Dizziness and Vertigo

About Dizziness

Dizziness is a general term that is often used to describe a variety of sensations including spinning, lightheadedness or even unsteadiness. Among all age groups, dizziness is the third most common complaint people bring to their physician. Many conditions can cause dizziness including: 

• Disruption of the inner ear (vestibular system)
• Trauma to the head or neck
• Problems with blood pressure or the heart
• Peripheral neuropathy (changes in sensation—particularly your lower legs and/or feet)
• A stroke or brain tumor
• Migraines

The most common and curable cause of dizziness is a condition known as Benign Paroxysmal Positional Vertigo (BPPV). About 20% of all dizziness is due to BPPV and about 50% of all dizziness in older adults is due to BPPV. The condition renders a brief sense of movement, a room spinning sensation similar to a merry-go-round. Although benign, the sensation can be very disturbing and can interfere with work and activities of daily life. In an older adult, BPPV can cause balance disturbances and increased fall risk. 

A feeling of disequilibrium or unsteadiness is often a consequence of dizziness, especially in older patients. This sensation is often resolved once the symptoms of dizziness have resolved, but sometimes further assessment and treatment of balance may be helpful to ensure decreased fall risk. For older adults, it may be necessary to use a cane or walking stick until these symptoms of unsteadiness are fully resolved. 

What to Expect at Your First Visit

A typical evaluation begins with a detailed history of your symptoms related to dizziness. Your balance will be assessed to determine the impact of the dizziness on your stability, and a thorough oculomotor and vestibular system (inner ear) exam is performed by using our infrared video goggles. This allows us to visualize any eye movements that can provide us with information on how the vestibular system is working. Other evidence-based walking tests may be performed as well. Any results from testing performed outside our clinic may be obtained to use in conjunction with our findings to help determine the most effective treatment for you. Depending on the cause of your symptoms, we may begin treatment on your first day.

What to Expect During Treatment

Based on the results of your evaluation, your physical therapist will create an individualized treatment plan to improve your symptoms. Treatment for BPPV will include canalith repositioning maneuvers, while treatments for other causes of dizziness may include specific eye and head movements and balance training to improve your inner ear’s function and tolerance to movements.