Vertigo: Can Physiotherapy Help?



Over the last couple months I have been seeing quite a few clients in the clinic presenting with episodes of dizziness or vertigo.



When most people experience vertigo, it comes on quickly and can leave one feeling completely disoriented with both dizziness and nausea.



This commonly results in a visit to the GP or Emergency Room. Anti-nausea medications may be prescribed to help ease initial symptoms.


From there one is instructed to limit movements that bring on their dizziness and go to see a Physiotherapist who specializes in treating dizziness.


So, yes, Physiotherapists can treat and help you manage your vertigo.




What is vertigo (also known as Benign Paroxysmal Positional Vertigo)?



Benign Paroxysmal Positional Vertigo (BPPV) is a condition characterized by episodes of dizziness (vertigo) lasting from 1-60 seconds. Episodes may be followed by lightheadedness and imbalance.


Episodes are brought on with rapid changes in head position relative to gravity (such as turning the head, looking up or down). BPPV may be accompanied by nausea and vomiting, which can last for several hours. Symptoms usually resolve spontaneously with 1-2 weeks but may persist for months.


BPPV is a disorder of the inner ear that happens when tiny crystals of calcium carbonate shift or move within the inner ear. Dizziness occurs when the crystals are displaced from the utricle to the semicircular canals. Dizziness stops once the crystals stop moving.



How do the crystals become displaced?

  • Injury to the utricle (location where the crystals are normally located)

  • Infection of the inner ear

  • Inflammation of the inner ear

  • Advanced age.


Other causes of vertigo include:

  • Head trauma

  • Labyrinthinitis

  • Vertebrobasilar ischemia

  • Middle ear surgery

  • Prolonged bed rest

  • Meniere’s disease

  • Minor strokes

  • Viruses (e.g. vestibular neuritis)


In 50% of all cases vertigo there is no determined cause.



Activities that bring on vertigo vary from individual to, but may include some of the following:

  • Change in the position of the head with respect to gravity.

  • Getting out of bed

  • Rolling over in bed

  • Looking up/tipping the head back

  • Tilting head back at the hair salon when getting hair washed



20% of all cases of vertigo is due to BPPV.


That leaves 80% of vertigo or dizziness not due to BPPV.



As Physiotherapists we often find that in those that experience vertigo there are signs of neck tension and restricted movement of the neck. One side of the neck may be significantly more restricted than the other. This may be a contributing factor to one’s experience of dizziness, particularly if it is not “true” BPPV based on the diagnostic test done in the clinic known as the Dix-Hallpike Test.


In the clinic Brendan is experienced in assessing vertigo using the Dix-Hallpike test and subsequent treatment with Epley’s maneuver. Vertigo is often self-limiting and can resolve spontaneously, but for some it may persist and it is those that will require further intervention, such as Physiotherapy. Your physiotherapist can also teach you how to treat yourself at home if you have recurrent episodes of vertigo.


If you would like to know more about how Physiotherapy may help vertigo get in touch with Brendan at brendan@redohealth.com.au




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