Dizziness Vs. Manual Physical Therapy: The Results Are In

posted at February 23, 2012

Manual Physical Therapy Helps Resolve Common Causes of Dizziness

By Sandy VanHooydonk PT, DPT, COMT, Results Physiotherapy – Brentwood

Dizziness is a frightening experience, conjuring fears of falling, worries about possible stroke, and can also be significantly limiting in the ability to perform your normal daily activities.  However two of the most common causes of dizziness can be treated by physical therapy.

BPPV
Benign Paroxysmal Positional Vertigo, or BPPV, can be immediately eliminated with one or two visits to the physical therapist. This form of dizziness is triggered by movements such as: rolling over in bed, getting out of bed, looking up, or looking down. Patients report a spinning sensation, occasionally with nausea and imbalance, which typically lasts 30-60 seconds. The cause in simple terms is small crystals in your inner ear get out of place causing you to feel dizzy.  The clinical explanation is that calcium carbonate crystals called otoliths have migrated from the utricle of the inner ear into the semicircular canals, where they float freely or stick to a structure called the cupula, affecting the flow of endolymph fluid.No matter what the explanation the person dealing with BPPV feels horrible.

Common Causes of BPPV
BPPV may occur for no reason at all, but is more common after a head trauma such as a car accident or a fall, or prolonged head-tilt, as one might experience at the dentist or hairdresser.  It is more common in women than men, in middle and advanced age. BPPV will typically resolve in 2-6 months without treatment, but can be resolved in 90% of patients with 1, (occasionally 2), 5-minute procedures in an outpatient physical therapy clinic, without drugs, x-rays, or surgery.

Success Rate with One Treatment
It is estimated that 30-50% of dizziness is related to the inner ear. If your therapist suspects you have BPPV after asking you several questions about your dizziness, they will perform a few quick tests to confirm their suspicion. If you test positive, your therapist will guide you through a series of positioning maneuvers, referred to as a modified Epley maneuver, to return the crystals back into the appropriate portion of the ear canal where they will no longer cause symptoms.  Studies show an 80-100% success rate in eliminating symptoms with one treatment using this maneuver.  Some patients need a second treatment, and most therapists will want to follow up in one week and again at one month to ensure that the problem has not returned.

Cervical Vertigo
Another cause of dizziness that is easily treated by a physical therapist is cervicogenic dizziness, commonly referred to as Cervical Vertigo.  People with this condition often complain of lightheadedness, floating, or rocking, which is worse during head movements or sustained neck positions. These symptoms usually occur after the onset of neck pain and are often accompanied by a headache. The symptoms of dizziness can last from minutes to hours.

Several studies have reported that approximately 75% of patients with cervicogenic dizziness improve with conservative treatment of the neck such as medication, gentle mobilization through “Hands-On” manual therapy, exercise, and instruction in proper posture and use of the neck. Frequently the combination of vestibular retraining along with neck treatment is required to completely resolve these symptoms.

Other Causes of Dizziness
Other causes of dizziness are defined as medical, which includes problems with blood pressure, problems with blood sugar as in diabetes, and medications.  Neurological causes of dizziness can include problems with the central nervous system, vascular problems and visual problems.  Other categories include psychiatric and undiagnosed dizziness.

We Can Help!
Every Results Physiotherapy clinic has a therapist that has been through specific training in the treatment of BPPV and cervicogenic dizziness.  If you have been experiencing these symptoms or know someone else who has, it is time that you contacted Results for an evaluation. Most health insurances now allow individuals to self-refer to physical therapy without a referral from a physician.

To find a Results Physiotherapy clinic near you visit our locations page or call 800-888-0531.

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