By Anthony Curtis, PT

Dizziness, unsteady balance, and vertigo can be scary. Patients who experience a sudden or gradual onset of symptoms such as lightheadedness or wobbliness may worry about the underlying cause of their disorientation. Here we will discuss common causes, when to seek medical attention, and what you can expect from a visit to Virginia ENT.

What causes vertigo?

Bouts of dizziness are often caused by a hypofunction of the vestibular system. The vestibular system, or the human balance system, is comprised of sensory organs such the eyes and skin, the inner ear, and the brain. To oversimplify: a person takes in information about where her or she is in space through the senses, that information is checked against information collected by the inner ear, and all that data is sent to the brain. If the eyes say, “I’m standing still,” but the inner ear says, “Whoa, I’m in motion,” the brain is unsure which data is accurate and the result is experienced as dizziness or imbalance.

Often, this sensation is caused by a loose crystal or crystals in the inner ear. This condition is also called benign paroxysmal positional vertigo, or BPPV. The tiny calcium crystals are responsible for sensing gravity, or, you might say, knowing which end is up. When a crystal moves out of its proper position, the result can feel like the most unpleasant rollercoaster ever.

Can a vestibular physical therapist treat vertigo?

DG7A1388-1No one likes the feeling of vertigo. It can be accompanied by nausea and headaches, but, beyond that, there are other risks associated with the condition. The risk of falling can be quite serious, especially for older patients. A lack of balance can also keep a person from being able to perform their job or enjoy usual activities.

Sometimes the onset of symptoms can be more gradual, and a patient may not be aware there is a problem right away. It’s important to note if you have recently transitioned to using a cane or from using a cane to needing a walker to feel confident while standing. Regardless of the severity or acuity of symptoms, a vestibular physical therapist will be able to diagnose the root cause and resolve the issue.

What to expect from a Balance PT visit

Patients are typically referred from a primary care physician or ENT to Balance PT for resolution of an issue with dizziness or unsteadiness. Prior to a visit, it is especially helpful to your specialist if you can identify what provokes your bouts of vertigo. Having a clue of what causes the problem will help during assessment.

balance-1An assessment will include positioning testing to score how likely a patient is to fall. This test will also home in where the balance issue is originating and how severe the problem is. Balance PT employs the use of a Balance Master in assessing how a patient shifts weight. The Balance Master is a NASA-developed machine with a dynamic force plate that collects precise data on a patient’s balance or lack thereof. Frenzel Goggles are also used to asses the vestibular system. These goggles display a zoomed-in image of the patient’s eyes to a screen, allowing the therapist to see how the eyes are tracking during movement.

Once a Balance PT therapist understands the weak links in a patient’s balance, whether it’s a sensory issue—eyes, inner ear and leg perception—or a motor issue, resolution can begin quickly. The physical therapist will use your assessment results to customize the therapy program and length of rehab needed to your condition. If the underlying issue is BPPV, it is usually resolved in one visit. If a patient is struggling with a loss of balance due to weakened motor or sensory system skills, resolution may take 4-6 weeks or longer.

A Case Study

It is not uncommon for patients to suffer from a combination of sensory and motor deficiencies which require separate treatments. One Balance PT patient was referred because he was unable to perform his job cleaning floors due to dizziness and an inability to squat. The patient was over 65 and couldn’t complete tasks such as emptying a vacuum cleaner. Balance PT therapists first resolved the BPPV causing his dizziness. After that, they were able to tackle his physical deficiencies through aggressive strength training. The final step was coordination training. In the end, the patient was able to return to work confident in his ability to safely perform the duties required.

If your quality of life is affected by occasional or persistent vertigo, balance deficits or fear of falling, ask your primary care physician for a referral to Balance PT. Our therapists will design a regimen to address your specific issues and teach you techniques for preventing or treating all forms of BPPV.