Vestibular Migraines

Vestibular migraines (VM) are more than just headaches—they can significantly impact balance, mobility, and quality of life. As physiotherapists, understanding this condition is essential for supporting patients to regain confidence, reduce dizziness, and improve functional movement.

What is a Vestibular Migraine?

A vestibular migraine affects the vestibular system, the part of the inner ear and brain that helps control balance and spatial orientation. Unlike typical migraines, VM often presents with:

• Vertigo or spinning sensations

• Imbalance or unsteadiness

• Motion sensitivity (triggered by head movements or visual stimuli)

• Nausea or vomiting

Some patients may still experience classic migraine symptoms, but dizziness may be the primary complaint.

Impact on Mobility

VM can affect daily life in several ways:

• Gait instability on uneven or low-light surfaces

• Increased fall risk and fear of falling

• Difficulty with movements like turning the head or bending

• Deconditioning due to reduced activity

Physiotherapy Interventions

Physiotherapy can play a crucial role in improving balance and functional mobility for VM patients.

Vestibular Rehabilitation Therapy (VRT)

• Gaze stabilization exercises to improve eye control during head movements

• Balance training (static and dynamic) to enhance postural control

• Habituation exercises to reduce motion sensitivity

Functional Mobility Training

• Walking on varied surfaces, stair climbing, turning safely

• Reducing reliance on visual input for balance

• Gradual practice of daily activities in a controlled environment

Education and Lifestyle Guidance

• Identify triggers: stress, sleep deprivation, visual overload

• Encourage safe activity to prevent deconditioning

• Teach strategies to manage dizziness and prevent falls

Tips for Patients

• Maintain consistent sleep, hydration, and stress management

• Track symptoms and triggers for your healthcare team

• Stay active with guided, gentle exercises