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Vestibular Physical Therapy: Treating Your Dizziness

If you are dealing with dizziness, imbalance, or incoordination, physical therapy may be able to help! Studies indicate that 15-20% of adults experience dizziness or vertigo annually, according to Medscape. These issues become more common with age, with rates exceeding 40% in individuals over 40. 

Dizziness can significantly impact daily life, affecting activities like walking, driving, exercising, and reading. It increases risks for falls, impacts people’s ability to work, and can lead to general fear or hesitation for people to want to participate in physical or social activities.

What Causes Dizziness:

There are a variety of causes for dizziness symptoms in the population. Symptoms can come on gradually over time with no known cause for some or can come on very suddenly in others. Here are several of the most common causes:

  • Head trauma: Any potential brain injury sustained by events such as a concussion or stroke can damage the areas of the brain that control our balance systems. Neck injuries such as from whiplash in an MVA can also damage these areas.
  • Vestibular Conditions: There are a variety of inner ear conditions or disorders that cause dizziness and imbalance as the main symptoms. Some of the most common conditions include Benign Paroxysmal Positional Vertigo (BPPV), Meniere’s Disease, Acoustic Neuroma, Labyrinthitis, and Vestibular Neuritis.
  • Aging and Inactivity: As we age, changes in vision, loss of strength, and reduced mobility can all contribute to altered balance and coordination leading to decreased activity. With decreased exposure to movement, the systems that control for balance and dizziness become deconditioned leading to issues when suddenly attempting to move quickly or attempting an unfamiliar activity.
  • Side Effects from Medications or Other Health Issues: Dizziness is a leading side effect in many medications taken for a variety of conditions. Talk to your doctor if you notice dizziness symptoms soon after starting a new medication as this may mean dosage must be altered or the medication should be discontinued and switched to another type. Common health issues including hypertension and hypotension (High and Low Blood Pressure respectively) can also cause dizziness due to altered blood flow to the brain.
  • Anxiety and Stress: Stress can increase the body’s release of certain hormones such as cortisol and adrenaline which can set off a variety of effects on the body including increased heart rate, rapid breathing, and muscle tension all of which can affect blood flow to the brain.

How Can Physical Therapy Help?

Physical therapists can be trained to help identify and potentially diagnose certain vestibular conditions through testing. If BPPV is diagnosed, one of the most common vestibular conditions, physical therapists can perform a specific manual technique to fix the condition in as quick as a few minutes!

For more complicated conditions or causes of dizziness, physical therapists can help to identify which movements or activities elicit symptoms in order to help guide patients in exercises specific to their dysfunction. One common issue patients with dizziness present with is known as a Vestibulo-ocular Reflex (VOR) Dysfunction. VOR refers to a person’s ability to coordinate movements between the head and eyes in order to maintain focus on something being looked at. Think of it like the image stabilizer setting you can turn on your phone when taking a video to keep the image clear despite your hand shaking. Without the stabilizer, the video looks very blurry and out of focus.

A person’s VOR can be impacted by many of the causes listed above that contribute to dizziness, but the treatment generally remains the same. Physical therapists can guide you through exercises designed specifically for improving VOR. Though often uncomfortable at first, these exercises have been shown to reduce symptoms in as fast as 2 weeks.

Once VOR is managed, physical therapists can continue to guide patients back toward their prior level of function through working on balance and coordination and by designing a program geared directly toward the goal activities.

If you have been dealing with dizziness, feeling off balance, or just feeling uncoordinated with movement, speak with a physical therapist trained in vestibular rehabilitation. They will get you back to feeling your best.