Treating Vertigo With Physical Therapy

Vertigo and dizziness are common conditions that lead people to seek medical care. Dizziness can be caused by something small like a change in medication or by a serious medical condition.

“Dizziness is the most common complaint in medicine,” said Mary Grace Dy. She's a Franciscan Health physical therapist with a certification for neurodevelopmental treatment for stroke and brain injury, Lee Silverman Voice Treatment for Parkinson's Disease and vestibular rehabilitation treatment for vertigo and dizziness.

“One recent study estimated that as many as 35% of adults aged 40 years old in United States is going to experience some sort of vestibular dysfunction. And 42% of US population will complain of at least one in their lifetime.”

In some cases, a physical therapist may be able to help with dizziness and vertigo in just a few sessions. Dy explains vertigo or dizziness and the role of physical therapists in treating vertigo.

What Causes Vertigo?

Many conditions can trigger vertigo. The first step in treating it is to find out what's causing your vertigo or dizziness.

There are many causes of vertigo, including:

• Central nervous system issues such as stroke or tumor
• Cervical spine issues
• Vascular impairment
• Meniere’s disease
• Inner-ear infections
• Benign paroxysmal positional vertigo, also known as BPPV or “loose crystals” in the inner ear
• Middle ear fluid
• Vestibular neuritis, or inflammation of a nerve in the inner ear
• Vestibular migraine

Vertigo can last hours or even days.

What Is The Difference Between Vertigo And Dizziness?

“Vertigo and dizziness are two of the symptoms that is common with vestibular disorder,” Dy said. “Vertigo is a sensation of self-motion when no motion is happening. It could be spinning or non-spinning. Dizziness is a sense of disturbed or impaired orientation of the environment or space without a false or distorted sense of motion.”

What Are Symptoms Of Vertigo?

Dizziness, a sense of spinning, rotation, rocking or moving, experienced even when someone is perfectly still, are common symptoms of vertigo.

• Other symptoms of vertigo include:
• Pre-syncope, or the feeling of faintness or passing out.
• Gait instability
• Unsteadiness
• Pulsion, or the feeling of being pushed down or pushed to one side
• Imbalance with tendency to fall in a particular direction, like falling backward, falling forward or sideward.

“Visual vertigo or dizziness is provoked with complex moving objects or objects around that is moving or in motion, such as walking in the grocery aisle or driving,” Dy said.

What Are Red Flag Symptoms With Dizziness?

Red flag symptoms with dizziness include:

• Double vision
• Difficulty of talking
• Difficulty swallowing
• Fainting
• Nystagmus
• Involuntary movement of the eyes
• Nausea
• Impaired sensation of the face

“This should be treated with high level of suspicion as central or caused by the brain until proven otherwise,” Dy said. “Go to the urgent care or emergency room.

“Twenty-five percent of the older patients presenting to ER with acute isolated vertigo have cerebral infarction or stroke. And more likely, after that, you go to the ER, then the doctor or your physician will more likely refer you to a physical therapist.”

What Are Common Causes Of Dizziness?

There are two main causes of vertigo: central and non-central.

“Central is caused by brain, such as stroke, traumatic or non-traumatic brain injury, toxicity, migraine, and basilar insufficiency, among others,” Dy said.

“Non-central means brain is not the cause such as dizziness, accompanied with neck pain, viral or bacterial infection, allergies, autoimmune disease, diabetes, motion sickness, and BPPV.”

How Can A Physical Therapist Help Dizziness?

If you are experiencing vertigo or dizziness, physical therapist who is trained or certified for vestibular rehabilitation treatment can evaluate and begin treating vertigo with physical therapy.

“The physical therapist will rescreen for red flags and evaluate the patient to identify other factors contributing to the patient's symptoms and determine the correct diagnosis,” Dy said. “Correct diagnosis is very crucial to proper treatment protocol.

“Here at Franciscan Health, we are blessed to have the Video Frenzel goggles to be able to examine and review eye movements to better diagnose and treat patients with vestibular disorder. We have a team of trained and certified therapists who will work together for patients' optimal functional recovery.

“Once diagnosis is made, the physical therapist will perform the appropriate maneuver to reposition the crystals back into the utricle in case of BPPV. For central vertigo or dizziness, the physical therapist will work with vestibular rehabilitation that includes habituation, substitution, and balance retraining among others.”

How Can You Treat Vertigo With Physical Therapy?

“With appropriate diagnosis, physical therapy can help you treat and abolish vertigo or dizziness,” Dy said. “BPPV has very good outcome with physical therapy. In early acute intervention, it can be resolved in one to three treatment sessions. Other vertigo caused by the brain or central requires a more intensive physical therapy, vestibular rehabilitation that usually is outpatient.”

If you want help treating vertigo with physical therapy, Franciscan Health physical therapists who specialize in vestibular rehabilitation treatment can help. Get started today by contacting Franciscan’s physical therapy team.

Listen Now: Vertigo & Dizziness

Mary Grace Dy, a Franciscan Health physical therapist with a certification in vestibular rehabilitation treatment for vertigo and dizziness, explains this common condition and the role of physical therapists can play in helping you find relief from vertigo.