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Feeling dizzy? Try physical therapy

October 17, 2018

Dizziness can be caused by a variety of things, including vertigo, migraine headaches, concussions, blood pressure changes and inner ear infections.

To cure inner ear problems and the nausea and balance issues that go along with them, doctors often prescribe medication and at-home exercises. But many doctors also recommend a visit to the physical therapist.

Physical therapists are specially trained to do specific head movements that can alleviate dizziness and other vestibular (inner ear) problems, in some cases after just a single visit, says Northwest Community Healthcare (NCH) Physical Therapist Jennifer Cuisinier, who works at NCH Lake Zurich Physical Rehabilitation Services and the Rolling Meadows NCH Outpatient Center.

The most common cause of dizziness is an inner ear problem known as Benign Paroxysmal Positional Vertigo (BPPV), often just called vertigo. BPPV is caused by small crystals of calcium carbonate or “ear rocks” that collect in the inner ear. It can cause people to be off-balance, have trouble walking or feel dizzy when they move or change positions.

Most BPPV patients require three to five physical therapy sessions until their dizziness subsides, and it could be longer for other conditions, such as central or peripheral vestibular dysfunction.

“This can help BPPV, and it’s not a medication,” Cuisinier says. “If it’s severe, or they’ve had it for longer, it’s going to take a few sessions to make them feel better.”

Physical therapists can maneuver the head into different positions and move the crystals out of the sensitive part of the ear and into a less sensitive location, alleviating the dizzy spells.

“If it’s BPPV, then physical therapy may be more effective (than other treatments) in taking it away completely,” Cuisinier says.

Physical therapy also is useful for those who have had a concussion or infection related to the inner ear, such as vestibular neuritis or labyrinthitis.

After patients are diagnosed by their doctor, physical therapists do a vestibular evaluation to assess their condition, symptoms, age and motor impairments. Then the therapist develops a series of head movements designed for patients’ specific condition. They also might instruct patients to practice things at home to improve their vestibular and balance systems, such as:

  • Standing at a counter (for safety) with their eyes closed, or standing on one leg
  • Walking sideways along the counter at home to prevent falls to the side
  • Practicing sitting and standing

Vision also factors into dizziness conditions, and NCH’s specially trained physical therapists can help with that, too. One way is with the state-of-the-art Frenzel lens. Patients wear camera-equipped goggles that allow therapists to watch their eye motions on a TV screen. The Frenzel lens helps physical therapists treat BPPV more effectively because the therapist can see which direction their eyes are moving. If the eye reflexes are not working well, the therapist can provide exercises to improve the impairment.

Cuisinier warns against do-it-yourself physical therapy for vertigo and other inner ear problems, because it’s difficult for someone to see which direction their eyes are moving in certain poses. Incorrect movements can cause the calcifications to move into a different area of the ear canal, making the problem more serious.

“I had someone come in and say they looked it up on YouTube and tried to do it themselves, and it actually made it worse,” Cuisinier says. “It’s not something you can do by yourself.”

If patients still aren’t more balanced and stable after a few weeks, the physical therapist will recommend they go back to the doctor for further testing.

“If it’s not better by then, then something else is going on,” Cuisinier says.

Physical therapists at NCH treat problems with standing, walking, range of motion, balance, coordination, strength and endurance. Read more about our programs and locations. To schedule an appointment, call 847-618-3550.