Vestibular Rehabilitation
Approximately 90 million Americans will experience dizziness or vertigo at some time in their lives. In fact, dizziness – resulting from disorders in the inner ear's vestibular system – is one of the most common reasons for visits to the doctor, and is most often seen in older adults.
Until recently, many patients suffering from dizziness and vertigo were left to perform therapeutic exercises at home on their own. Now, Kapi'olani's program provides a structured regimen individually designed for each patient and guided by our rehabilitation therapists.
Rehabilitation exercises have proven effective in treating inner ear disorders when medications fail to provide relief, symptoms last for an extended period, or there is sudden loss of vestibular function. Kapi'olani also offers electronystagmographic (ENG) testing of the eyes, which is helpful in diagnosing vestibular problems.
Our highly trained staff is experienced in helping individuals manage and often overcome vestibular dysfunction.
For More Information
To receive more information or to schedule an appointment, call (808) 535-7000.
How do I know if I have a vestibular problem?
If the following activities cause you dizziness or imbalance, you may have a vestibular problem:
- Turning your head quickly
- Heights
- Walking in the dark
- Bending over
- Looking at moving objects
- Walking down a supermarket aisle or through a mall
Do you lose your balance frequently?
Do you avoid activities because they make you dizzy?
Do you feel as if you are moving or spinning when you are sitting or standing still?
What is the vestibular system?
To maintain your balance, the brain must receive accurate information from three different systems:
- Visual system (eyes)
- Somatosensory system (muscles and joints)
- Vestibular system (inner ear)
The vestibular system, or inner ear, is not only a critical link in your ability to hear, it also tells the brain where your head is and the direction and speed it is moving. When there is a loss of vestibular function, a person may experience imbalance, dizziness, or vertigo (spinning sensation). About 85% of people complaining of dizziness or imbalance have a vestibular (inner ear) disorder.
What causes vestibular disorders?
There are a number of medical conditions that can result in a vestibular disorder:
- Viral and bacterial infections
- Head trauma
- High doses or long-term use of certain antibiotics
- Blocked or decreased blood flow to the inner ear or brain
- Degeneration of the vestibular system
Because the vestibular system interacts with many other areas of the brain, you may also experience problems with vision, muscle weakness, concentration, and memory loss. People with vestibular disorders may suffer headaches and muscle aches in the neck and back. They may be prone to nausea and motion sickness, and have increased sensitivity to noise and bright lights. Vestibular disorders can be minor and temporary or they can be completely disabling.
What is vertigo?
Vertigo occurs when you are at rest, but feel as if you are moving, particularly spinning. Vertigo is another signal that there is a problem with the vestibular system.
Can vestibular disorders be treated?
Although the specific cause of dizziness and vertigo is not always known, most people with vestibular disorders can benefit from rehabilitation therapy.
Vestibular rehabilitation appears to have the most benefit in the following instances:
- When symptoms such as dizziness last for more than six months.
- When medications fail to provide relief.
- When there is a sudden loss of vestibular function.
Vestibular rehabilitation involves the use of exercises and guided activities to train other fully functioning systems (visual and somatosensory) to help maintain balance.
Try this test to demonstrate how vision contributes to your sense of balance:
- Hold on to a chair and stand on one foot with your eyes closed.
- Can you feel how much more difficult it is to balance without visual input?
When there is a problem with the inner ear, we can often strengthen the other systems to compensate for the loss of vestibular function.
Therapy also strengthens muscles that have become weak from inactivity. Strong muscles and flexible joints help compensate for the loss of vestibular function by improving mobility and balance.
The first step is to have a thorough examination by your doctor who may also order an ENG (electronystagmography) test of the eyes, which is helpful in diagnosing vestibular problems.
Once your doctor confirms that you have a vestibular dysfunction, you may be referred to one of our trained physical therapists who will design an individualized exercise program for you.
Things you can do to prevent falls when you experience dizziness:
- Use non-skid wax on floors
- Make sure all carpeting is attached securely
- Keep the floor clear of tripping hazards, such as area rugs, electrical cords, and phone cords
- Install and use handrails
- Use a non-skid mat or strips in the bottom of the bathtub
- Use night lights
- Wear shoes that fit well and support your feet
- Use caution when moving from one type of floor to another, such as from a carpeted hall to a tiled bathroom
- When rising from a lying position, sit up first and rest for a minute, then stand up slowly and wait a few seconds before walking
- Have your eyes checked regularly and update your lens prescription as needed