Overview

Dizziness and disequilibrium are common problems among adult populations, second only to low back pain in occurrence. The balance and vestibular systems within the body are responsible for knowing where your head, trunk and extremities are located in space while standing still and during movement. When these systems do not function properly individuals present with poor balance and dizziness. During an assessment, we examine the entire body in order to treat not only the symptoms, but the cause of the problem.

Vestibular System:

There are two categories of vestibular dysfunction that typically occur:

1. Benign Paroxysmal Positional Vertigo (BPPV):
   Small crystals located in the inner ear become dislodged
   and travel through the semicircular canals during head
   motion. Symptoms typically last for less than a minute
   and then resolve.
   
2. Vestibular Hypofunction: Signals are sent from the inner ear to the brain telling it where the head is located in space. With a hypofunction, the inner ear is not functioning as well as it should leading to a discrepancy in the information that the brain interprets from the inner ear, visual system, and sensory system of the body.

Treatment goals for BPPV:

1. Typically, BPPV can be treated in 1-2 sessions by using
   the Epley Maneuver to reposition the crystals of the inner
   ear. Following this maneuver, the patient must follow strict precautions for the next 48 hours; however, the dizziness should resolve following this treatment. Any remaining balance deficits are treated similar to a vestibular hypofunction.

Treatment goals for Vestibular Hypofunction:

1. Vestibular retraining uses dizziness evoking positions in a controlled environment as exercises to increase the signals being sent by the vestibular system to the brain called habituation exercises.
   
2. Utilizing and strengthening other balance systems within the body to increase body awareness during movement and ultimately reduce or resolve dizziness.