Tuesday, December 29, 2009

Dizziness and Physical Therapy

Have you ever stood up and experienced the sensation that the room is spinning around you? Most often this is a result of standing too quickly, standing too long, or low blood sugar. Usually the symptoms pass quickly, and there are no long term implications. Unfortunately many individuals endure these sensations on a daily basis as a result of a more complex diagnosis. The good news is many causes of dizziness are successfully treated by physical therapy.

Anyone who experiences dizziness on a regular basis, experiences dizziness in conjunction with a loss of balance or sickness, or becomes dizzy after any injury to the head should contact their doctor to discuss these symptoms. Once a Doctor determines the specific cause, an appropriate treatment plan may be developed.

Let’s begin with the most severe cause, a traumatic event such as a brain-stem injury, concussion, or whiplash. A motor vehicle accident that leads to a neck injury can result in cervical vertigo. Along with dizziness, cervical vertigo symptoms may include neck pain, decreased neck range of motion, pain in the shoulders or into your shoulder blades and headache. By treating the cause of the neck pain and headaches, along with improving neck range of motion, patients experience a decrease in occurrences of dizziness.

Another common condition is Begign Paroxysmal Positional Vertigo (BPPV), a result of debris collecting in the inner ear. Commonly referred to as “ear rocks”, this debris causes a disturbance to the neurons located inside the canals when it moves1. Dizziness will occur with position changes such as getting in and out of bed, rolling over in bed, straightening up, leaning forward, turning your head while walking or sitting in the car. A physical therapist is able to create an exercise program to habituate certain head movements, improve balance, reposition the debris in the canal, and treat additional symptoms like neck pain1.

Lesions in the vestibular system may impact the messages sent to the brain regarding your body’s position in space resulting in decreased balance, reduction in the ability to focus on an object, and a lower tolerance to motion2. Physical therapy treatment will include exercises to improve balance, habituate head with body motions, and stabilization of visual focus on both moving and stationary objects.

Physical therapy had proven to be an effective treatment for many causes of dizziness. A prescription from a Doctor for a physical therapy evaluation is all you need to get started on the path to reduce dizziness caused by one of the above diagnoses. During the evaluation the physical therapist will obtain a complete medical history, perform tests to assess your balance and other symptoms. With the development of a treatment plan, your therapist will help you to overcome these conditions, allowing you to return to your normal daily living.

References:

1. Herdman S. Treatment of Benign Paroxysmal Positional Vertigo. Phys Ther. 1990;70:381-388.
2. O’Sullivan SB, Schmitz TJ. Physical Rehabilitation Assessment and Treatment: 4th edition. F.A. Davis Company, Philadelphia, 2001.


Posted by Jessica A. Knapp PT, DPT