If you’ve experienced dizziness before, you know that it can be very disorienting and disruptive to your daily life, making even simple tasks seem challenging. Dizziness can be caused by a variety of things and is perceived differently by each person who experiences it. This can make getting the right care difficult. Physical therapy can treat the #1 leading cause of dizziness and get the process of recovery started sooner.
There are two main causes of dizziness that can be treated with physical therapy. The first and most common cause of dizziness is called Benign Paroxysmal Vertigo (BPPV). This type of vertigo occurs when crystals in the inner ear that help to sense the position of our head in space, move out of their proper position in the utricle (shown to the right by the red dot) and move into one of the semicircular canals (pictured in yellow). When this happens, the brain gets a false sense of movement or spinning. Individuals often describe their symptoms as room spinning dizziness that occurs when they roll over in bed or lie on their back, but it can also occur with quick head movements, bending down, or looking up. Vertigo symptoms typically last for a short period of time (30 seconds to a minute), but may be accompanied by other symptoms such as nausea, imbalance, or headaches which may last longer. After evaluating you, your physical therapist will treat this issue by guiding you through a series of simple head movements. During these corrective head movements, the crystals in your ear canals will move back into their proper position and resolve your dizziness. Individuals with diabetes, migraine, high blood pressure, age >50, cardiovascular disease, concussion, vitamin D3 deficiency, anxiety, and depression may have an increased likelihood of developing BPPV. Research shows that 50% of the population will experience an episode of BPPV at least once before age 70. The good news is, physical therapy can often treat and resolve this issue within 1-2 treatment sessions.
The second type of dizziness that physical therapy can help treat involves an issue with the vestibulo-ocular reflex. This reflex communicates between your inner ear, brain, and eye muscles to allow you to keep your gaze focused on an object while your head is moving. Typically when you turn your head one direction, your eyes must move in an equal and opposite direction so that you can maintain your focus. When there is an issue with this reflex, patients report dizziness with head movement, feeling of exaggerated sense of movement with changes in head position, imbalance with head or body movement, and issues with busy patterns (carpets, wallpaper) or busy environments (traffic, grocery store). With physical therapy, this type of vertigo is treated with exercises that train and strengthen this reflex to better respond to quick head movements and changes in the environment. This treatment often requires more physical therapy sessions to be treated, but can be resolved with proper treatment interventions from a trained PT.
Sources:
Richard Gans, Joseph Sakumura. Vestibular Rehabilitation Certification Manual. American Institutes of Balance. p1-285.
Paz Pérez-Vázquez, Virginia Franco-Gutiérrez. Treatment of benign paroxysmal positional vertigo. A clinical review. J Otol. 2017 Dec;12(4):165-173. doi: 10.1016/j.joto.2017.08.004. 2017 Aug 25.
