Why Vestibular Physical Therapy?

About 40% of the general population experiences dizziness, with about 30% of those having significant enough symptoms to interfere with daily activities. 1 , 2. Of all the people experiencing dizziness, a majority of them are never referred for treatment or testing. 3. Those that are seen by the emergency department or by a primary care physician are often given medication and diagnosed with vertigo, rather than given a cause of their symptoms. Medication can be useful with some diagnoses such as using steroids in the first couple days of a vestibular neuritis, in the case of vestibular migraines, with anxiety, and some other conditions. However, physical therapy is the first and best treatment of choice. 4. Medications given to reduce symptoms such as nausea can have a negative effect on the recovery from dizziness, suppressing your brain’s ability to adapt. 5. BPPV can often be resolved within 1 visit, vestibular neuritis or cervicogenic dizziness can be resolved within a couple of weeks, and dizziness/imbalance with vestibular migraines can reduced or resolved.

Vestibular physical therapy can help find the root cause of your vertigo and provide treatment right away, instead of waiting months going through multiple doctors and spending thousands of dollars before you find any solutions.

The vestibular system, visual system, and somatosensory system (ability to feel the weight shift in feet in this instance) all contribute to balance. Often when dizziness or difficulty with balance is involved, there has been a disruption in how sensory information is being received. Either there has been damage to the sensory system itself (a peripheral problem), or how the brain processes the sensory information (central problem). Often a peripheral problem can lead to a central problem, as the brain will prioritize one system over another, which can lead to over reliance, such as visual dependency. Vestibular rehabilitation focuses on changing how the brain prioritizes sensory information to regain a sense of equilibrium and reduce feelings of dizziness or unsteadiness. A recent study was done showing a significant reduction in falls and improvement in balance after participating in vestibular rehab. 6.

Untreated vestibular dysfunction can lead to chronic dizziness disorders like Persistent Postural Perceptual dizziness, anxiety, or fear avoidance behaviors.

If you are experiencing dizziness or imbalance, know that this is not a normal age related change and that there is something you can do about it! Find a vestibular physical therapist near you that can help reduce your dizziness and improve your stability.

1. Teggi, R., Manfrin, M., Balzanelli, C., Gatti, O., Mura, F., Quaglieri, S., Pilolli, F., Redaelli de Zinis, L. O., Benazzo, M., & Bussi, M. (2016). Point prevalence of vertigo and dizziness in a sample of 2672 subjects and correlation with headaches. Prevalenza dei sintomi vertigine e instabilità in un campione di 2672 soggetti e correlazione con il sintomo cefalea. Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale, 36(3), 215–219. https://doi.org/10.14639/0392-100X-847

2. Yardley, L., Burgneay, J., Andersson, G., Owen, N., Nazareth, I. and Luxon, L. (1998), Feasibility and effectiveness of providing vestibular rehabilitation for dizzy patients in the community. Clinical Otolaryngology & Allied Sciences, 23: 442-448. doi:10.1046/j.1365-2273.1998.00179.x

3. Prevalence and presentation of dizziness in a general practice community sample of working age people.

   L Yardley, N Owen, I Nazareth, L Luxon

   British Journal of General Practice 1998; 48 (429): 1131-1135.

4. Hain, T. C., & Uddin, M. (2003). Pharmacological treatment of vertigo. CNS drugs, 17(2), 85–100. https://doi.org/10.2165/00023210-200317020-00002.

5. Soto, E., & Vega, R. (2010). Neuropharmacology of vestibular system disorders. Current neuropharmacology, 8(1), 26–40. https://doi.org/10.2174/157015910790909511.

6. Rossi-Izquierdo, M., Gayoso-Diz, P., Santos-Pérez, S., Del-Río-Valeiras, M., Faraldo-García, A., Vaamonde-Sánchez-Andrade, I., Lirola-Delgado, A., & Soto-Varela, A. (2018). Vestibular rehabilitation in elderly patients with postural instability: reducing the number of falls-a randomized clinical trial. Aging clinical and experimental research, 30(11), 1353–1361. https://doi.org/10.1007/s40520-018-1003-0