Dizziness and balance problems are very common especially in older people. There are numerous causes for these symptoms with many being related to problems with the vestibular apparatus in the ear.

Symptoms of vestibular disorders can include:

• Vertigo
• Visual disturbance
• Imbalance
• Dizziness: light-headedness, faintness, or unsteadiness

Additional secondary problems may include:

• Nausea and/or vomiting
• Reduced ability to focus or concentrate
• Fatigue
• Reduced quality of life
• Anxiety and depression

Many of these symptoms can be helped by physiotherapists using vestibular rehabilitation therapy. This exercise based form of therapy can alleviate both the primary and secondary problems caused by vestibular disorders. The therapy teaches the brain to use other senses (vision and somatosensory, i.e. body sense) to substitute for the deficient vestibular system.

The aim is to create compensation, habituation, and substitution for the deficits. Vestibular rehab involves specific techniques and exercises for the head, body and eyes, and includes gaze stability exercises which work on the vestibular ocular reflex (VOR). For many this rehab can accelerate the return to normal function after a vestibular disorder. It can be effective for longstanding disorders that have failed to improve with traditional medical management.

Examples of vestibular disorders are:

• Benign paroxysmal positional vertigo (BPPV)
• Issues associated with vestibular migraine
• Persistent postural-perceptional dizziness (PPPD)
• Issues associated with labyrinthitis/vestibular neuritis
• Acute or abrupt loss of vestibular function following surgery for vestibular disorders

Our specialist physiotherapist, Suzie Kirkpatrick, can diagnose whether your symptoms are coming from a vestibular issue and if so, then choose appropriate treatments. All the treatments used have very good evidence for their effectiveness in alleviating symptoms of vestibular disorders.

Please click here for more information about the therapy.

BPPV – Benign Positional Paroxysmal Vertigo

This condition occurs when crystals which are naturally present in the inner ear, become dislodged and stimulate the vestibular apparatus to send signals to the brain that tell it that the head is moving when it is not. This confuses the brain as all the other senses are signalling that the head is still . This then leads to spinning sensations or dizziness. These sensations occur only when the head moves into certain positions. The condition is not serious and may resolve by itself eventually as the crystals break down, but the symptoms are very unpleasant and disabling. Correct diagnosis is important, requiring taking a full subjective history and objective testing including the Dix-Hallpike test. Once confirmed, a treatment known as the Epley Manoeuvre (also known as the canolith repositioning manoeuvre) can give instant resolution of the symptoms.

The Epley Manoeuvre being performed on a patient by Suzie

What people have said about Vestibular Rehabilitation Therapy...

A huge thank you to Suzie Kirkpatrick for helping me get my life back on course.

Following Covid, I initially experienced symptom that left me unable to drive, struggling to walk outside often with unsteadiness, pain and severe fatigue and even slurring speech. Large screens, supermarkets, and even stairs with gaps left me feeling dizzy and nauseous. My left ear felt sore inside and doctors could not explain it. MRI head scan showed nothing. I was left having to work out my own recovery plan. I had a good measure of success with walking but still struggled with confidence to drive, go into a supermarket or go to gigs with light shows . Eighteen months later, I searched for vestibular rehabilitation therapists and found Suzie. It was a long shot that this could possibly progress my recovery.

Suzie listened carefully and conducted some tests and I was amazed that she was quickly able to BPPV with PPPD as a consequence of that. She performed the Epley manoeuvre which brought relief immediately from the BPPV and set me tasks to work on my PPPD. Her clear explanation of my problem and how to help myself saw improvements within a few weeks. Now I am driving and learning how to negotiate situations that had proved difficult with new found confidence and tips on how to negotiate.

I highly recommend Suzie to anyone with dizzy and balance problems. She is professional, personable and inspires confidence. Booking is simple and the reception staff are very helpful and efficient. I wish I'd known there was this help available 18 months ago.

Thanks Suzie and Physiofit - T.W. June 2023

I just wanted to say how impressed I was today with the treatment for my vertigo. I felt like a different person when I walked out of Physiofit. The dizziness had gone and my head felt like it belonged to me again. You explained everything very clearly and gave me exercises to do at home which I promise I will do. The treatment wasn't half as bad as I thought it was going to be. You were very gentle and made sure I was never uncomfortable. Thank you so much Suzie. You were worth every penny. - J.S January 2023

I had BPPV for 6 weeks before I found out about Suzie at Physiofit, and I wish I'd known about her sooner. It was so debilitating and comes with so many unknowns – how long will it last? Will it come back? If it comes back, will it be worse? – that I honestly thought I would have to change my lifestyle, which with two children would be very difficult. Suzie was amazing. She did a thorough assessment and fully explained the condition and how she would treat it. She then performed the Epley manoeuvre and my BPPV was gone. Incredible. I was given exercises to do at home to help my recovery, which worked brilliantly. I wish everyone suffering knew about her and then they wouldn't have to put up with it for so long and would know it can be dealt with. It's very reassuring to know that if I get BPPV again, I know who to go to and it won't be as debilitating, and last as long as last time. I can now get on with the normal things I usually do in my life. Thank you! - S.D. Sept 2022

I saw Suzie when I was diagnosed with vestibular neuritis. The worst of the dizziness had gone but my balance had been badly affected and wasn't getting any better. I assumed that I was going to feel like this forever! My Pilates teacher recommended Suzie and it turned out to be brilliant advice. After an initial consultation Suzie pinned down my exact problems, explained fully what was happening to me. It was good to be told that I would recover. She gave me a series of simple exercises and after only 3 or 4 sessions the improvement was marked. Thankyou Suzie. I can't recommend you highly enough S.W. September 2022

I chose Suzie Kirkpatrick at Physiofit after researching on line and reading about the Dizziness and Balance Clinic. I'd been struggling for several months with inner ear problems that caused difficulties with my balance, daily headaches, tiredness etc. When I read the information I immediately thought "that's me!"

Suzie was very thorough at my initial appointment, explained what I needed to do to improve my symptoms, and why. I had 3 sessions in total and graded exercises to do at home. When I was discharged I felt reassured that I could make a full recovery, plus Suzie stressed that I could ring her or email at any time if needed.

I would encourage anybody who is suffering similar problems to contact Suzie; she is professional, supportive and a light at the end of the tunnel. Thank you. - Amanda P. Oct 2021

I was bed-bound for 3 months due to severe dizziness and sickness. Due to COVID 19 I couldn't see a specialist or GP face to face. I felt very alone and lost all hope of getting better. I did some research and found Suzie. Suzie helped diagnose my BPPV and gave me courage to fight this very persistent bout of BPPV. I don't think I can find words that could best describe my appreciation towards Suzie. She is an amazing person and if it wasn't for her I don't think I would have made a full recovery.

I would recommend her to anyone suffering from any form of dizzness or any balance related issues. Suzie is very knowledgeable and skilled. She helped me to carry out the Epley mManoeuvre at home and her motivational words gave me courage to be brave enough to carry out the manoeuvre at home. The credit for my full recovery goes to Suzie for giving me a first class service. S.M.

I have recently had need to use the services of Suzie Kirkpatrick at Physiofit in Horsforth. I had been diagnosed with labyrinthitis, a condition that I had never heard of. It is horrendous as it destroys your balance which leaves you nauseous, dizzy and generally feeling very unwell. After reading up on the condition I approached Physiofit to see if they could carryout the Epley manoeuvre, which resolves one of the causes.

Suzie was very well aware of the condition and was able to help me with exercises that helped alleviate the symptoms. It was a great relief to find someone who was so knowledgable about the condition, who could reassure me in this testing time in addition to helping with exercises. I cannot recommend Suzie and this practice highly enough. - Shirley C. Jan 2019

Following a diagnosis of BPPV, my GP gave me some vestibular rehab exercises to do at home (Brandt-Daroff). I was very happy to have a diagnosis that explained the persistent dizziness but I wasn't really convinced that the exercises were doing any good. All I seemed to be doing was throwing my head about, which just made the dizziness worse. So I did a little research and discovered a very specific exercise that is best performed by a specially trained physiotherapist. Some reports even suggested that if performed correctly, this manoeuvre could fix the problem very quickly. I was a bit sceptical about this, but decided to give it a go and set about trying to find a physio that could help. My local therapist didn't offer the treatment in question but then I found Physiofit who confirmed that they had physios who were trained to treat BPPV.

I saw Suzie Kirkpatrick, who did a thorough assessment before performing the Epley manoeuvre - and it was like magic! The dizziness stopped immediately and hasn't returned. It was literally like a miracle cure, albeit based on sound scientific principles. I would definitely encourage anyone suffering from BPPV to go and see Suzie and it's such a shame my the GP didn't seem to be aware of this instant cure. - Andrea R. Jan 2019

I cannot thank Suzie enough for getting me back on track after suffering a very debilitating bout of Labyrinthitis. I still have a little way to go but the improvement in my balance is amazing and the horrendous symptoms I've been experiencing in my head have almost gone. This is all down to the excellent therapy I've received from Suzie and also very importantly her amazing encouragement. I honestly thought I was a lost cause and that I would have to live with the symptoms for the rest of my life. - Debbie M. June 2019