Is your dizziness treatable?

Understanding Dizziness and Its Treatment

One of the more challenging yet rewarding disorders to treat as a physical therapist is dizziness. Did you know that dizziness is so debilitating that it is the number one reason adults over the age of 65 visit a physician? After pain, dizziness and unsteadiness are the next most frequent medical complaints. Many individuals also experience loss of balance and falls, highlighting the severity of the issue.

Types of Dizziness

Patients with dizziness can be classified into one of three subtypes:

Vertigo
Presyncope
Dysequilibrium

1. Vertigo

Vertigo is a false sensation of movement, often described as spinning. It usually indicates a vestibular system dysfunction and can be either peripheral or central in origin. The most common peripheral vestibular disorder is benign paroxysmal positional vertigo (BPPV).

BPPV occurs when sedimentous material is released into the endolymphatic fluid or disrupts the normal flow within the semicircular canals of the inner ear. This can be caused by trauma, such as a motor vehicle accident, or by degenerative changes. The dislodged material becomes sensitive to gravity and head positioning, leading to dizziness.

A key symptom of BPPV is nystagmus, an involuntary eye movement that occurs in a unidirectional pattern but is never vertical.

BPPV often occurs alongside cervicogenic dizziness, which originates from the cervical spine. It can be effectively diagnosed and treated using the Dix-Hallpike test and the Epley maneuver.

2. Presyncope

Presyncope differs from vertigo as it is a feeling of faintness rather than movement. It results from inadequate oxygen, blood, or glucose reaching the brain. Common causes include:

Arrhythmia
Carotid stenosis
Postural hypotension

3. Dysequilibrium

Dysequilibrium is an altered sense of balance without vertigo. It is often experienced while standing or walking and may be triggered by eye, head, or body movement.

Two common causes of dysequilibrium include:

Vertebral Basilar Artery Insufficiency (VBI)
Cervicogenic Dizziness (originating from the cervical spine)

Many individuals with dizziness report worsened symptoms with cervical motion rather than whole-body movement. These individuals may also experience nystagmus, neck pain, suboccipital headaches, and reduced cervical mobility.

Treatment Approaches

Manual therapy is an effective treatment for cervicogenic dizziness. This hands-on therapy aims to:

Restore joint mobility
Reduce muscle spasms
Relieve trigger points of pain in the cervical musculature

These techniques are especially beneficial when dizziness is triggered by neck movement.

Contact a Specialist

For expert treatment of dizziness and balance disorders, contact Therapeutic Rehab Specialists at:

📍 Pinellas Park – (727) 470-6070
📍 Lakeland & Brandon, Florida – (813) 876-8771

For more information, reach out to Anthony Pribila, PT, DSc, CMPT, CMP, CEAS at (813) 876-8771.