Vertigo and Dizziness: Vestibular Rehabilitation at Home in Gloucestershire

Feeling dizzy is frightening. The room spins, the floor tilts, and you start to worry that something serious is wrong. But a lot of dizziness comes from the balance organs in the inner ear, and a lot of it gets better with the right physiotherapy. That physiotherapy is called vestibular rehabilitation.

What is the vestibular system?

Deep inside each ear, next to the part you hear with, are tiny balance organs. Together they are called the vestibular system. They tell your brain which way your head is moving and which way is up.

Your brain puts that together with what your eyes see and what your feet feel. When all three agree, you feel steady without thinking about it. When the inner ear sends the wrong message, the brain gets mixed signals, and you feel dizzy.

Not all dizziness is the same

It helps to put a name to what you feel, because each kind has different causes.

• Vertigo – the room spins, or you feel as if you are spinning. This is usually the inner ear.
• Feeling off balance – unsteady on your feet, as if you are on a boat. This can be the inner ear, weak legs, or both.
• Feeling light-headed or faint – often blood pressure, tablets or not drinking enough. Your GP should check this first.
• A woozy, swimmy feeling in busy places such as supermarkets. This often follows an inner ear problem that has not fully settled.

Common causes that physiotherapy can help

• BPPV – short bursts of spinning when you roll over in bed, lie down or look up. It is the most common cause of vertigo, and it is often fixed in one or two visits.
• After an inner ear infection (labyrinthitis or vestibular neuritis) – the bad spinning goes, but you are left unsteady and woozy for weeks or months.
• Getting older – the balance organs, eyes and feet all send weaker signals with age, and dizziness and falls become more likely.
• After a head injury – including a knock to the head from a fall.
• Dizziness that has gone on for months – sometimes the brain stays on high alert long after the first problem has healed. Gentle, steady exercise helps it settle.

What does vestibular rehabilitation involve?

A careful assessment. The physiotherapist asks when it started, what brings it on and how long it lasts. They watch your eye movements, test your balance, and check what happens when you move your head or lie down. That usually points to the cause.

Treatment on the day. If it is BPPV, the treatment is a set of slow head and body positions called a repositioning manoeuvre. It takes a few minutes, and many people feel better straight away.

Exercises. For most other inner ear problems, the answer is a short set of exercises, done every day. They train the brain to make sense of the signals again. They might include:

• keeping your eyes on a word on the wall while you turn your head
• gently repeating a movement that brings the dizziness on, so the brain gets used to it
• balance practice: standing with your feet closer together, then walking and turning

The exercises may make you a little dizzy for a short time. That is normal, and it is how they work. They start easy and get harder as you improve.

How long does it take?

BPPV often needs only one to three visits. Other problems usually take six to eight weeks of daily exercises, with visits every week or two to check progress and move things on.

Why a home visit makes sense

When you are dizzy, driving is not safe and a bus or a busy waiting room can make it worse. At home, the physiotherapist can treat you on your own bed and practise the things that are hard in your own house: getting up at night, the stairs, turning in the kitchen, bending to the oven. Dizziness also raises the risk of a fall, so it makes sense to look at the house at the same time.

Raj does vestibular rehabilitation himself, and Anna on the team also works with people who feel dizzy.

When to get urgent help instead

Most dizziness is not dangerous. But some is, and it needs a doctor, not a physiotherapist.

• Call 999 if dizziness comes on suddenly with a drooping face, weakness or numbness in an arm or leg, slurred speech, double vision, trouble walking or a very bad headache. These can be signs of a stroke.
• See your GP or call 111 the same day if you suddenly lose hearing in one ear, if you have a high temperature with it, or if you have fainted or blacked out.
• See your GP if you feel faint or light-headed rather than spinning, especially when you stand up. That is often blood pressure or tablets, and worth a check.

Vertigo treatment at home across Gloucestershire

Home visits for vertigo and dizziness are available across Gloucester, Cheltenham, Stroud, Cirencester, Tewkesbury, Lydney, Yate and across Gloucestershire. You can read more about vertigo treatment in Gloucester and in Cheltenham, or about home visits in Stroud.

If you are worried about falls as well, read our guide to falls prevention in Gloucestershire.

About Raj and the My Rehab at Home team

Rajan Kurian (HCPC PH113871) founded My Rehab at Home, a team of five physiotherapists who visit people at home across Gloucester, Cheltenham, Stroud, Cirencester, Tewkesbury, Lydney, Yate and across Gloucestershire. Raj also works in the NHS as a First Contact Physiotherapist in GP surgeries and a Senior Physiotherapist in local hospitals. He works with Sophie, Fliss, Anna and Katie, whose interests include falls and balance, recovery after surgery, stroke and neurological conditions, vertigo and dizziness, jaw (TMJ) problems and rehabilitation after an amputation.

Read Raj's profile or call 01594 203707.

Please mention Mobile Physiotherapist.co.uk when you call.