Vertigo Relief - Understanding and Managing Dizziness with Physiotherapy
▫️Written by John Keller
✅ Reviewed by Dr. Jenny Hynes on May 3, 2024
Vertigo is a specific type of dizziness characterized by a sensation of spinning or movement, often caused by issues in the inner ear or the brain. It's distinct from general dizziness, which can refer to a broader range of sensations like lightheadedness or unsteadiness without the perception of movement. The key difference lies in the perception of motion: vertigo involves a false sense of spinning or motion, while dizziness can encompass various sensations of unsteadiness or imbalance.
These conditions are highly relevant in everyday activities and can significantly impact quality of life. Vertigo, in particular, can lead to falls, affect the ability to drive or operate machinery safely, and cause anxiety or fear of experiencing sudden episodes. Dizziness, on the other hand, can result in decreased productivity, limitations in physical activities, and increased risk of accidents, especially in older adults.
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Understanding the distinction between vertigo and dizziness is crucial for accurate diagnosis and appropriate management, as treatment approaches differ. Therefore, raising awareness about these conditions and their impact is essential for improving outcomes and enhancing the quality of life for individuals affected by vertigo and dizziness.
What Causes Vertigo?
Vertigo can be caused by various factors, often related to inner ear problems. One common cause is Benign Paroxysmal Positional Vertigo (BPPV), which occurs when tiny calcium particles called canaliths clump up in the inner ear canals, affecting the sense of balance. Meniere's disease, another inner ear disorder, can also lead to vertigo episodes due to fluid buildup and changes in pressure within the ear.
Lifestyle factors and medical conditions can trigger or worsen vertigo symptoms. Stress, lack of sleep, and certain medications can contribute to vertigo attacks. Additionally, medical conditions such as migraines, vestibular neuritis (inflammation of the vestibular nerve), and acoustic neuroma (a noncancerous growth on the vestibular nerve) can all be underlying causes of vertigo.
It's important to note that vertigo is a symptom rather than a disease itself, and identifying the underlying cause is crucial for appropriate treatment. Lifestyle modifications, such as stress management and regular sleep patterns, along with medical interventions tailored to the specific cause, can help manage and reduce the frequency of vertigo episodes.
Recognising the Signs of Vertigo?
Vertigo is characterized by a false sensation of spinning or movement, often accompanied by symptoms such as dizziness, lightheadedness, nausea, and imbalance. The primary distinguishing feature of vertigo is a spinning sensation, as if the world around you is moving or tilting, even when you are stationary.
Vertigo episodes can vary in duration and intensity. Some people may experience brief, mild episodes, while others may have more severe and prolonged bouts. Episodes of vertigo can be triggered by changes in head position, such as looking up or turning over in bed, or they can occur spontaneously.
Identifying vertigo episodes is crucial for safety and wellbeing. During an episode, individuals may feel disoriented or unsteady, leading to an increased risk of falls or accidents. Activities that require balance, such as driving or operating machinery, should be avoided during a vertigo episode to prevent injury.
In addition to the physical symptoms, vertigo can also have a significant impact on emotional wellbeing. The unpredictability of vertigo episodes can lead to anxiety, fear, and a decreased quality of life. Seeking medical attention for proper diagnosis and management is essential for improving safety and quality of life for individuals experiencing vertigo symptoms.
Can Vertigo be Prevented?
While it may not be possible to prevent all cases of vertigo, there are steps individuals can take to reduce their risk and minimize the impact of vertigo episodes. Here are some tips and advice:
Maintain a Healthy Lifestyle: Eating a balanced diet, staying hydrated, and exercising regularly can help improve overall health and reduce the risk of conditions that can lead to vertigo, such as obesity and cardiovascular disease.
Manage Stress: Stress can exacerbate vertigo symptoms, so practicing stress management techniques such as mindfulness, yoga, or meditation can be beneficial.
Avoid Triggering Factors: Identify and avoid factors that can trigger vertigo episodes, such as certain head movements or positions, excessive alcohol consumption, and smoking.
Stay Active: Regular physical activity can improve balance and coordination, reducing the risk of falls during vertigo episodes.
Get Regular Check-ups: Regular medical check-ups can help identify and address underlying health issues that may contribute to vertigo, such as high blood pressure or inner ear disorders.
Be Mindful of Medications: Some medications can cause dizziness or vertigo as a side effect, so it's important to discuss any concerns with a healthcare provider and review medication use regularly.
Practice Good Sleep Habits: Getting enough restful sleep is important for overall health and can help reduce stress and improve balance.
While these measures can help reduce the risk of vertigo, it's important to consult with a healthcare professional for personalized advice and to address any underlying medical conditions that may contribute to vertigo.
Diagnosing and Treatment Options for Vertigo
Proper diagnosis of vertigo is crucial for determining the appropriate treatment. Healthcare providers may use a variety of tests to identify the underlying cause of vertigo, including:
Physical Examination: This may include assessing balance, coordination, and eye movements to help pinpoint the source of the vertigo.
Dix-Hallpike Maneuver: A diagnostic maneuver used to diagnose BPPV by observing the characteristic eye movements (nystagmus) that occur when the head is moved into specific positions.
Videonystagmography (VNG): A test that measures involuntary eye movements to assess inner ear and central motor functions related to balance.
MRI or CT Scan: Imaging tests that can help identify structural issues in the brain or inner ear that may be causing vertigo.
Blood Tests: These may be done to check for conditions such as anemia or infection that could be contributing to vertigo.
Treatment options for vertigo depend on the underlying cause and may include:
Medication: Medications such as vestibular suppressants (e.g., meclizine) or anti-nausea drugs (e.g., ondansetron) may be prescribed to alleviate symptoms.
Vestibular Rehabilitation: A type of physical therapy that focuses on exercises to improve balance and reduce dizziness.
Canalith Repositioning Maneuvers: Techniques like the Epley maneuver can help move canaliths (calcium particles) in the inner ear to alleviate symptoms of BPPV (Fife & von Brevern, 2008)
Surgery: In some cases, surgery may be recommended to correct underlying structural issues in the inner ear or brain.
Lifestyle Changes: Avoiding triggers, such as caffeine or alcohol, and maintaining a healthy diet and regular exercise routine can help manage vertigo symptoms.
Proper diagnosis and treatment can greatly improve quality of life for individuals with vertigo, highlighting the importance of seeking medical attention for persistent or severe symptoms.
The Effectiveness of Physiotherapy in Treating Vertigo
Physiotherapy, particularly vestibular rehabilitation, is a highly effective treatment for vertigo, especially when it is caused by inner ear issues such as BPPV or vestibular neuritis. Vestibular rehabilitation aims to improve balance and reduce dizziness by promoting the brain's ability to compensate for inner ear deficits through specific exercises and maneuvers.
Research has shown that vestibular rehabilitation can significantly reduce vertigo symptoms and improve balance and quality of life. For example, a study published in the Journal of Neurology, Neurosurgery & Psychiatry found that patients with chronic unilateral vestibular hypofunction who underwent vestibular rehabilitation had significant improvements in balance and gait compared to those who did not receive rehabilitation (Balaban, 2004).
Another study published in the Journal of Vestibular Research showed that patients with BPPV who underwent a single session of canalith repositioning maneuvers, a common component of vestibular rehabilitation, experienced immediate resolution of vertigo in 80-90% of cases (Meldrum, D., & McConn-Walsh).
Patient testimonies also highlight the effectiveness of vestibular rehabilitation. Many individuals report a significant reduction in vertigo symptoms, improved balance, and increased confidence in daily activities after completing a course of vestibular rehabilitation.
Overall, physiotherapy, especially vestibular rehabilitation, is a highly effective treatment for vertigo, offering many patients significant relief and improved quality of life.
Conclusion
In summary, physiotherapy, particularly vestibular rehabilitation, is a highly effective treatment for vertigo, offering significant relief and improved quality of life for many patients. Research has shown that vestibular rehabilitation can reduce vertigo symptoms and improve balance and confidence in daily activities. Patient testimonies also highlight the positive impact of vestibular rehabilitation on managing vertigo symptoms.
If you are experiencing vertigo, it is important to consult with a physiotherapist for a personalized approach to treatment. A physiotherapist can assess your condition, identify the underlying cause of your vertigo, and develop a tailored treatment plan to address your specific needs. With the right treatment and support, you can manage your vertigo symptoms and improve your quality of life.
Don't let vertigo hold you back. Consult with a physiotherapist today and take the first step towards a healthier, more balanced life.
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Article by
John Keller
Clinical Director | Sports & Musculoskeletal Physiotherapist
John graduated as a Physiotherapist from the Auckland University of Technology with the John Morris memorial prize for outstanding clinical practise in 2003. John has since completed Post Graduate Diplomas in both Sports Medicine and Musculoskeletal Physiotherapy with distinction, also collecting the Searle Shield for excellence in Musculoskeletal Physiotherapy.
Reviewed by
Dr. Jenny Hynes FACP
Clinical Director | Specialist Musculoskeletal Physiotherapist
Jenny sat extensive examinations to be inducted as a fellow into the Australian College of Physiotherapy in 2009 and gain the title of Specialist Musculoskeletal Physiotherapist, one of only a few physiotherapists in the state to have done so.