Physical Therapy Use in the Treatment of Vertigo

By: Dr. Tuba Bayram

Have you ever experienced a spinning sensation or felt wobbly? You may be having one of the most common inner ear (vestibular system) issues, which is vertigo. People who experience vertigo often describe the sensation as rocking or spinning even though they are standing still. They can also report nausea, vomiting, fogginess in the head, changes in vision, sensitivity to head movements, and imbalance. While vertigo may seem like a debilitating condition, physical therapy can be a highly effective treatment option to reduce symptoms and restore ability to perform daily tasks such as getting out of bed, bending over, walking, and driving.

Causes of Vertigo

The most common cause of vertigo is benign paroxysmal positional vertigo (BPPV), which occurs when small calcium carbonate crystals in the inner ear become dislodged and move into semicircular canals where they are not supposed to be. When this happens, the brain receives false signals about the body’s position and movement which results in symptoms mentioned earlier. Other causes include vestibular neuritis, which is an inflammation of the inner ear; Meniere’s disease, a chronic ear disorder that also causes ringing in the ear and hearing loss, and head trauma which also can lead to vertigo.

The Role of Physical Therapy in Treating Vertigo

Vestibular physical therapy provides substantial relief from symptoms and improves balance by incorporating the following treatment options based on patients’ needs:

1. Canalith repositioning maneuvers, the most common of which is called Epley maneuvers, are highly effective treatments for BPPV. This type of physical therapy involves head and body movements that guide the dislodged calcium carbonate crystals into a correct position in the inner ear. (Envision the child’s game where you move the board to drop the silver balls into the various holes.) This treatment has a high success rate and often provides immediate relief from vertigo. It is very gratifying to take a patient who is feeling nauseated or vomiting and unable to walk into the clinic to the point where he or she can get up off the treatment table and walk into the parking lot feeling well again.
2. Balance training is also an important part of vestibular physical therapy. Exercises that are designed to improve the body’s ability to maintain balance may include standing with eyes closed, walking on uneven surface, and using special equipment such as balance boards. By committing to balance exercises, patients can reduce the risk of falls. Additionally, physical therapists use habituation exercises to help the brain become accustomed to movements that may trigger symptoms. This type of exercise is particularly helpful for patients who have difficulty with turning their head, bending over, lying down, or having their hair washed at a salon.
3. Gaze stabilization exercises are also effective in treating symptoms due to dysfunction of visual focus and tracking as these types of exercises improve the coordination between the eyes and head, which enable patients to focus on stationary objects even when their head is moving.
4. Physical therapists may also use lightboards or visual motion boards as part of the treatment. Patients will follow moving lights or patterns to help improve visual tracking, balance, and coordination. The light boards stimulate the vestibular system and help the brain adapt to certain movements, thereby reducing symptoms.
5. Infrared video goggles are also used to assess and treat vertigo. The goggles allow the physical therapist to observe a patient’s eye movements which can indicate issues within the inner ear. During the canalith maneuvers for treating vertigo, the goggles enable the physical therapist to see how a patient’s eyes respond to the positional changes allowing effective and efficient treatments.

Common Questions About Vertigo

1. Is vertigo the same as dizziness? No. Vertigo is a sensation of spinning or moving when you are not moving. Dizziness is simply a general term for sensation of lightheadedness, faintness, or unsteadiness.
2. Can vertigo be cured? Yes, a physical therapist can successfully treat vertigo, sometimes in just two or three sessions. However, success certainly depends on the underlying cause, the treatment received, and the patient’s dedication to participating in his or her own treatment.
3. How long does vertigo last? Again, this depends on the underlying cause of the issue. BPPV episodes may last seconds to minutes. Menier’s attacks can last hours. Migraine-related vertigo can last minutes to days. Vertigo can come and go. Treating the issue with physical therapy reduces the symptoms and can keep it at bay.
4. When should I get treatment for vertigo? Patients should seek treatment for their vertigo if symptoms are interfering with normal activities or if symptoms become more frequent or more severe. Also, seek help from a physician if symptoms are accompanied by additional issues such as sudden weakness, memory & speech difficulties, or severe headaches.

At Rehab Associates, we offer a focused and individualized approach to treating vestibular issues with physical therapy. We provide patients with the tools and education to manage symptoms and to ultimately overcome vertigo. For more information about the treatment of vertigo or to schedule an appointment with one of our vestibular therapists, please give us a call today at 855-722-8478. For more information about our vestibular therapists, please follow this link: https://racva.com/dizziness-vertigo/

Dr. Tuba Bayram received her Doctorate of Physical Therapy degree from Northwestern University in Chicago, Illinois, in 2017. She received a certificate of achievement in Vestibular Rehabilitation from Emory University in Atlanta, Georgia. Her interests include geriatrics, neurology, gait & balance, and vestibular therapy. She is also certified in LSVT-BIG for Parkinson’s Disease. Dr. Bayram sees patients at our Clifton clinic in Lynchburg, Virginia.