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Physical Therapy Guide to Vertigo

Physical Therapy Guide to Vertigo

What Is Vertigo?

  • How Is It Diagnosed?

  • How Can a Physical Therapist Help?

  • What Kind of Physical Therapist Do I Need?

  • Further Reading

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:

  • Double vision

  • Difficulty speaking

  • 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

  • Migraines

  • 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

  • Stroke

You also might have:

  • Nausea

  • Vomiting

  • Sweating

  • 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 hav