Head & Vestibular Pain

Vestibular physiotherapy is one of the most effective treatments for conditions which cause symptoms such as vertigo, dizziness, nausea, room spin and loss of balance.

Anatomy of the Vestibular System

The two inner ear balance organs (one for each ear) send information about head movements to the balance centre in the brain. This information is essential for the maintenance of balance. If either balance organ sends incorrect information to the brain the result is dizziness and imbalance. This in turn can cause nausea and vomiting, all of which can be quite distressing.

This can be improved by practising vestibular rehabilitation exercises. These are visual and balance exercises aimed at compensating for the uneven messages the brain receives. It can sometimes take months to correct but you do not need to attend frequently during this time.

Alternatively, in the condition BBPV, there is a build up of crystals in the balance organs causing problems and this can be resolved in one or two treatments by using repositioning techniques, most commonly the Epley Manoeuvre.

vestibular anatomy

Common Conditions

Whether dizziness and balance are of an acute onset or have been a problem for years, a specially designed assessment can identify the problem and a specific individualised rehabilitation programme can be set up to deal with it.

Commonly Treated Conditions are:

  • Headaches.
  • Benign Paroxysmal Positional Vertigo (BPPV).
  • Vestibular Neuritis/Labyrinthitis.
  • Visual vertigo.
  • Migrainous vertigo/Vestibular migraine.
  • Menières disease.
  • Post operative rehabilitation following removal of acoustic neuroma.

Headaches are a common presentation worldwide. There are multiple types of headaches including tension type headaches, migraines, exertion headaches and secondary headaches. Cervicogenic headaches are a type of secondary headaches in which pain is referred from the neck (cervical spine). Typically, the referred pain arises from the upper three cervical segments.

Symptoms include:

  • One-sided head pain which may also be experienced in the neck, shoulder and face.
  • Non-throbbing pain.
  • Reduced neck movement.
  • Neck movement and sustained head / neck postures may make the headache worse.

Accurate diagnosis is important in the successful management of headaches. If you feel your headache may be referred from your neck you will benefit from a physiotherapy assessment of your head, neck and shoulder movement, you posture and potentially your work station. Physiotherapy including hands on treatment and specific exercises has been shown to be effective in the management of cervicogenic headaches.

If you are experiencing double vision, facial numbness or tingling, problems with your speech or swallow, dizziness and or fainting it is recommended that you seek medical attention from your GP.

Concussion injury results from either a direct or indirect blow to the head and is common in contact sports such as Rugby.

Symptoms include temporary headaches, confusion, dizziness, blurring of vision, neck pain, memory loss, balance issues, nausea, loss of orientation or complete consciousness. Symptoms usually appear within a few minutes/hours of the blow, but sometimes it can take a few days to notice symptoms of concussion. Therefore, care must be taken to observe the injured person closely in the few days after the event. Symptoms severity can vary from minor, to moderate, to life threatening and requiring emergency treatment. Help should be sought from a GP or doctor immediately, if there is any concern about serious head injury. Symptoms can last a few days or weeks and some people develop ‘post-concussion syndrome’, where symptoms persist for a few months.

Getting plenty of rest, avoiding mentally stressful situations, avoiding alcohol, avoiding strenuous exercise and gradually getting back to your activities can aid recovery. Physiotherapy can help guide the recovery process and facilitate you getting back to sport.

How We Can Help You

A thorough examination comprised of specific questions and physical tests can help to diagnose the cause of your vestibular symptoms or headache. A treatment plan would then be discussed and implemented, to help you towards being pain free and get you back to performing your desired activities. A fundamental part of the treatment plan is explaining the cause of pain and ways to manage it.

Treatment could include hands-on therapy (joint mobilisation/soft tissue massage), a programme of stretches or strength based exercises, Taping, Acupuncture, Ultrasound or perhaps Shockwave Therapy (if appropriate).

If further investigations such as MRI, Ultrasound scan, blood tests or X-rays are required, our Physiotherapists can point you in the right direction. If the Physiotherapist feels you need to see another health professional (such as an Orthopaedic Consultant or Rheumatologist), they will ensure you see the right person via our vast network and close links with consultants.

So, if you have been struggling recently with vestibular symptoms or headache, click here to contact us so we can help you get better!

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