Request an appointment

Contact Us

How Physical Therapists Treat Dizziness and Vertigo

Causes and Treatments
 Nov 8 2019

What causes dizziness? Maybe a recent injury left you feeling unbalanced, a stroke or other brain trauma caused episodes of vertigo, or a medication you’re taking lists dizziness as a potential side effect.

But what if you suddenly start to experience dizziness or vertigo and see no obvious cause? Feeling unsteady on your feet can be frightening, especially if you’re not sure why it’s happening. Even if you know the root cause, unexpected dizziness can make you feel unsafe and keep you from the activities that matter to you.

While consulting your physician about new symptoms is always a good place to start, your physical therapist can also help provide answers! Let’s look at some of the ways physical therapists can help diagnose and treat the causes of dizziness.

 

What Causes Dizziness and Vertigo?

Your physical therapist is equipped to diagnose some of the most common causes of dizziness and vertigo, including:

 

Inner Ear Issues

When you’re experiencing dizziness or vertigo, inner ear issues are the most likely culprit. One inner ear issue you may have already heard of is Benign Paroxysmal Positional Vertigo, or BPPV. It’s the most common cause of vertigo in older adults. Crystals in the inner ear help you sense your head’s position against gravity (so you can tell up from down). When these “crystals” get displaced in the inner ear canal, you’ll have trouble sensing your head’s position and feel dizzy.  Many patients describe feeling like the room is spinning around them, especially when changing head positions such as lying down or getting up. The good news is, BPPV is one of the easiest causes of dizziness to treat! A trained physical therapist can treat BPPV in just 1-4 visits. See more information on treatment below.

Another common inner ear issue, Meniere’s Disease, occurs when there is abnormal fluid build up in the inner ear. Similar to BPPV, you may suddenly feel like your head is spinning, with episodes of vertigo that can last minutes or even hours. Patients with Meniere’s disease will also usually experience other symptoms like ringing in the ears, partial deafness, or a feeling of fullness in the ears. Unlike BPPV, there is no direct treatment or cure available for Meniere’s disease, so physical therapy will focus on symptom management and returning to activities that matter to you.

 

Concussions and Head Injury

Concussions and other head trauma can result in symptoms like dizziness and vertigo, even long after the original injury occurs. A physical therapist can provide holistic treatment to get you back on your feet after a head injury, including treating any dizziness or associated vertigo. Read more about baseline testing and concussion treatment at Compleat Rehab here.

 

Blood Flow Restrictions

Conditions that cause blood flow restrictions in the brain, such as stroke, migraines, or other vascular diseases, may be accompanied by dizziness and vertigo. Physical therapists are trained to recognize symptoms of dangerous conditions that require a doctor’s attention, and we will refer you accordingly. On the other side of treatment, if you have recently had a stroke or been diagnosed with a vascular condition that causes dizziness, physical therapy can help treat the symptom while improving your overall health.

 

Issues with Back and Neck Muscles

Many people don’t realize it, but inflammation or degeneration of the muscles around the upper spine and neck can actually cause dizziness! It’s called cervical vertigo or cervicogenic dizziness (cervical refers to the spinal vertebrae in your neck). This inflammation can be cause by trauma, injury, surgery, or the body’s natural aging process. If you have cervical dizziness, you may experience a spinning sensation when you move your neck, especially when turning your head. The muscles in your neck and upper back have nerves that send signals to your brain about where your head’s location, so conditions that mess with these nerves can therefore mess with your balance! Luckily, a physical therapist can both prevent and treat cervical dizziness.

 

How Can a Physical Therapist Help?

Physical therapy treatment for dizziness will vary based on the cause, and may include:

 

Direct Treatment (Canalith Repositioning)

One of the most common sources of dizziness comes with a simple solution. BPPV is caused by dislodged inner ear crystals; to treat it, we just shake them back into place! Ok, so it’s not as crazy as it sounds. Essentially, your physical therapist will direct or move you through carefully ordered positions in order to help move the crystals back where they belong. There are 6 evidence-backed ‘positioning maneuvers’ that we use. Which variation works best for you will depend on your symptoms and level of comfort. For instance, the “Gans Repositioning Maneuver,” one of the less intensive options, has you repeatedly roll back and forth and then gently tilt your head to the side. It may seem like a fruitless exercise, but the technique is backed by real results – in one study, 95% of patients had no dizziness or vertigo symptoms after just 2 treatments using the Gans Repositioning Maneuver.

Your physical therapist might try a couple of different maneuvers before finding the one that works for you, but most instances of BPPV can be treated in just 1-4 therapy visits!

 

Vestibular Rehabilitation

For some causes of vertigo, direct treatment is not an option. Some chronic conditions can be managed with medication or therapy but will never actually go away, such as Meniere’s disease, vascular disease, and other conditions. The good news is: physical therapy can still treat the symptoms of these conditions, including dizziness or vertigo.

To help patients manage dizziness symptoms, we use vestibular rehabilitation. Vestibular rehabilitation focuses on ‘rehabbing the brain’ as opposed to treating the underlying cause of the dizziness itself. Your physical therapist will have you perform exercises that require balance and coordination, while providing strengthening and conditioning as well. They may also recommend alternative ways you can move or perform certain tasks to avoid triggering vertigo. The exercises train your brain to work with the changes in your body, whether that’s inflamed nerves or inner ear fluid levels. You are essentially relearning up from down! It may sound difficult, but your brain is an amazing organ! And a trained physical therapist can help you achieve rehabilitation quickly, with treatment averaging from 4-8 weeks.

 

Manual Therapy

Issues with the muscles in and around your neck, or cervical muscles, can wreak havoc on your vestibular system, leading to dizziness and vertigo. A physical therapist can address these issues with manual therapy and corrective exercise to help reduce or completely treat symptoms of dizziness.

Your physical therapist will use hands-on techniques to massage the affected muscles, alleviate tension, improve blood flow, and provide myofascial release. They may also directly manipulate your head, neck, shoulders, and arms in order to work or stretch the affected muscles. Your musculoskeletal system is complex, and a problem in one muscle group can cause problems in its neighbor. A trained physical therapist can find the source!

Corrective exercises to improve strength and range of motion may also help relieve pain and associated dizziness. We create unique treatment plans for each patient, but for less involved cases, effective treatment may require as little as two weeks of therapy.

 

Strengthening, Conditioning, and Awareness Training

Regardless of the cause of your vertigo, strength and conditioning training can help you manage the symptoms and get back to living. We work with patients to pick the goals that matter to them. For a lot of patients who have symptoms like dizziness and vertigo, regaining independence and movement is one of their primary goals. Physical therapy helps these patients improve their physical strength and coordination, equipping them to handle bouts of vertigo and feel less out of control when dizziness occurs.

Your physical therapist can also train you to be aware of your body, to notice signs that an episode could occur, and to avoid activities that trigger vertigo. Training may include leg, core, and arm strengthening; gait training to reduce fall risk; and balance and reaction testing.

 

Are you struggling with dizziness, or do you know someone who is? Physical therapy can help! Contact us today to schedule a free consultation.

 

Don’t miss out on more tips to stay health and keep moving! Subscribe to our newsletter:


article categories

other articles

close  

google analytics policy

we may collect information about your computer, including your IP address, operating system and browser type, for system administration and in order to create reports. This is statistical data about our users' browsing actions and patters, and does not identify any individual.

The only cookies in use on our site are for Google Analytics. Google Analytis is aweb analytics tool that helps website owners understand how visitors engage with their website. GoogleAnalytics customers can view a variety of reports about how visitors interact with their website so that they can improve it.

Like many services, Google Analytics users first-party cookies to track visitor interactions as in our case, where they are used to collect information about how visitors use our site. We then use the information to compile reports and to help use improve our site.

Cookies contain information that is transferred to your computer's hard drive. These cookies are used to store information, such as the time that the current visit occured, whether the visitor has been to the site before and what site referred the visitor to the web page.

Google Analyticsw collets information anonymously. It reports website trends without identifying individual visitors. you can opt out of Google Analytics without affecting how your visit our site- for more information on opting our of being tracked by Google Analytics across all websites you use, visit this Google page

close  

HIPAA privacy

Compleat Rehab

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

If you have any questions about this Notice of Privacy Practices, please contact our Privacy Officer, by telephone at (704) 824-7800 or in writing at 2675 Court Drive, Gastonia, NC 28054.
This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. Protected health information is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.

A. WE MUST PROTECT YOUR PROTECTED HEALTH INFORMATION

We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our Notice of Privacy Practices at any time. The new Notice of Privacy Practices will be effective for all protected health information that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices. You may request a revised version by calling or writing our Privacy Officer and requesting that a revised copy be sent to you in the mail or asking for one at the time of your next appointment.

B. USE AND DISCLOSURES OF PROTECTED HEALTH INFORMATION

Your protected health information may be used and disclosed by our office staff others outside of our office who are involved in your care and treatment for the purpose of providing health care services to you.
Your protected health information may also be used and disclosed to pay your health care bills and to support the operation of our practice.
Following are examples of the types of uses and disclosures of your protected health information that we are permitted to make. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office.

1. Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with another provider.
For example, we would disclose your protected health information, as necessary, to a home health agency that provides care to you. We will also disclose protected health information to other healthcare providers who may be treating you.
For example, your protected health information may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you. In addition, we may disclose your protected health information from time-to-time to other health care providers (e.g., a specialist or laboratory) who become involved in your care by providing assistance with your health care diagnosis or treatment to us.
2. Payment: We may use and disclose protected health information about you so that the treatment and services you receive at Compleat Rehab may be billed to and payment may be collected from you, an insurance company, or a third party. This may include certain activities that your health insurance plan may undertake before it approves or pays for the health care services we recommend for you such as: making a determination of eligibility or coverage for insurance benefits, and reviewing services provided to you for medical necessity. For example, if you have a back injury, we may need to give your health plan information about your condition, supplies used, and services you received.
3. Healthcare Operations: We may use or disclose, as needed, your protected health information for healthcare operations. These uses and disclosures are necessary to run Compleat Rehab and make sure that all of our patients receive quality care. For example, we ma)'use protected health information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine protected health information about many patients to decide what additional services Compleat Rehab should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, technicians, medical students, and other personnel for review and learning purposes, we may remove information that identifies you from this set of protected health information so others may use it to study health care and health care delivery without learning the identities of specific patients.
We may share your protected health information with third party "business associates" that perform various activities (for example, billing or transcription services) for our practice. Whenever an arrangement between our practice and a business associate involves the use or disclosure of your protected health information, we will have a written contract that contains terms that will protect the privacy of your protected health information.
We may use and / or disclose protected health information to contact you to, remind you about an appointment you have for treatment or medical care.
We may use or disclose your protected health information, as necessary, to provide you with information about treatment alternatives or other health--related benefits and services that may be of interest to you. You may contact our Privacy Officer to request that these materials not be sent to you.
4. Other Permitted and Required Uses and Disclosures That May Be Made Without Your Authorization or Opportunity to Agree and Object:
We may use or disclose your protected health information in the following situations without your authorization or providing you the opportunity to agree or object. These situations include:
(i) Required by Law: We may use or disclose your protected health information to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited d to the relevant requirements of the law. You will be notified, if required by law, of any such uses or disclosures.

(ii) Public Health: We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. For example, a disclosure may be made for the purpose of preventing or controlling disease, injury or disability.

(iii) Communicable Diseases: We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

(iv) Health Oversight: We may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies t-rat oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws.

(v) Abuse or Neglect: We may disclose your protected health information to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your protected health information if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.

(vi) Legal Proceedings: We may disclose protected health information in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), or in certain conditions in response to a subpoena, discovery request or other lawful process.

(vii) Law Enforcement: We may also disclose protected health information, so long as applicable legal requirements are met, for law enforcement purposes, these law enforcement purposes include (1) legal processes and otherwise required by law, (2) limited information requests for identification and location purposes, (3) pertaining to victims of a crime, (4) suspicion that death has occurred as a result of criminal conduct, (5) in the event that a crime occurs on the premises of our practice, and (6) medical emergency (not on our premises) and it is likely that a crime has occurred.

(viii) Research: We may disclose your protected health information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information.

(ix) Criminal Activity: Consistent with applicable federal and state laws, we may disclose your protected health information, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual.

(x) Military Activity and National Security: When the appropriate conditions apply, we may use or disclose protected health information of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits, or (3) to foreign military authority if you are a member of that foreign military services. We may also disclose your protected health information to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.

(xi) Workers' Compensation: We may disclose your protected health information as authorized to comply with workers' compensation laws and other similar legally established programs.
5. Other Permitted and Required Uses of Disclosures That Require Providing You the Opportunity to Agree or Object
We may use and disclose your protected health information in the following instances. You have the opportunity to agree or object to the use or disclosure of all or part of your protected health information. If you are not present or able to agree or object to the use or disclosure of the protected health information, then we may, using professional judgment, determine whether the disclosure is in your best interest.

Others Involved in Your Health Care or Payment for our Care:

Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your protected health information that directly relates to that person's involvement in your health care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment. We may use or disclose protected health information to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition or death. Finally, we may use or disclose your protected health information to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care.
6. Uses and Disclosures of Protected Health Information Based upon Your Written Authorization Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law as described below. You may revoke this authorization in writing at any time. If you revoke your authorization, we will no longer use or disclose your protected health information for the reasons covered by your written authorization. Please understand that we are unable to take back any disclosures already made with your authorization.
C. YOUR RIGHTS
Following is a statement of your rights with respect to your protected health information and a brief description of how you may exercise these rights
1. You have the right to inspect and copy your protected health information
This means you may inspect and obtain a copy of protected health information about you for so long as we maintain the protected health information. You may obtain your medical record that contains medical and billing records and any other records that we use for making decisions about you. As permitted by federal or state law, we may charge you a reasonable copy fee for a copy of your records.
2. You have the right to request a restriction of your protected health information
This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or health care operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply.

We are not required to agree to a restriction that you may request. If we agree to the requested restriction, we may not use or disclose your protected health information in violation of that restriction unless it is needed to provide emergency treatment. With this in mind, please discuss any restriction you wish to request with your health provider.

You may request a restriction by making your request in writing to our Privacy Officer. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure, or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
3. You have the right to request to receive confidential communications from us by alternative means or at an alternative location
We will accommodate reasonable requests. We may also condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact. We will not request an explanation from you as to the basis for the request. Please make this request in writing to our Privacy Officer.
4. Your may have right to amend your protected health information
This means you may request an amendment of protected health information about you in a designated record set for so long as we maintain this information. In certain cases, we may deny your request for an amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. Please contact our Privacy Officer if you have questions about amending your medical record.
5. You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information This right applies to disclosures for purposes other than treatment, payment or health care operations as described in this Notice of Privacy Practices. It excludes disclosures we may have made to you if you authorized us to make the disclosure, to family members or friends involved in your care, or for notification purposes, for national security or intelligence, to law enforcement (as provided in the privacy rule) or correctional facilities, as part of a limited data set disclosure. The right to receive this information is subject to certain exceptions, restrictions and limitations.
6. You have the right to obtain a paper copy of this notice from us
upon request, even if you have agreed to accept this notice electronically.
D. COMPLAINTS
You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our Privacy Officer of your complaint. We will not retaliate against you for filing a complaint

You may contact our Privacy Officer at (704) 824-7800 for further information about the complaint process.

This notice was published and becomes effective on August l, 2011.