As a physical therapist that treats persons with dizziness and balance deficits, I’ve come to realize that people do not know what to expect when they attend physical therapy (PT) for these issues. Due to the lack of exposure to this treatment and unfamiliarity with how it works, people come to their first session with trepidation and fear. So, let’s see what I can do to clear up some of your queries and give a more clear vision of what will occur in PT.
WHY DO PEOPLE GET DIZZY?
There are so many reasons! As I’ve previously mentioned in an earlier blog post, some of the reasons are:
• Inner ear dysfunction having to do with loose calcium deposits. This condition is called Benign Paroxysmal Positional Vertigo (BPPV)
• Nerve changes in the inner ear, often but not always associated with aging
• Fluid imbalance in the inner ear, called Meniere’s Disease
• Strokes in the part of the brain called the cerebellum
• On rare occasion, tumors
Each of these issues requires a different management strategy. Some are movements meant to shoo the calcium deposits out of the canals, and others are aimed at getting your brain used to, and less responsive towards, dizzying movements. That’s why it’s important to work with both your doctor and PT in an effort to maximize your success and initiate the process of understanding your unique scenario.
I GUESS I’LL COME TO PT TO WORK ON MY DIZZINESS. HOW DO YOU KNOW WHAT’S CAUSING IT?
The purpose of the initial evaluation is to better understand the nature of your dizziness. Physical therapists can help illuminate what the cause is and how the symptoms might be made better. The therapist will do an ocular examination, motion sensitivity testing, postural awareness testing, and dynamic balance testing in an effort to tease out the cause and identify the most dysfunctional systems. Included as well is positional testing of the inner ear to identify if there are loose crystalline bodies in the canals. Suffice it to say, people are varied and so too is their dizziness. So the first visit, and maybe the second or third, is aimed at giving a more clear picture as to the nature of the problem.
I HATE FEELING DIZZY. WILL MY THERAPIST MAKE ME DIZZY?
Sometimes. The path to solving a problem means that we might provoke the symptoms to understand the cause. This unfortunately means that, at times, persons will experience their dizziness in PT. It is always my recommendation that a person plans to give themselves a few minutes of rest after their first PT visit, like for example sitting or lying with their eyes closed for 10 minutes prior to leaving the clinic. I also encourage that they don’t attempt to drive for the remainder of that first day. Have a friend or cab driver on standby! The good news is that, once the problem and triggers are understood, the therapist and patient can work together to build a treatment program that allows for progressive and tolerable movement forward into greater life participation and less discomfort. As with all PT, the patient should feel better over time, and therefore the dizziness provoked in the clinic should be gradually less and less.
HOW LONG WILL IT TAKE TO FEEL BETTER?
It depends! As I imagine you’d guess by now, different problems have different time frames of healing. Recovery from a stroke can take months, while some forms of BPPV can improve in one to two visits. It’s dependent on the individual. You’re thinking, “How vague?!” To this I’d respond, “I know!” The key is to get the process moving, and start the work of healing. To that end, I encourage anyone with questions or the desire to live without dizziness to contact your doctor and therapist.
Elizabeth D’Annunzio Shah, PT, DPT, OCS, MTC works with patients of all ages and abilities including recreational athletes, professional dancers and performing artists. She has a special interest in vestibular and balance disorders, movement theory and creative solutions for both neurologically and musculoskeletally impaired persons. Elizabeth is passionate about exercise as a means to maintain health, manage stress and enjoy life! She practices yoga in the Iyengar tradition, is an avid surfer, and participates in distance running events whenever possible. (read more)