15 Apr How can physiotherapy treat dizziness?

Do you regularly feel dizzy? Are you wondering how physiotherapy can treat dizziness?

Dizziness accounts for an estimated 5 percent of primary care clinic visits. Diagnosing the cause of dizziness can be difficult because symptoms are often nonspecific and the differential diagnosis is broad.

However, a few simple questions and physical examination tests can help narrow the possible diagnoses. A medical and medication history is necessary to rule out the cause of dizziness as some medications have dizziness as a side effects.

Recent head trauma, whiplash, use of alcohol, nicotine and caffeine need to be ruled out as the cause of dizziness as well! Once these questions have been cleared and have no association to the patient’s dizziness, we can proceed to further narrowing the cause of dizziness.

Dizziness can be classified into one of four categories: vertigo, disequilibrium, presyncope, or light-headedness.

Vertigo

Vertigo is the feeling that you’re moving, even when you are not.

Vertigo will present with a false sense of motion, possibly spinning sensation.

There are two types of vertigo where physiotherapy can help: migrainous/tension vertigo, and benign paroxysmal positional vertigo.

 Migrainous or tension vertigo

If you have tension vertigo, you will present with symptoms of vertigo associated with a migraine attack or tension headache
Treatment: if vertigo is minimal gentle mobilisation, postural correction can help. This can be completed in clinic by your physiotherapist, with ongoing exercises prescribed.

Benign paroxysmal positional vertigo (BPPV)

Episodes of dizziness and a sensation of spinning with certain head movement.

This form of vertigo is usually triggered by specific changes in the position of your head. This might occur when you tip your head up or down, when you lie down, or when you turn over or sit up in bed, and it only last for around 30s.

Treatment: Dix-Hallpike maneuver which should only be performed by a trained doctor or physiotherapist. Do not self perform this test at home. 

The other forms of vertigo where a GP treatment is recommended are vestibular neuritis, labyrinthitis, and meniere disease.

Vestibular neuritis (viral infection of the vestibular nerve)

If you are suffering vestibular neuritis, you will present with persistent vertigo lasting all day or long period

Treatment: seek treatment with your GP to treat the viral infection

Labyrinthitis (infection of the labyrinthine organs)

If you are suffering labyrinthitis, you will also present with persistent vertigo lasting all day or long period and has hearing loss

Treatment: seek treatment with GP to treat infection

Meniere disease (increased endolymphatic fluid in the inner ear)

If you are suffering meniere disease, you will present with progressive hearing loss and episodic vertigo

Treatment: seek treatment with GP and may need referral to ENT specialist for further testing

Disequilibrium

Disequilibrium is an unsteadiness or imbalance, often accompanied by spatial disorientation

If you have disequilibrium you will present with being off-balance or suffering wobbliness.

Possibility: Stroke, Peripheral neuropathy (Weakness, numbness and pain from nerve damage, usually in the feet) or Parkinson’s disease

Physiotherapy will assist with strengthening, assessment of gait, balance and help to teach coping strategies to manage symptoms.

Presyncope

If you have presyncope you will present with feelings of losing consciousness or blacking out, but consciousness is maintained.

Possibility: Cardiovascular causes of dizziness include arrhythmias, myocardial infarction, carotid artery stenosis, and ortho-static hypotension (drop in blood pressure)

Treatment: seek treatment with a doctor immediately

Light-headedness

If you have lightheadedness, you symptoms may be vague, possibly feeling disconnected with the environment

Possibility: anxiety Attack, panic disorder or depression can present with light-headness

Treatment: seek treatment with a doctor

If you are currently suffering from dizziness, we recommend booking an appointment with your doctor or physiotherapist.

Need to book an appointment with a physiotherapist at Redcliffe Physiotherapy? Book online here