If you’ve ever experienced dizziness, you know that it can be scary and alarming. When it happens frequently, it can have serious negative effects on your quality of life and ability to function. In some cases, dizziness results in a higher risk of falls and serious injuries.
If dizziness does not go away, patients may be referred for vestibular therapy, a type of physical therapy (PT) that incorporates both the neurological and vestibular systems. Amanda Dailey, PT, DPT, a board-certified neurologic clinical specialist, advanced vestibular physical therapist, and assistant director of the Outpatient Neurologic/Vestibular Program at UPMC, treats patients who struggle with dizzy spells by creating a vestibular PT plan customized to each person.
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What Causes Dizziness?
Dizziness is a catchall term used to describe a range of sensations, such as feeling a sense of motion, faint or woozy, unsteady, or as if the room is spinning. It is one of the most common reasons adults visit their doctors.
“Patients may be diagnosed with dizziness for a variety of reasons,” says Dailey. “The most common causes of dizziness are benign positional paroxysmal vertigo (BPPV), Meniere’s disease, and vestibular hypofunction. But patients with inner ear tumors, stroke, and other medical conditions also can have dizziness and balance issues that may be improved with vestibular therapy, following clearance from their physician.”
To treat the dizziness, Dailey says she first has to figure out what is causing it. Often, she can determine the cause just by how the patient describes their symptoms. “I ask the patient to describe how they feel without using the word ‘dizzy,'” she says. “If they say, ‘I feel like I’m spinning’ or ‘I feel woozy when I roll over in bed,’ that’s a clue that the problem is BPPV, and that the individual has some particles out of place in their ear. This can be confirmed with positional testing and can typically be managed with some repositioning maneuvers.”
Other patients may describe feeling a motion sensation where they feel unsteady on their feet, as if they’re on a boat, which can be a different kind of vestibular problem, requiring a different type of vestibular rehabilitation.
Examination of Dizziness
Once she is able to get the patient to describe the symptoms, Dailey conducts a physical exam and tries to replicate them. “There are specific positional tests and a variety of special exam techniques that are used to rule in or out different vestibular conditions.”
Then, she designs a therapy program that incorporates exercises and experiences to desensitize the patient to their dizziness triggers and retrain the vestibular system to process normal movement.
What Is Vestibular Therapy?
The vestibular system includes structures in the inner ear and connections to the brain that maintain the body’s sense of equilibrium, or balance. Vestibular rehabilitation is a type of physical therapy that focuses on minimizing the effects of imbalance disorders.
Therapy consists of exercises specifically prescribed to treat the condition so that patients can return to a safe and active lifestyle. Exercises often incorporate eye and head movement to restore vestibular ocular reflex function.
Dailey also assigns homework to enhance the effectiveness of PT sessions. For example, a person who gets dizzy in a busy environment might be assigned a trip to the gym at lunchtime or a walk through the mall. “The idea is to push patients by exposing them to their triggers in small doses, then allowing them to recover, with the goal of progressing to the point where they can tolerate normal things,” she says.
For other patients, such as older adults with balance issues, therapy might include safer walking and transfer techniques, as well as vestibular exercises.
Benefits of Vestibular Therapy
At UPMC, specially trained therapists work to restore your sense of balance and return you to a full and independent life as soon as possible. Vestibular therapy can retrain the brain to integrate sensory information and can significantly reduce symptoms of dizziness.
“For some patients with BPPV, we can achieve results in only a few visits,” Dailey says. “It may take longer for people with other conditions, but our team makes therapy very manageable for patients. We try to make therapy sessions convenient, effective, and tailored to their lifestyle, so they aren’t overwhelmed by the exercises or the sessions. Our goal is to make each patient’s therapy plan just right for them.”
Our highly trained vestibular therapists offer comprehensive examination and individualized treatment programs. Through examination, including use of technology and vestibular testing equipment, some individuals may be referred to other medical professionals for additional evaluation and treatment.
For more information, call 1-888-723-4277 or visit our website.
The UPMC Rehabilitation Institute offers inpatient, outpatient, and transitional rehabilitation, as well as outpatient physician services so that care is available to meet the needs of our patients at each phase of the recovery process. Renowned physiatrists from the University of Pittsburgh Department of Physical Medicine and Rehabilitation, as well as highly trained physical, occupational, and speech therapists, provide individualized care in 12 inpatient units within acute care hospitals and over 80 outpatient locations close to home and work.