By Professional Physical Therapy with Marissa Lynn, PT, DPT
Vertigo and Dizziness are often used interchangeably, but they describe different sensations. Dizziness is the feeling of being lightheaded, loss of balance, or unsteady. Vertigo is not the same as being lightheaded. Vertigo is less common than dizziness and makes people feel as though they are spinning, or moving, or that the world is spinning around them.
Both conditions affect people of all ages, but older adults are more likely to experience dizziness or vertigo. The symptom of dizziness is the number 3 reason individuals over the age of 65 seek medical attention and the number one reason for individuals over the age of 70. Symptoms of dizziness can include visual disturbance, imbalance, nausea, vomiting, reduced ability to focus and fatigue.
Older adults are also at greater risk for fractures and major injuries from a fall caused by imbalance. Each has different causes. Let’s break it down.
Causes of Dizziness
Dizziness occurs for a variety of reasons, including but not limited to:
- Poor blood circulation
- Inner ear disorders & injuries
- Neurological conditions
- Low blood sugar
- Certain medications
- Injury to the spine, neck, head, hips, knees, and/or feet
Causes of Vertigo
Vertigo can be classified into 2 main types with varying causes.
- Peripheral vertigo: typically associated with an issue in the inner ear. Most commonly known as Benign Paroxysmal Positioning Vertigo (BPPV).
- Central vertigo: indicates a problem with the brain, usually in the back part (the cerebellum).
Other possible vertigo causes include:
- Blood vessel disease
- Certain medications
- Meniere Disease
- Migraine headaches
- Multiple sclerosis
- Tumors or any type of lesion that interferes with the brain’s ability to process balance information coming from the inner ears.
What is BPPV?
Benign Paroxysmal Positioning Vertigo or BPPV is the most common cause of vertigo. It accounts for 50% of dizziness in patients over the 65. The cause is related to an inner ear disorder where tiny calcium crystals come loose from their normal location in the inner ear. Symptoms include brief (typically less than 1 minute) of vertigo associated with head changes. For example, intense dizziness can be triggered when:
- Looking up
- Bending over
- Rolling over in bed
- Lying down
Treatment includes repositioning maneuvers and exercises to move the crystals back to the proper location.
Is Hereditary a Cause of Vertigo?
According to the medical experts, vertigo is not necessarily hereditary, but there can be symptoms of various conditions that run-in families. For example, a history of ear infections and other related diseases could help assess your risk of developing vertigo later in life.
Scientists recently discovered six gene variants that could cause a person to have a predisposition to vertigo. This could prove to be a big breakthrough in understanding vertigo and who is more likely to suffer from it, but the research is still ongoing.
Physical Therapy Treatment Options
If you are experiencing dizziness or vertigo, your doctor or physical therapist can examine your physical limitations and discomfort caused by vertigo and dizziness symptoms. A physical therapist certified in Vestibular Rehabilitation Therapy (VRT) is trained to assess your inner ear organs and treat the problem. The exact treatment plan will depend on the root cause of your condition. Below are just some of the physical therapy treatments available:
- Vestibular Rehabilitation Therapy (VRT), is a specialized form of therapy that includes an exercise-based program to reduce vertigo and dizziness, reduce gaze instability, and/or reduce imbalance and fall risk. This can include motion sensitivity/positional sensitivity, compensation techniques for permanent vestibular lesions, reprogramming of eye movements, adaption techniques and Brandt- Daroff exercises, Canalith Repositioning and Semont Maneuver for BPPV.
- Strength, flexibility, and mobility exercises
- Coordination and balance exercises
- Strategies to cope with dizziness when it occurs
- Training for common activities (i.e., vacuuming or dusting) to reduce the occurrence of the symptom
- Education on lifestyle changes, i.e., avoiding alcohol, caffeine, and salt
Getting Recovery Started at Professional PT
Physical Therapist are movement experts who improve quality of life through hands-on care, patient education, and prescribed movement. If you are experiencing vertigo or dizziness, here’s what to expect at your appointment with one of our specialists.
- A thorough evaluation of your strength, flexibility, balance
- Discussion regarding nutrition
- Assessment of environmental risk factors
- Assessment of gait assistive device
- Vestibular assessment
- Posture assessment
- Gait assessment
- Advice regarding appropriate therapeutic exercises based on findings
- Shoe/orthotic assessment
Our highly trained staff are here to properly evaluate and quickly identify your vertigo and dizziness concerns giving you the confidence to get you back to doing the things you love. If you want to consult with one of our skilled physical therapists, visit Professional Physical Therapy.
Choose PT: Physical Therapy Guide to Vertigo
Healthline: How to Tell the Difference Between Dizziness and Vertigo
Penn Medicine: Vertigo
Medical News Today: Everything You Need to Know About Vertigo