Vertigo and Physical Therapy
What is Vertigo?
Vertigo is a subtype of dizziness caused by dysfunction in the vestibular system which is responsible for sense of movement and balance located in the inner ear. Vertigo has been wrongly associated with fear of heights which is not true. When a patient feels that the objects and environment around them are moving it is called objective vertigo and when a patient feels like he / she is moving it is called subjective vertigo. Around 20-30% of the adult population is affected by a form of vertigo making it very common. Prevalence of vertigo has been noted in adults more than children with more number of cases reported in females.
There are two main causes of vertigo distinguished by the dysfunctional organ involved.
- Vertigo caused by a dysfunctional vestibular system located in the inner ear is called the peripheral or otologic or vestibular vertigo. Benign Paroxysmal Positional Vertigo (BPVV) and Meniere’s disease are peripheral vertigos.
- Vertigo that is caused by an injury to the Central Nervous System (CNS) is known as the central vertigo. The injury might be caused by a lesion in the brainstem causing illusion of movement, nausea, slurred speech and double-vision.
How physical therapy and exercise therapy can help?
Physical therapy has been effective in restoring loss of balance and movement impairment caused by vertigo amongst patients. BPVV is the most commonly observed vertigo related disorder which can be easily treated with physical or exercise therapy. Your physical therapist will put you through a series of tests such as rotation tests, head-thrust test, caloric reflex test and eye-head coordination tests to measure posture, balance and gait. A rehabilitation plan is developed depending on the severity of the condition. Exercises included in the rehabilitation plan are aimed at retraining the brain to recognize and process signals and coordinate with the vision system. Following are two of the most commonly used techniques for treating vertigo.
- The Epley manoeuvre
The Epley manoeuvre was developed by Dr. John M Epley who first called it the canalith repositioning. The concept behind this manoeuvre is to loosen and disperse the particles or crystals from the semicircular canal back into the appropriate area in the inner area. The manoeuvre is complex and can only be performed by a certified physical therapist or occupational therapist.
- Brandt-Daroff exercises
Depending on the patient’s test results, physiotherapists might recommend these self-supervised exercises to be performed at home. The exercise includes lying down on the bed in a specific position and controlling the vertigo symptoms. These exercises are performed without any specialized equipment and so can be easily done at home once your therapist gives you a go ahead.
Many patients suffer from vertigo for years when they can easily be treated with physiotherapy. If you suffer from dizziness see your therapist and get back to normal function in no time.