Treatment of Meniere’s Disease
Dietary management and medications are the standard intervention for managing patients with Ménière’s.
However, it is always possible that you may have something else going on superimposed on top of the Ménière’s disease.
For example, patients with Ménière’s disease can get BPPV which can be treated by a vestibular physical therapist. They can even have recurrent attacks of BPPV over time and each episode of BPPV should be treated as soon as possible.
Therefore, you may choose to seek out vestibular PT at some point for evaluation and treatment.
Can Vestibular Physical Therapy Help?
It depends. If BPPV or vestibular damage is underlying the Meniere’s disease, then vestibular PT may help.
I am not certain if a vestibular physical therapist will find anything else beyond the Ménière’s disease, such as BPPV, when they conduct your exam.
Therefore, honestly, I am not sure if the vestibular therapy for Meniere’s disease can actually help provide any relief.
Sometimes if a hands-on vestibular PT exam is inconclusive, the way a patient responds to vestibular PT’s attempts at treatment for certain peripheral vestibular conditions can help with the assessment process in hindsight for mystery cases.
Due to the typical success rate of vestibular physical therapy, many patients do not need to complete any vestibular diagnostic testing.
Research indicates that vestibular diagnostic testing typically should be ordered by your doctor only after a reasonable course of vestibular physical therapy visits have been completed but were unsuccessful.
If you do not improve with Vestibular PT within a reasonable amount of time, you may choose to seek out vestibular diagnostic testing such at VNG/ ENG, vHIT, and VEMP to assess for peripheral vestibular damage. That may occur over time due to repeated attacks in the ear affected by Ménière’s disease.
Normal aging of the vestibular system would also be a factor to consider and could be addressed with vestibular PT along with balance training, for anyone with Meniere’s disease.
However, completing a treatment plan for vestibular physical therapy for Ménière’s Disease could possibly yield no relief if Ménière’s disease is the only true problem causing your vertigo attacks and there are no other co-occurring vestibular or balance problems.
Medical Management is Key
The focus of day-to-day management for people with Meniere’s disease should instead be on a diet and medication management.
According to this article, there are now five sub-types of Meniere’s disease that have been proposed. Medical management strategies are specific to the sub-type.
Unfortunately, patients with Ménière’s disease usually lose hearing in the affected ear over time due to repeated attacks.
One glimmer of hope for patients with Ménière’s-like attacks is that they could possibly have a Ménière’s syndrome, which is mimicking Ménière’s disease. That syndrome would be addressed by dealing with the root cause.
This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.