Dizziness is common in adults and can be a big problem in daily life. Feeling unsteady, lightheaded, or like the room is spinning can be alarming and make day to day tasks difficult. The good news: dizziness is often treatable and your physical therapist may be the perfect person to help.
Understanding Dizziness
Dizziness isn't a specific problem - it's a symptom that can come from many different issues. Dizziness can result from issues with your inner ear, issues with your vision, issues in the joints or muscles in your neck, migraines, changes in blood pressure, head injuries, or other neurological problems.
How Physical Therapists Help
To understand dizziness and how a physical therapist can help, you need to know a little about balance. Your brain uses information from your inner ears, your vision, and input from your joints about their position and movement to keep you balanced and stable. Typically all of this information paints the same picture for your brain. When your brain gets conflicting information - say your inner ear sends information different from your vision and joints - it often results in a feeling of dizziness, unsteadiness, or vertigo.
Your physical therapist will ask questions about your history, then perform testing on all of the systems that help you stay balanced to determine the cause of your dizziness.
Your treatment plan will vary depending on what your PT finds. Some common treatments include:
Exercises: Your PT may prescribe specific exercises to improve your balance, to stretch or strengthen specific muscles, or to help retrain your brain to interpret sensory information. These can include gaze stabilization exercises which help your eyes and inner ears work better together, habituation exercises that help your brain get used to different types of input, and balance training on different surfaces.
Canalith repositioning maneuvers: If your dizziness is caused by benign paroxysmal positional vertigo (BPPV), a specific type of inner ear problem, your therapist may perform maneuvers to reposition tiny crystals within your ear canal, alleviating your vertigo. You may also learn how to do these techniques at home.
Education: Your therapist will educate you about your condition, how to manage dizziness, and exercises you can perform at home. They may also help you modify activities that can cause dizziness or help you figure out different ways to work through it.
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Dizziness doesn't have to interfere with life. Physical therapists can help reduce your dizziness, improve your balance, lower your risk of falls, and improve your confidence in your daily activities.
References
Cervicogenic Dizziness: A Review of Diagnosis and Treatment https://www.jospt.org/doi/10.2519/jospt.2000.30.12.755
Physical therapy interventions for older people with vertigo, dizziness and balance disorders addressing mobility and participation: a systematic review. BMC Geriatr 20, 494 (2020). https://doi.org/10.1186/s12877-020-01899-9
Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Evidence-Based Clinical Practice Guideline: FROM THE AMERICAN PHYSICAL THERAPY ASSOCIATION NEUROLOGY SECTION. J Neurol Phys Ther. 2016 Apr;40(2):124-55. doi: 10.1097/NPT.0000000000000120. PMID: 26913496; PMCID: PMC4795094 10.1097/NPT.0000000000000120
Between Cognitive Assessment and Balance Measures in Adolescents Referred for Vestibular Physical Therapy After Concussion. Clin J Sport Med. 2016 Jan;26(1):46-52. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856020/
Physical Therapy lowers falls by 68% after Dizziness https://www.apta.org/article/2023/09/19/study-physical-therapy-after-dizziness-diagnosis-lowers-fall-risk-by-86
Physical Therapy Guide to Dizziness https://www.choosept.com/guide/physical-therapy-guide-vertigo
Vestibular Rehabilitation Therapy https://my.clevelandclinic.org/health/treatments/15298-vestibular-rehabilitation
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