Why might I have vertigo?

Dizziness and vertigo are common medical issues and affect approximately 20%-30% of the general population. Vertigo can occur in people of all ages. The prevalence of vertigo rises with age and is about two to three times higher in women than in men, accounting for about 2-3% of emergency department visits. The leading causes of vertigo are benign paroxysmal positional vertigo (BPPV), Meniere’s Disease, vestibular neuritis or labyrinthitis, concussion, or vestibular migraine. Excessive drinking of alcohol can also cause symptoms of vertigo. Onset may result from a recent infection, a trauma to the head, or for no known reason.

How can physical therapy help my vertigo?

Treatment or therapy for vertigo depends on what is causing it. In many cases, vertigo goes away without any treatment. This is because your brain can adapt to the inner ear changes, at least in part, relying on other mechanisms to maintain balance. For some, treatment is needed and may include:

1. Medicine to relieve symptoms of nausea or motion sickness
2. Antibiotic treatment or steroids if vertigo is caused by infection
3. Surgery
4. Vestibular physical therapy – Canalith repositioning maneuvers. A series of specific head and body movements are used to treat BPPV. The activities are done to move the calcium deposits out of the canal into an inner ear chamber so the body can absorb them. Patients will likely have vertigo symptoms during the procedure as the canaliths move. The movements are safe and often effective.

In vestibular physical therapy, patients are treated with canalith repositioning maneuvers, vestibular exercises, balance training, and neck stretching to improve their range of motion. Manual therapy is used to alleviate myofascial restrictions in the neck contributing to pain and headaches, and other modalities. The goal is to help strengthen the vestibular system. The vestibular system’s function is to send signals to the brain about head and body movements relative to gravity. Vestibular rehab may be recommended if you have recurrent bouts of vertigo. It helps train your other senses to compensate for vertigo. This will include retraining of head & neck mobility in horizontal and vertical planes, eye movements including diagonal patterns, and balance and gait activities.