Vestibular & Balance Service

Vestibular and Balance Services – All About Balance

angli-EAR Hearing is one of the few multidisciplinary clinics outside London offering both assessment and rehabilitation for vestibular and balance issues. You don’t need to have hearing loss to benefit from our expertise—vestibular problems can affect anyone.

Our services are open to all on a direct, self-referral basis—no need for a GP or Consultant referral.

Why do we need balance?

Everyday tasks such as getting out of a chair, carrying shopping bags whilst walking, or standing on tiptoes to reach an object, all require good balance.

Imagine your balance is like a 3-legged stool: one leg is your vestibular system, one is your visual system and the third one is the proprioceptive system.

Your brain uses information from the vestibular, visual, and proprioceptive systems, to keep you upright, maintain steady vision when you turn your head, and quickly react if there is a sudden risk of falling.

If you have an issue with one of these systems, it can affect your static and dynamic balance which may impact your daily living activities and put you at a risk of fall.

What is the vestibular system?

The vestibular system is a special sensory system that plays an important role in maintaining your balance, orientation, and coordination of movement.

It involves the inner ear and a complex network of structures that work together to tell your brain where your body is in space.

Although amazing and efficient when it is working, disorders involving the vestibular system can cause vertigo, dizziness, and balance issues – leading to falls and perhaps serious injury.

Falls aren’t just a concern for the elderly. Balance and vestibular issues can affect anyone, regardless of age. Untreated, these problems can lead to injuries and significant health costs.

While adult vestibular disorders have often been talked about, there’s growing recognition of its impact on children as well. Balance, vision, and reading difficulties can stem from underlying vestibular issues in children that can affect a child’s normal development and daily activities if not addressed on time.

What are some of the symptoms of vestibular and balance disorders?

There are many different symptoms which can occur when a person is suffering from a vestibular or balance disorder. Common symptoms include:

• Vertigo (e.g., “spinning of the room”)
• Dizziness (“feeling giddy, foggy, fuzzy, woozy”)
• Lightheadedness
• Unsteadiness, imbalance and falls
• Nausea and Vomiting
• Visual problems
• Auditory problems
• Headache and Migraine
• Neck and back problems
• Psychological distress

 

What are some of the more common vestibular and balance disorders?

There are many different conditions which can cause problems with vertigo, dizziness, and imbalance. The more common vestibular conditions include:

• Benign Paroxysmal Positional Vertigo (BPPV)
• Vestibular Neuritis/Labyrinthitis
• Meniere’s Disease
• Vestibular Migraine
• Persistent Postural and Perceptual Dizziness (PPPD)
• Concussion/Traumatic Brain Injury
• Age-related vestibular loss and balance problems

 

Why should you have your vestibular or balance problem assessed?

Although the symptoms of vestibular and balance disorders can be frightening many of the conditions can be effectively managed following a thorough assessment and accurate diagnosis.

Thankfully many symptoms can also be reduced, or resolve completely, with an appropriate treatment plan.

Unfortunately, if vestibular or balance disorders are left undiagnosed and untreated, they can result in a worsening of symptoms, which can lead to increased unsteadiness, a higher risk of falls, reduced confidence, and often a more significant impact on your quality of life.

Vestibular and Balance Assessment

At angli-EAR Hearing your physiotherapist will perform a thorough targeted examination of, not only your vestibular system, but all the systems of the body including neuro and musculoskeletal system that also contribute to maintaining good balance.

After discussing your history and symptoms, your physiotherapist will run through several tests involving eye and head movements, as well as balance and walking.

Additionally, your physiotherapist will perform a number of positional tests, to assess whether you have any positional vertigo.

To enhance the effectiveness of the assessment your physiotherapist will use specialised equipment, including VNG videonystagmography (infrared goggles) – which are essential for a thorough and accurate assessment.

From all the information gathered, your physiotherapist will have gained valuable information about the function of your vestibular system and will be able to discuss these findings with you and answer any questions.

 

Tailored Treatment and Vestibular Rehabilitation

Following a thorough assessment, you will be provided with a tailored rehabilitation treatment plan. This will include information about the findings from your assessment and effective strategies for ongoing management.

For those individuals with BPPV, you will be treated using the most appropriate repositioning manoeuvres, whilst most other individuals will be given a customised home exercise programme. In some cases, dry needling may also be incorporated into treatment to address neck muscle tightness, which can contribute to dizziness. This technique, used by our Vestibular Physiotherapist, Shreya, helps release trigger points in the muscles, reducing stiffness and improving overall movement.

As part of your treatment plan, your physiotherapist will also discuss with you when would be a suitable time for you to return for a review and reassessment.

We understand the challenges that come with navigating a vestibular or balance problem and are here to provide ongoing support. We want to assist you to live the life you want and to not have to constantly worry about your vertigo, dizziness, or balance problem.

Seeking an assessment from angli-EAR Hearing will assist you in determining the cause of your symptoms and identifying the best pathway forwards regarding self-management and restoring your quality of life.

Vestibular and Balance Appointments:

• Initial Vestibular and Balance Appointment: 60 minutes / £120
• Follow-up Vestibular and Balance Appointment: 30 minutes / £60
• Vestibular and Balance Health Check: 15 minutes / FREE

All our Vestibular and Balance appointments are available on a self-referral basis, simply book an appointment with our Vestibular Physiotherapist.

Our Expertise

 

Shreya Tiwari is our Balance and Vestibular Physiotherapist

With years of experience in prestigious healthcare settings in UK, India & UAE and an MSc in Musculoskeletal Physiotherapy (UK), Shreya is a dedicated balance and vestibular physiotherapist. She’s passionate about helping individuals improve their overall quality of life by overcoming dizziness, vertigo, and balance disorders.

Shreya’s expertise includes:

– Assessing and treating balance & vestibular disorders.

– Addressing inner ear, neurological and musculoskeletal issues that could be contributing towards balance impairment.

– Utilising latest treatment approaches for balance restoration.

We are CQC-registered (Care Quality Commission) and our professional team have been thoroughly examined and assessed, to ensure they are working to the highest possible clinical standards.