Frequently Asked Questions
What Happens At A Vestibular Assessment Appointment?
Vestibular problems can be complicated, and your physiotherapist will spend time listening to you and taking a detailed history. We will ask questions about the nature and severity of your problem, what makes it better or worse, how it impacts your life, and what your goals are, in addition to taking a medical history.
During the physical assessment itself we will do neurological testing of various eye movement tasks as well as muscle and coordination tests. Infrared goggle technology called Frenzel lenses are used to check for abnormal eye movements called nystagmus that give us a window into the function of the vestibular system. You will be taken through a detailed balance assessment as well as tests that involve putting your head in various positions and checking your eye reflexes.
Your neck will also be assessed to determine if it is a factor in your dizziness. Once we have a working diagnosis the physiotherapist may treat you with a repositioning manuever if you have BPPV (positional vertigo), design a vestibular rehab exercise program for you, perform hands on treatment for your neck if appropriate, and educate you on your condition and its management.
Do I Have Vertigo If Things Aren’t “Spinning”?
The term “Vertigo” is defined as the false sense of movement. This sensation is often experienced as a spinning or a falling feeling. Many vestibular disorders such as BPPV are experienced as vertigo, others may start out as vertigo and change over time, and others may not give you vertigo at all. Sensations of dizziness, swaying, blurred vision, nausea, imbalance, dysequilibrium, fullness in the head and being “off kilter” are all common with vestibular disorders.
Will I Get Sick At My Appointment?
As nausea is common with vestibular disorders, many people are worried about getting sick at their initial appointment. While the assessment process may temporarily bring on some of your symptoms, trust us we don’t want you to get sick either! We will take you through the assessment process at a careful pace. If you are very concerned about this you could discuss with your pharmacist taking an over-the-counter anti-nausea medication prior to, or just after your appointment.
How Many Appointments Will I Need?
This will vary depending on your unique condition, and your physiotherapist will discuss a plan with you at your assessment appointment. Positional vertigo (BPPV) will usually resolve within 1-3 sessions. Conditions of vestibular hypofunction (neuritis/labrynthitis) or post-concussion syndrome will take longer for your body to adapt to, in this case you will be given home exercises to work on and generally follow-up with your therapist every 2-4 weeks.
Why Is Vestibular Therapy More Expensive Than “Regular” Physiotherapy?
Vestibular or Neurological physiotherapy sessions are more expensive because of the time involved. While at a regular physiotherapy session you may spend between 15-30 minutes one on one with your therapist, the rest of your time may involve treatment where your therapist is not directly with you, such as exercises or modalities such as heat, TENS or acupuncture.
At a vestibular or neurological appointment your therapist will be focused exclusively on you the entire time and you can expect to spend 60-75 minutes with them for your assessment and 45 minutes for any follow-up.
