What is Ménière’s disease?

Ménière’s disease physiotherapy may help manage vertigo, balance problems, and movement confidence using balance rehabilitation and vestibular strategies.

Ménière’s disease is a disorder that affects the inner ear. The inner ear contains tubes filled with fluid called labyrinths. The inner ear supports balance and hearing. This disorder can cause vertigo (a spinning sensation), hearing problems, and ringing in the ear (tinnitus).

What causes Ménière’s disease?

Symptoms of Ménière’s disease relate to fluid changes in compartments of the inner ear, called the labyrinth. The labyrinth contains the organs of balance (the semicircular canals and otolithic organs) and hearing (the cochlea). It has two sections: the bony labyrinth and the membranous labyrinth.

Ménière’s disease symptoms

Symptoms may include:

• vertigo (attacks can last from minutes to 24 hours)
• hearing loss in the affected ear
• tinnitus (ringing) in the affected ear
• a feeling of fullness in the affected ear
• loss of balance
• headaches
• nausea, vomiting, and sweating during severe vertigo

How is Ménière’s disease diagnosed?

Diagnosis often involves at least two episodes of vertigo, each lasting 20 minutes or longer but not longer than 24 hours. A hearing test can confirm hearing loss. People may also report tinnitus or a feeling of fullness in the ear.

Ménière’s disease treatment

Medical treatment may include medicines to reduce dizziness and nausea. Examples include motion sickness medicines such as meclizine, or prescribed medicines such as diazepam (Valium). Anti-nausea medicines, such as promethazine, may help control nausea and vomiting during an episode.

Ménière’s disease prognosis

Many people manage symptoms with diet and lifestyle changes plus a medical plan guided by their doctor.

• With a thorough evaluation and regular follow-ups, many people can reduce the impact of attacks over time.
• Only a minority of people require surgery to control attacks. An ear, nose, and throat specialist may be needed if medical management does not help.
• If hearing levels decrease over time, hearing aids or other interventions may be considered in some cases.

People also ask

Can physiotherapy help Ménière’s disease?

Physiotherapy cannot change inner ear fluid levels. However, vestibular rehabilitation may help reduce dizziness between attacks, improve balance, and build safer movement confidence.

Vertigo & dizziness

Common causes

• What is vertigo?
• What is dizziness?
• BPPV – benign paroxysmal positional vertigo
• Ménière’s disease
• Neck dizziness (cervicogenic dizziness)
• inflammation in the inner ear
• vestibular migraine
• vestibular neuritis
• acoustic neuroma
• rarely, vertigo can be a symptom of a serious neurological condition such as stroke or brain haemorrhage

Vertigo and dizziness can have many causes. Because symptoms overlap, assessment by an appropriately trained healthcare practitioner is often required to help identify the most likely cause.

What to do next

If vertigo, imbalance, or dizziness is affecting daily activities, a physiotherapy assessment may help guide safe management options and practical next steps.

References

1. van Esch BF, van der Zaag-Loonen HJ, van Benthem PPG. Vestibular rehabilitation in Ménière’s disease. Journal of Vestibular Research. 2022.
   
2. Strupp M, Kim JS, Murofushi T, et al. Vestibular disorders: diagnosis, management, and treatment. Lancet Neurology. 2020.
   
3. Hall CD, Herdman SJ, Whitney SL, et al. Vestibular rehabilitation for peripheral vestibular hypofunction. Journal of Neurologic Physical Therapy. 2022.
   
4. Hain TC. Ménière Disease. StatPearls Publishing. Updated 2024.