Vertigo and dizziness treatment – how physical therapy can help

Vertigo is the false sensation of movement, often described as a feeling of spinning or swaying, that typically results from head movements such as rolling over in bed or getting out of bed. Unlike general dizziness, which can manifest as lightheadedness or unsteadiness, vertigo is characterized by a specific type of "false movement".

One of the most prevalent causes of vertigo is Benign Paroxysmal Positional Vertigo (BPPV). Understanding BPPV and how physical therapists can help is essential for anyone suffering from dizziness or vertigo.

BPPV stands for Benign Paroxysmal Positional Vertigo. It occurs when tiny calcium carbonate crystals, known as otoconia, become dislodged from their usual position in the inner ear (in the utricle and saccule) and get trapped in the semicircular canals. To visualize this, imagine shaking a snow globe and watching the snowflakes get caught where they shouldn’t be.

These otoconia play a crucial role in maintaining balance by providing your brain with information about gravity and acceleration. The otoconia sit in a fibrous membrane above tiny hair cells contained within fluid. When your head moves, the increased weight of the fibrous membrane containing otoconia causes the membrane to move one way or another, which then displaces the hair cells and sends signals to your brain with information about head positioning and acceleration. When they become dislodged, the brain receives incorrect signals, leading to the false sensation of movement or spinning associated with vertigo.

There are three semicircular canals, and if otoconia get dislodged and make their way into one or more of the canals, vertigo follows. Nausea and vomiting may also occur. This can be very scary, especially if you have never had vertigo before. 

How can physical therapy help with BPPV?

Physical therapy is highly effective in eliminating BPPV. In fact, seeing a physical therapist is an excellent place to start if you have vertigo. Your therapist can confirm if your vertigo is caused by BPPV and can help eliminate it, or coordinate further medical workup. 

Here’s how the process typically works:

Assessment: Your physical therapist will conduct a thorough assessment to determine if BPPV is the cause of your dizziness. This involves a series of tests and questions about your symptoms and when they occur. If your therapist suspects BPPV, positional testing will be performed to determine the affected canal of the inner ear.

Corrective Exercises: Once BPPV is confirmed, your therapist will guide you through specific exercises designed to reposition the displaced crystals in your inner ear. These exercises, known as canalith repositioning maneuvers, are carefully tailored to move the otoconia back to their correct location, alleviating vertigo.

Additional Interventions: If there are residual symptoms or balance issues after the initial treatment, additional interventions may be required. These could include exercises to improve overall balance and reduce the risk of falls, as well as assessing your visual and postural reflexes. 

If your physical therapist determines that BPPV is not the cause of your dizziness, physical therapy may still be helpful. Your therapist can also help you determine if additional medical workup is needed. 

If balance or falling rather than dizziness is your primary concern, physical therapy can still help. A full balance assessment will be performed to identify any deficits or areas of weakness. Based on this assessment, your therapist will develop a customized program to improve your balance, enhance your strength, and prevent falls.

If you’re experiencing dizziness or balance issues, don’t wait to seek help. We have doctors of physical therapy who specialize in treatment of dizziness, vertigo and balance at all of our clinic locations. Our experienced therapists are here to help you feel better and stay safe in your day-to-day activities.

Give us a call or request an appointment today to get started on your dizziness and vertigo treatment. We offer comprehensive services at all our clinic locations and are committed to helping you achieve better balance and a higher quality of life.

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