Wednesday, September 7, 2011

Vertigo and Physical Therapy

Vestibular Rehabilitation

“Dizziness”, or Vertigo, is the 3rd most common reason for seeking medical care in individuals over the age of 65 and it is the number one reason for those over the age of 70.

Vertigo is not an inner ear infection as many people believe, and cannot be treated with medication.  It comes on suddenly with changes in the position of the head--lying down, turning to the side or looking up to a cupboard shelf for example.  The attacks can be brief but disrupting. 

Half of the people over the age of 65 will develop a condition known as BPPV (medically known as Benign Positional Paroxysmal Vertigo).  This is a common and sometimes a disabling cause of dizziness that is readily diagnosed and treated.  BPPV may be suspected by careful history and confirmed by appropriate physical examination. Pharmacologic therapy is of little benefit and exercise therapy is curative in over 90% of patients!

BPPV is caused by crystals that are normally found in one part of the inner ear migrating to another part.  Moving the head activates the displaced crystals and they send a message to the brain that brings dizziness.  The inner ear is not only for hearing; it's also for balance.  The crystals can be brought back to their original site through a series of movements called the Epley repositioning maneuvers. 

Other common causes of Vertigo also include Meneire’s, Perilymphatic Fistula, and Migraine Headaches among others.

Most patients experience similar symptoms regardless of the cause of their Vertigo.  These can include: imbalance, unsteady gait, head movement sensitivity, visual  motion sensitivity, disequilibrium in the dark or on uneven surfaces just to name a few. 

Physical Therapy can greatly improve (and in over 90% of patients actually cure!) Vertigo symptoms through the use of “Vestibular Rehabilitation”.  Techniques that Physical Therapists use in this form of rehab include exercises such as ankle sways and focus head turns.  Physical Therapists also use different maneuvers to treat Vertigo such as: the Epley Maneuver (as mentioned above), the Brandt-Daroff Treatment, and the Semont Liberatory Maneuver. 

The type of treatment the Physical Therapist chooses depends upon the underlying cause of the Vertigo, which is determined after careful examination of the patient by the Therapist.  A treatment plan is then devised and acted upon in the same visit.  Our Therapists have found great success with the use of the Epley Maneuver and are well trained in it’s technique.

If you or someone you know is suffering from Vertigo, give us a call today!  You will be very surprised how effective Physical Therapy can be with this problem!

For more information on Vertigo and the Epley Maneuver, click the links below:

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