Physical Therapy Guide to Vertigo
What Is Vertigo?
Vertigo usually is described as a spinning sensation, whereas dizziness usually is described as "lightheadedness." Often, they have different causes and different treatments.
If you have vertigo accompanied by one or more of the following symptoms, immediately call 911 or emergency medical services (EMS) so that an ambulance can be sent for you:
A change in alertness
Arm or leg weakness
Inability to walk
What Is Vertigo?
Vertigo is the sensation of spinning—even when you're perfectly still, you might feel like you're moving or that the room is moving around you. Most causes of vertigo involve the inner ear ("vestibular system"). A number of conditions can produce vertigo, such as:
Inner ear infections or disorders
Tumors, such as acoustic neuroma
Surgery that removes or injures the inner ear or its nerves
Head injury that results in injury to the inner ears
A hole in the inner ear
You also might have:
Abnormal eye movements
One of the most common forms of vertigo is benign paroxysmal positional vertigo, an inner-ear problem that causes short periods of a spinning sensation when your head is moved in certain positions.
How Is It Diagnosed?
Your physical therapist will use your answers to the following questions to help identify the cause of your vertigo and to determine the best course of treatment:
When did you first have vertigo (the sensation of spinning)?
What are you doing when you have vertigo (turning your head, bending over, standing perfectly still, rolling in bed)?
How long does the vertigo last(seconds, minutes, hours, days)?
Have you had vertigo before?
Do you have hearing loss, ringing, or fullness in your ears?
Do you have nausea with the spinning?
Have you had any changes in your heart rate or breathing?
Your physical therapist will perform tests to determine the causes of your vertigo and also to assess your risk of falling. Depending on the results of the tests, your therapist may recommend further testing or consultation with your physician.
How Can a Physical Therapist Help?
Based on your physical therapist's evaluation and your goals for recovery, the therapist will customize a treatment plan for you. The specific treatments will depend on the cause of your vertigo. Your therapist's main focus is to help you get moving again and manage the vertigo at the same time. Treatment may include specialized head and neck movements or other exercises to help eliminate your symptoms. Conditions such as benign paroxysmal positional vertigo have very specific tests and treatments.
If you have dizziness and balance problems after your vertigo has stopped, your physical therapist can develop a treatment plan that targets those problems. Your physical therapist will teach you strategies to help you cope with your symptoms:
Do certain activities or chores around the house cause you to become dizzy? Your therapist will show you how to do those activities in a different way to help reduce the dizziness.
Have simple activities become difficult and cause fatigue and more dizziness? Your therapist will help you work through these symptoms right away so you can get moving again and return to your roles at home and at work more quickly.
Physical therapy treatments for dizziness can take many forms. The type of exercise that your therapist designs for you will depend on your unique problems and might include:
Exercises to improve your balance
Exercises to help the brain "correct" differences between your inner ears
Exercises to improve your ability to focus your eyes and vision
In addition, your physical therapist might prescribe exercises to improve your strength, your flexibility, and your heart health—with the goal of improving your overall physical health and well being.
What Kind of Physical Therapist Do I Need?
All physical therapists are prepared through education and experience to treat people with dizziness. You may want to consider:
A physical therapist who is experienced in treating people with neurological problems. Some physical therapists have a practice with a neurological vestibular rehabilitation focus.
A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in neurological physical therapy. This therapist has advanced knowledge, experience, and skills that may apply to your condition.