Ear Nose and Throat (ENT) Vestibular Physiotherapy Service
What is Vestibular Physiotherapy?
The Ear Nose and Throat (ENT) Vestibular service aims to improve the quality of life of people who have developed dizziness and imbalance. The vestibular system is another name for the part of the inner ear which helps us balance, it can make you feel dizzy when this is not working. The inner ear works alongside your eyes and joints to help us stay upright and balanced.
ENT Vestibular Physiotherapy is a speciality that focuses on problems with dizziness and balance which are not limited to:
- Vertigo (BPPV)
- Labyrinthitis, Vestibular Neuritis
- Vestibular Migraine
- Vestibular Hypofunction
- Meniere’s Disease
- Dizziness with neck pain
- Chronic dizziness
- Balance
We also help adults and children who develop dizziness as a result of head injury/trauma, strokes, degenerative changes or other causes of inner ear damage.
Through this service, you can be referred onwards to ENT, Falls Service, Day Hospital, or Neurology.
The aim of Vestibular Physiotherapy is to provide evidence-based treatment to improve or help manage your condition. This can be:
Vestibular Rehabilitation
Exercises to help your system return to normal or allow you to adapt and cope with a change in your inner ear or balance system.
Vestibular Manoeuvres
Can be performed in clinic or advised by a health professional to perform at home. These will help BPPV or positional vertigo.
Disclaimer
The information and videos are not a substitute for an assessment, diagnosis, or treatment for a medical condition and any exercises shown are not specific to your medical condition. Please remember if there is any doubt about your fitness for doing these exercises then discuss this with your GP or healthcare professional.
Visit our Balance page for more information on how your balance works and ideas on how to help balance.
Within NHS Lanarkshire Physiotherapy our aim is to provide a website that is designed for you and we want to make it as helpful as possible. We would appreciate it if you could provide us feedback and we will act on it to make improvements through our Feedback Form. Your feedback will be anonymous and will be reviewed by our website development team.
Who works in the ENT Vestibular Service?
The ENT Vestibular Service involves ENT Consultants, Advanced Practice Physiotherapists, Physiotherapists and Audiologists who work together as a team to provide the best possible care for its patients.
How can I access an ENT Vestibular physiotherapist in NHS Lanarkshire?
There are two ways you can access Vestibular physiotherapy:
- Your GP may refer you
- Another Health Care professional may refer you
What happens after ENT receive my referral?
Your details will be added to the ENT Vestibular waiting list based on your clinical need after it is reviewed by a specialist nurse, physiotherapist or ENT Consultant. While you are on the waiting list we may send you advice to try to help your symptoms while you are waiting.
If we are able to see from your referral that you need to see both an audiologist and physiotherapist you may asked to attend an appointment in our joint clinic as your first appointment. These clinics run at University Hospital Hairmyres, Stonehouse Hospital and Airdrie Health Centre.
If you do not need an Audiologist assessment, you will be given an appointment with the Physiotherapist either face to face or over the telephone initially.
You will be contacted by post or telephone when you reach the top of our waiting list.
Following this appointment, we will either;
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- Give you advice and exercises to help manage your condition yourself at home and review your progress by telephone,
- Refer you onto a more suitable service to help your symptoms.
Where do we work?
Currently, there are 2 Advanced Practice Physiotherapists assessing patients in NHS Lanarkshire. We are based at the following sites:
- Alison Lea Health Centre, East Kilbride
- Airdrie Health centre, Graham Street, Airdrie
- Houldsworth centre, Wishaw
- Stonehouse Hospital, Stonehouse
- Lanark Health centre, Lanark
- University Hospital Wishaw
If you need a further appointment with an ENT Consultant, this would be at one of the Acute Hospitals. ENT Consultants work from the main Acute hospitals in Lanarkshire which are:
The ENT Vestibular Service is sometimes not the best place to start managing your condition.
Your GP may wish to rule out other causes of your symptoms and send you to other specialties. Clinicians across NHS Lanarkshire work together to organise your care as effectively as possible. The Scottish Government has introduced “Right care, right time, right place, right team, every time”, which hopes to improve how patients are seen during their care.
NHS Lanarkshire’s ENT Vestibular Service works closely with the ENT Consultants and has clear referral pathways to help explore your problem further if required. Non-surgical treatment is the best option for many Vestibular problems, however, it is sometimes necessary to explore other investigations or treatments within ENT.
How should I prepare for my ENT Vestibular appointment?
Telephone call
- Please ensure you are beside your phone at the pre-agreed time and ready to take the call.
- The assessment can take up to 20 minutes so please ensure you have time set aside to complete the assessment.
- Please ensure you have a list of any medications you are taking.
One-to-one physiotherapy appointment
- Bring a list of any medications you are taking
- Wear, or bring suitable clothing so you can move easily and flat shoes so we can look at your balance.
- Give yourself time after the appointment as some manoeuvres can make you feel dizzy or sick at first. Once this clears it will take your symptoms with it but best to make sure you do not have a busy day and have time to recover. If someone is able to bring you to an appointment this is a good idea.
Joint Specialist Clinic with Audiologist and Physiotherapist
- Bring a list of any medications you are taking
- Wear, or bring suitable clothing so you can move easily and flat shoes so we can look at your balance.
- The appointment will take 40 minutes as both the audiologist and physiotherapist will assess your symptoms.
- Give yourself time after the appointment as some manoeuvres can make you feel dizzy or sick at first. Once this clears it will take your symptoms with it but best to make sure you do not have a busy day and have time to recover. If someone is able to bring you to an appointment this is a good idea.
What to expect during an ENT Vestibular clinic appointment?
We will have a conversation with you then carry out a physical examination to help understand your problem better.
If you have not seen an audiologist previously then you will be assessed by both Specialist Audiologist and Advanced Practise Physiotherapist so we can fully understand your problem. This allows us to assess both the hearing and balance functions of the ear.
The physiotherapist will want to gain an insight into your perception of the problem. It is very important to discuss your expectations and set realistic goals that physiotherapy can help you achieve at this stage.
A Little Secret about your Therapist
Your therapist doesn’t just hold you in their mind for the time you sit in front of them. They research topics related to your case outside those sessions, take notes, and plan treatment. When something they see reminds them of you, they think about you. They talk to colleagues about your case to ensure they are providing you with the best treatment.
It’s more than just your appointment time.
The possible treatments will be explained and will be based on the best clinical evidence available. The potential benefits and risks of the treatment options will be discussed. The physiotherapist may also discuss the option and implications of doing nothing.
Possible outcomes of the consultation may include:
- advice/management plan and a follow-up appointment with a Physiotherapist if required
- referral to undergo further tests, for example, blood tests, blood pressure checks, scans (not commonly required)
- being referred to a different specialty e.g. ENT, Day Hospital, falls service
What the Physiotherapist will expect from you?
If you choose to engage with physiotherapy, the expectation is that you will work alongside the physiotherapist and follow your agreed treatment and rehabilitation programme under supervision, as well as on your own at home or in a gym to try and achieve your agreed goals.
Who do I contact if I need to change my appointment?
Please phone the Referral Management Service on 0300 3030 249 as soon as possible if you need to re-arrange or cancel your appointment. They are open Monday to Thursday: 8:00am-7:45pm and on Friday: 8:00am-4:15pm.
What happens if I do not attend my appointment?
If you fail to attend your appointment without contacting us, you will be discharged from the service. If you cancel two consecutive appointments, or three within an episode of care, you will be discharged. Remember each missed appointment costs the NHS at least £136
Your Feedback – comments, concerns and complaints
NHS Lanarkshire is committed to improving the service it provides to patients and their families. We therefore want to hear from you about your experience. If you would like to tell us about this please visit our feedback page.
