan L, Tong Q, Zhang H, Wu C, Yang X. The effectiveness of the modified Epley maneuver for the treatment of posterior semicircular canal benign paroxysmal positional vertigo. Front Neurol. 2023 Dec 21;14:1328896. https://pubmed.ncbi.nlm.nih.gov/38187143/
- Huang HH, Chen CC, Lee HH, Chen HC, Lee TY, Tam KW, Kuan YC. Efficacy of Vestibular Rehabilitation in Vestibular Neuritis: A Systematic Review and Meta-analysis. Am J Phys Med Rehabil. 2024 Jan 1;103(1):38-46. https://pubmed.ncbi.nlm.nih.gov/37339059/
- Koc A, Cevizci Akkılıc E. Effects of vestibular rehabilitation in the management of patients with and without vestibular migraine. Braz J Otorhinolaryngol. 2022 Nov-Dec;88 Suppl 3(Suppl 3):S25-S33. https://pubmed.ncbi.nlm.nih.gov/34799267/
- Popkirov S, Stone J, Holle-Lee D. Treatment of Persistent Postural-Perceptual Dizziness (PPPD) and Related Disorders. Curr Treat Options Neurol. 2018 Oct 13;20(12):50. https://pubmed.ncbi.nlm.nih.gov/30315375/
- Gottshall KR, Topp SG, Hoffer ME. Early vestibular physical therapy rehabilitation for Meniere’s disease. Otolaryngol Clin North Am. 2010 Oct;43(5):1113-9. https://pubmed.ncbi.nlm.nih.gov/20713248/
- Dai M, Cohen B, Smouha E, Cho C. Readaptation of the vestibulo-ocular reflex relieves the mal de debarquement syndrome. Front Neurol. 2014 Jul 15;5:124. https://pubmed.ncbi.nlm.nih.gov/25076935/