Vertigo is a condition that can affect people of all ages. It is disorientating and uncomfortable and can really impact the person’s quality of life. In this article, Rachel Allen – vertigo rehabilitation specialist at Mid West Physiotherapy, Limerick – outlines some common presentations that she sees in clinical practice. 

Vertigo is a physical sensation that everything around you is spinning, making you feel unsteady or off-balance. A bout can last a few seconds up to a few minutes. In severe cases it can go on much longer. You may feel light-headed and/or experience a concurrent humming, buzzing or ringing in your ears.

Vertigo is a condition that can affect all ages, and can range in severity. Here are two common scenarios that I encounter in clinical practice, which are treated with vestibular rehabilitation:

Scenario 1

One of the most common cases of severe vertigo I see in younger people is best described by a Korean neurotologist who experienced it himself at the age of 54; his story, quoted below, is from his own journal article published in 2020:

“I…felt dizzy and nauseated on awakening. When I sat up and opened my eyes, I noticed that the room appeared to be continuously spinning to the left…even when I was perfectly still. I was able to sit up but could not stand, so I crawled to the dressing room, and barely managed to change clothes with the help of my wife. When I tried to walk to go to the hospital, however, the vertigo and nausea immediately got worse, and I sank to the ground after a couple of steps due to severe vertigo, vomiting and…could not walk even with help on both sides.

I asked my wife to call 911 and was transferred to the nearby hospital by an ambulance. At admission, my vital signs and other findings on general physical examination were normal. During the first day in the hospital, I could not get up or eat anything due to severe nausea. I had to lie on my side, mostly to the left, since lying flat with my head facing up made the vertigo and nausea worse. However, there was no significant difference in how badly I felt depending on which ear was down when I was laying on my side.

The next day, I could sit and eat pieces of apple as the vertigo and nausea lessened, but I still could not walk. On the fourth day of my illness, I partially resumed my daily routine even though I still felt dizzy and unsteady. Symptoms and signs…had mostly resolved by 3 months after the onset of the illness while signs of dynamic vestibular imbalance…were still present in more than 30% of patients 1 year later.”

This is a very typical story of vestibular neuritis – click here for more detail on this condition. Some people also get hearing loss and ringing in their ear which is called vestibular labyrnthitis. After going to the doctor or hospital to rule out more sinister causes, people can be left with a feeling of vertigo and not knowing exactly what happened.

Scenario 2

“I still feel off after vertigo but I’m not as bad as I was.”

This is probably the second most common thing I hear in clinical practice. After the severe symptoms of the room spinning, vomiting, feeling incredibly unwell have subsided and some people have returned to work, they still feel “off”. This vertigo usually happens when moving your head quickly; such as looking around in the supermarket; checking blind-spots in the car; looking both ways before crossing the road; or looking up/down to hang laundry on the line.

Vestibular neuritis damages the strength of your inner ear. This lasting, sometimes subtle weakness causes the feeling “off”. Not unlike rolling your ankle, being able to walk again, but still not feeling quite right.

How to fix vertigo

Both scenarios outlined above need a physio! The good news is that vertigo can be treated very successfully with vestibular rehabilitation. As an experienced vertigo rehabilitation specialist, I deliver treatments that provide relief from the symptoms, as well as a personalised treatment plan to resolve the issues so that you can feel back to normal. You can find out more about this service here.

Booking

If you or someone you know is impacted by vertigo and would like to resolve it, Rachel Allen would be delighted to help. You can book an appointment online with Rachel by clicking this link; alternatively you can contact our Reception Team on 061-201444 or info@midwestphysio.ie