Vestibular & Vertigo Therapy

Vestibular & Vertigo Rehabilitation

Providing specialized Physical Therapy to those struggle with vestibular disorder to help them feel normal and be able to engage in their life again

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Our expert team of physical therapists have over 65 years of combined expertise treating sports and orthopedic injuries.

How are vestibular disorders treated?

Dizziness

The treatment of your dizziness depends on your diagnosis.  The most common vestibular disorder (BPPV) is treated by moving crystals out of your semicircular canals through a series of head positions.  The success of this treatment is very high and usually requires only 1-3 treatments.

Stable Unilateral Vestibular Loss

If you have a stable unilateral vestibular loss such as Labyrinthitis or Vestibular Neuritis, treatment involves medications early on and physical therapy after the first week.  The prognosis for these conditions is also very good.

Unstable vestibular conditions

Unstable vestibular conditions such as Meniere’s Disease are much more challenging to treat and physical therapy is not very successful as a standalone treatment. Usually, physical therapy is used to treat secondary conditions and deficits.

Central Vestibular Disorders

Treatment of central vestibular disorders caused by tumors, MS, or strokes is more divers in their treatment approach.   These conditions require a multidisciplinary approach.  Physical therapy can be a valuable component to the rehabilitation of these conditions by addressing the functional impact of these disorders to allow for a more normal life.

How is it diagnosed?

Diagnosing your vestibular disorders involves a comprehensive history, and neurological screen to make sure you are not experiencing a more serious condition involving your central nervous system.

Next, we examine the function of your vestibular system by examining how well you are able to visual fix, track, and move your eyes quickly.  We do this in part by utilizing specialized goggles that video your voluntary and involuntary eye movements.  These goggles allow us to visualize specific eye movements that correlate with specific vestibular disorders. 

We will also move you into specific head positions and watch for specific eye movements that are indicative of different vestibular disorders.

How is it diagnosed?

Diagnosing your vestibular disorders involves a comprehensive history, and neurological screen to make sure you are not experiencing a more serious condition involving your central nervous system.

Next, we examine the function of your vestibular system by examining how well you are able to visual fix, track, and move your eyes quickly.  We do this in part by utilizing specialized goggles that video your voluntary and involuntary eye movements.  These goggles allow us to visualize specific eye movements that correlate with specific vestibular disorders. 

We will also move you into specific head positions and watch for specific eye movements that are indicative of different vestibular disorders.

What is the vestibular system?

The vestibular system is located in the inner ear.  Its job is to sense head movement and position.

It is involved in stabilizing the eyes so that you can accurately fix on an object without losing focus as your head moves.  Without this function you would live with a shaky home video experience anytime you move.  You would also be unable to read road signs as you drive.

It is also involved in postural adjustments which help you maintain your balance.  When this system is not working properly you will have a much harder time balancing when it is dark or when you are on a soft surface.

What causes vertigo and dizziness?

Vertigo is the feeling of spinning or other illusions of movement.  It is usually caused by disorders of the vestibule system (inner ear) but it can also stem from central (brain) disturbances.  

  • There are multiple cause of vertigo.  The most common cause of vertigo is Benign Positional Paroxysmal Vertigo (BPPV) where small crystals become dislodged from your inner ear and become stuck in your semicircular canals thereby impairing their ability to seance head movement.     
  • Other caused of vertigo are Migraine Associated Vertigo, infection and inflammation of the inner ear and vestibular nerve, cervicogenic vertigo, tumors, Meniere’s Disease and central nervous system disorders. 
  • An accurate differential diagnosis is essential for effective treatment and requires specialized equipment and training.

What causes vertigo and dizziness?

Vertigo is the feeling of spinning or other illusions of movement.  It is usually caused by disorders of the vestibule system (inner ear) but it can also stem from central (brain) disturbances.  

  • There are multiple cause of vertigo.  The most common cause of vertigo is Benign Positional Paroxysmal Vertigo (BPPV) where small crystals become dislodged from your inner ear and become stuck in your semicircular canals thereby impairing their ability to seance head movement.     
  • Other caused of vertigo are Migraine Associated Vertigo, infection and inflammation of the inner ear and vestibular nerve, cervicogenic vertigo, tumors, Meniere’s Disease and central nervous system disorders.
  • An accurate differential diagnosis is essential for effective treatment and requires specialized equipment and training.

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Reviews

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I have come to Great Northern off and on for several years but this past year I had two knee replacements 6 months apart and had many appointments during that time. My recovery was outstanding both times but I also appreciated the personal care and the way my sometimes-changing challenges were addressed. I thought there a great balance between understanding where I was at but pushing me to do a little better. I worked with Kara mostly over this past year but have also worked with James and a couple others. I think all the therapists were knowledgeable and helpful and I would definitely recommend them. As I age, I’m sure I will be back but I’m confident they will be there for me.

Cynthia

Patient

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I had a wonderful experience working with Kate Dolan in 2021. I was experiencing urinary "urgency" and signed up for Pelvic Floor Physical Therapy with Kate. Kate is a fantastic teacher. Within a few sessions, I had no more episodes of "I'm going to pee my pants, now." As a bonus, Kate also helped me a lot with lifelong constipation issues. I really think every woman should do a few sessions of pelvic floor PT--you learn so much. At Great Northern, I've also had great experiences working with Christian Appel for my frozen shoulder and knee arthritis, and with Jim Sykes for bike fitting (a much-needed service in Bozeman). I will return to Great Northern for any PT needs in the future. (So many activities, so many joints, so many years behind me; the next injury can't be too far off, haha.)

Lisa

Patient

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Started PT with Christian Appel here for strengthening a-three-times-operated-on left shoulder that hurt just about all the time whenever I moved it or lifted anything. Christian commits his full time and attention to me each time I've been in. He is patient and kind. My shoulder is much stronger and more functional. It feels really good and solid. We're close to ending our sessions but more range of motion and strength apparently is available. The gym is spacious, airy and bright, and the equipment in it covers a broad range of needs. The administration is great, keeping me well-reminded of my appointments and being available and helpful when I need to reschedule or have other questions about my care. I have had plenty of interactions with others on staff and all of them have been wonderful. I've had PT at several Bozeman providers and I place GNPT at the top of them all by a wide margin. Highly recommend.

Bill

Patient

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