Vestibular Rehab: Helpful for Vestibular Migraine
Last updated: September 2023
As I wrote about a few months before, I sporadically suffer from a rare form of migraine known as vestibular migraine.
It means I was getting debilitating episodes of vertigo either during a migraine or shortly after a particularly terrible one.
Increasing vestibular migraine attacks
The incidences became more and more frequent until, before I knew it, I was spending at least several days (or sometimes a week or more) out of every month, barely able to leave my bed due to vertigo. And that was just the fallout of the acute episodes. Even when I wasn't experiencing the full-on spins upon moving positions, I still had a general sense of "wobbliness." Things might not spin, but they would tilt sideways when I moved my head a certain way, or I would feel as I walked around in my apartment like I was walking on a boat - drunk. Sometimes I would need a rollator when walking around, especially outside, just so I wouldn't lose my balance entirely and fall over - which happened more than once.
My doctor recommended vestibular rehab
After another horrible episode that rendered me bed-bound, I went to another ENT (ear, nose, and throat doctor) for a second opinion on what to do. He insisted I try something called vestibular rehab. Vestibular rehab is a form of physical therapy that tries to pinpoint the reasons behind the vertigo reaction and retrain the vestibular system. I was wary as I have not always had the best luck with PT, but I was also desperate to get the vertigo events under control. So I agreed.
My first vestibular rehab visit
A few weeks later, I met with my PT. We discussed the events that led to my first vestibular migraine and ran tests, like moving my head side to side at variouus speeds to discern when and how vertigo struck. My PT suspected that my vestibular events might be due to a combination of neck issues from cervical instability (when the cervical spine has deteriorated and become less stable from arthritis, herniated discs, and weak connective tissue - which can cause dizziness) and some kind of dysfunction in my inner ear (which often dictates balance).
The Epley maneuver
I agreed with her assessment as most of my migraines tend to be related to my neck. Past assessments of vertigo found that I sometimes (though not always) responded positively to something called the Epley maneuver (a series of head and body movements that resettle the crystals in your inner ear in ways that can relieve vertigo). As such, she had me do a series of mild strengthening exercises in my cervical spine and a series of visual exercises and head movements to help me reorient my vestibular system. It included things like looking at a specific object or pictures while moving my head up or down or from side to side.
Did it work?
I noticed an immediate improvement. My neck pain and vestibular symptoms are not as severe or frequent as they used to be but still more frequent and painful than I'd like and regardless of improvements. I had one of the worst migraines of my life just this week, and it did include some dizziness. Most notably, I have not gotten a full-fledged vertigo episode since undergoing vestibular rehab (though I have had some more general dizzy spells or walking-on-a-boat sensations).
I hope to continue to add more exercises to my repertoire of vestibular PT - which I continue to do daily on my own in my home - and hopefully experience even more improvements.
Have you ever tried it?
Have you ever tried vestibular rehab? Did it help with vestibular migraine, vertigo, or other related symptoms? Please feel free to share your experiences in the comments section below.
Are the family and friends you will be seeing this holiday season understanding about migraine?