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Vestibular Disorders


Deaconess Physical Medicine provides treatment and rehabilitation services for vestibular disorders


Patient Experiencing DizzinessThe vestibular system is a complex part of the inner ear that plays a key role in helping us keep our balance. (It also serves the somewhat lesser known purpose of keeping our eyes pointing at a specific object while our head is moving.) The brain coordinates input from our vestibular system, our eyes, and our joints and muscles to determine whether we are balanced and make the necessary corrections if we are not.

Changes in the inner ear, brought on by disease, age or injury, can lead to dysfunction of this delicate system. We call this dysfunction a vestibular disorder. They occur relatively frequently and are one of the top reasons for seeking medical treatment in those 65 or older.

Some examples of vestibular disorders are:
  •     Positional vertigo (sometimes known as BPPV, BPPN or BPV)
  •     Meniere’s Disease
  •     Inner ear infections (e.g., labyrinthitis or vestibular neuronitis)
  •     Inner ear concussion syndrome (caused by head injury)
  •     Endolymphatic hydrops and perilymph fistula


Symptoms and Causes

The most frequently reported symptom of vestibular disorders is dizziness (vertigo). Other symptoms may include unsteadiness when walking, nausea or vision problems. These symptoms may be either mild or severe, and they may last only a few minutes, several hours or even longer. Symptoms may become worse in dim lighting, in unfamiliar surroundings, on uneven surfaces, or when one is fatigued.

Other symptoms may include headaches, muscle aches in the neck or upper back, sensitivity to noise/lights, fatigue, or trouble with concentration, memory or thinking. If symptoms persist, they can lead to irritability, depression or loss of self-esteem.

Vestibular disorders have a wide variety of causes, including:
  •     Displacement of otoliths (calcium carbonate crystals that are part of any normal vestibular system)
  •     Viruses or upper respiratory infections
  •     Blows to the head or whiplash
  •     Ear infections or inflammation of the inner ear
  •     High-dose or long-term use of certain antibiotics
  •     Changes in intracranial or atmospheric pressure
  •     Reduced blood flow to the or brain
  •     Allergic reactions
  •     Migraines
  •     Acoustic Neuroma

Diagnosis and Treatment

The first step in diagnosing a vestibular disorder is a visit to your doctor for a complete physical and medical history. If necessary, your doctor will refer you to a specialist who will conduct specific tests to help identify the cause of your disorder. Once a diagnosis is made, your doctor may refer you to a physical medicine provider for treatment or rehabilitation.

Treatment varies depending on the disorder diagnosed and the individual needs of each patient. It usually begins with an evaluation of visual-motor skills, balance, gait, strength and coordination. A treatment plan is developed based on this evaluation and the physician’s diagnosis. It may include any combination of compensatory strategies, special exercises, education or other treatment modalities. The Balance Master allows for state-of-the-art objective evaluation, interactive treatment, and accurate progress and outcome measurements of movement and balance.

Your treatment plan may include only one or two treatments done in the office, or it may require visits over several weeks and treatments you will do at home. It’s very important that you follow your treatment plan closely to help ensure that the treatment is effective and that your symptoms are reduced or eliminated.

Tips on Preventing Falls


Many falls and the injuries that result from them can be attributed to vestibular disorders. Diagnosis and treatment of your condition is the first and best step toward preventing falls due to vestibular disorders, but here are a few extra tips to help decrease your risk of injury:
  • Pick up throw rugs
  • Sufficient lighting in the home
  • Stop and balance before moving
  • When dizzy, keep your eyes open and focus on a solid, stationary object until dizziness resolves

Therapist Qualifications

Physical and occupational therapists in the Deaconess Hospital Physical Medicine Department are trained in the assessment and treatment of vestibular and balance disorders. In addition to earning a professional degree, the therapists have attended educational programs dealing specifically with vestibular and balance disorders.


For more information, please contact:

Deaconess Hospital Physical Medicine Department  812/ 450-3353
600 Mary Street;  Evansville, IN 47747