Dizziness is one of the most common symptoms that causes people to seek medical attention every year. The sensation of dizziness is considered to be an umbrella term because it describes a variety of feelings like feeling faint, woozy, weak or unsteady. A specific form of dizziness, known as vertigo, refers to a false sensation of spinning or movement.
Being able to decipher your dizziness or vertigo can pose a major challenge for medical professionals. However, being able to determine the cause of your symptoms is crucial in order to rule out serious health conditions. This is why any bout of dizziness should be taken seriously and quickly assessed by a medical provider.
Non-serious forms of dizziness can be treated and managed by a physical therapist specializing in vestibular therapy. Finding ways to get rid of your dizziness begins with an understanding of common causes of dizziness, how it affects different body systems, and ways in which physical therapy can guide your recovery. Follow along with us as we break it down for you.
An Overview of Dizziness
Think of your brain and spinal cord as a central processing unit. The central processor receives valuable information from multiple areas of the body in order to make assumptions about your body’s function. Issues can arise when the central processor, aka the brain, is damaged. In these instances, information is unable to be processed which can result in dizziness and unsteadiness.
There are three main sensory systems outside of the brain that are responsible for relaying information about our body and environment. These systems are our eyes, inner ear (vestibular organs), and sensation (proprioceptive input).
The vestibular organs are located in each inner ear and provide information to the brain about the location of our head and neck in space. This is important information, especially when our head is moving in different directions. The eyes can relay information relative to our body and environment. Lastly, proprioceptive units within our body act as GPS and speedometers. They send signals to the brain regarding how fast the body is moving and where it is going. Damage to either system can create problems regarding the way our brain reads and digests information and lead to dizziness.
Physical Therapy for Dizziness
Physical therapists are well-qualified to treat a variety of diagnoses that result in dizziness. Sometimes, physical therapists may work alongside other healthcare professionals to provide comprehensive treatments for patients recovering from strokes, concussions, or motor vehicle accidents.
Individuals who suffer from problems related to the vestibular organs may have a specific set of diagnoses such as a hypofunction, labyrinthitis, benign positional paroxysmal vertigo, or vestibular neuritis. Others may experience dizziness or changes to balance due to visual issues resulting from an old eyeglasses prescription or an incorrect usage of bifocals.
Other forms of dizziness originate from disorders related to motion sensitivity, such as Persistent Postural-Perceptual Dizziness or Mal de Debarquement. These conditions affect the calibration of incoming information in the brain from the sensory systems. In other words, the brain is overwhelmed and unable to accurately respond to the incoming information.
In some, the nervous system can be highly sensitive and overly responsive to stimuli. These individuals may also have a history of chronic pain, allergy sensitivities, or difficulty tolerating loud noises or bright lights. When this occurs, it’s not uncommon for your body to read normal movement as an alert for dizziness.
Benign paroxysmal positional vertigo (BPPV) is a non-fatal condition that affects the inner ear and causes abnormal signals to be sent to the eyes and brain. Luckily, physical therapists are highly qualified to treat BPPV through special positional maneuvers with positive recovery rates.
Conversely, there are a few conditions that cause dizziness that may not be as responsive to physical therapy as others. Some of these may include:
- Medication side effects or polypharmacy
- Chronic neurodegenerative disorders like Parkinson’s Disease, Multiple Sclerosis, or Progressive Supranuclear Palsy
- Visual problems that require an optometrist or ophthalmologist
- Orthostatic hypotension
While physical therapy treatment may not address these conditions entirely, therapists can help improve your ability to stand, walk, and move safely without risk of falling. Physical therapists may also show you how to modify your current habits to improve your work environment, manage secondary symptoms like neck and shoulder pain, or use special equipment to help you dress or bathe.
There are four types of dizziness or vertigo that Peak Physiotherapy and Performance can help treat with vestibular therapy in Columbus, Ohio.
Benign Paroxysmal Positional Vertigo
This is a particularly common form of vertigo and is the most common vestibular disorder. A shift in the position of the otoconia crystals in your inner ear generally causes BPPV. When they accumulate, they interfere with the motion of fluid in your inner ear, which then sends false signals to the brain causing a dizzy sensation.
Generally, symptoms occur when you change position; in particular, anything that involves rotating your head such as rolling over in bed or bending over. BPPV does not give constant dizziness, affect your hearing, or cause trouble with coordination. It is more common in older adults. A physical therapist with vestibular training can treat BPPV by guiding you through a series of maneuvers or exercises designed to guide the crystals back where they want. We call these Canalith Repositioning Maneuvers. The precise maneuvers needed depend on where the crystals have ended up, so you should not try to self treat.
Vestibular neuritis is also a disorder of the inner ear. In this case, it’s caused by inflammation of the vestibulocochlear nerve, which sends information from the inner ear to the brain, disrupting the flow of information. Vertigo as a result of vestibular neuritis is severe and is accompanied by difficulties with balance and concentration and nausea. In most cases, the problems last a couple of days and then the patient takes three weeks to recover on their own; however, symptoms can sometimes linger. The most common cause of vestibular neuritis is a viral infection, which can include a simple head cold.
In other words, vertigo and balance issues after a head cold are probably due to vestibular neuritis. Most people are prescribed a course of drugs by their physician. If vestibular neuritis lingers, though, then physical therapy is likely necessary. By design, the program retrains the brain to fix long-term balance issues, including balance exercises, head turns, focusing on an object while turning the head.
Mal de Debarquement
You just took a cruise, but seem to have, well…lost your land legs. Mal de debarquement, or sickness of disembarkment, refers to the fact that when you get off a boat the land seems to be moving (however, it can also sometimes occur after a long plane flight, a long train ride, or even using a waterbed). For most people, mal de debarquement lasts about as long as getting used to being on the boat does – usually about 24 hours).
In rare cases, though, it can last for weeks, months, and even years. Mal de debarquement that lasts more than a month is considered persistent. True vertigo is rare, it’s more a sensation of the ground swaying, but it can make reading and using electronic devices difficult. Some individuals get anxiety. Vestibular therapy can help retrain the brain to stop thinking that the ground is going to move, and help patients stop rocking and swaying to compensate for movement that isn’t happening.
Cervicogenic means “starts in the neck.” In this case, the dizziness is caused by neck injury or pain. Like mal de debarquement, it doesn’t generally cause actual vertigo, but just dizziness. It is often accompanied by a headache. It’s often caused by whiplash. Cervicogenic dizziness is generally diagnosed if the person has neck pain and no other obvious cause for the dizziness.
The treatment is, obviously, to resolve the underlying neck problem. Physical therapy and special exercises help ease neck pain. The therapist will also give you instructions to improve your posture and ergonomics so as to avoid further neck problems.
What to Expect During Your First Physical Therapy Visit for Dizziness
Your physical therapist will always begin by taking a thorough history of your symptoms, descriptors of dizziness, and symptom triggers. He or she will also try to determine if your surgical history or current medications may be contributing to your issues, or if you are potentially experiencing symptoms due to a highly sensitive nervous system.
Next, your therapist will conduct a series of clinical tests that may involve eye movements, head and neck movements, and balance tests to assess if the cause of your dizziness is treatable through physical therapy. In doing so, your therapist can determine if physical therapy is the best treatment option and, if not, who may be more qualified to treat you.
How Long Does It Take To See Result With Vestibular Therapy?
Recovery times will differ depending on the cause of your dizziness.
There are some conditions that resolve quicker than others, like BPPV, can take one to three visits. More involved cases of dizziness that affect the brain or damage one of the three sensory systems may take up to 8-12 weeks to recover.
Individuals who are diagnosed with neurodegenerative disorders, such as Multiple Sclerosis or Parkinson’s Disease, may be seen on a regular basis as part of a maintenance program. Maintenance programs may include home modifications or balance exercises to maintain safety and independence in the home.
- Remember, dizziness is a symptom of an underlying condition in which one, or more, body parts could be affected. You should always seek medical attention to rule out serious conditions.
- Regardless of the cause of dizziness, treatment should be comprehensive beyond prescribing common dizziness medications. These types of medication may or may not be effective, depending on the condition, but almost never address the cause of dizziness itself.
- Finding the right provider to address your dizziness can be difficult and frustrating. It is essential that you find someone who specializes and has experience with dizziness disorders.
If you reside near Columbus, Canal Winchester, or Blacklick, Ohio, then check out Dr. Andrew Junak at Peak Physiotherapy Performance. He has years of experience in successfully treating patients with dizziness and can guide you through the rehabilitation process. Schedule your free consultation here or connect with us on Facebook.
About the Author
Dr. Andrew Junak is a Doctor of Physical Therapy and Board-Certified Orthopedic Specialist. Dr. Junak received his Doctorate of Physical Therapy from Walsh University and completed his Orthopedic Specialist training at the Cleveland Clinic. He is the owner of Peak Physiotherapy and Performance, a physical therapy clinic in Canal Winchester and Blacklick, Ohio. He serves the local communities of Lancaster, Grove City, Blacklick, Pickerington, and Columbus. Dr. Junak is passionate about helping people solve their problems in order to get them back to doing the things they love.