Healthy Living

Feeling dizzy or unbalanced? Vestibular physical therapy could help

A variety of medical conditions and injuries, including concussions, can interfere with a person's natural sense of bala
A variety of medical conditions and injuries, including concussions, can interfere with a person’s natural sense of balance. A branch of physical therapy, vestibular therapy, uses specific movements and exercises to help address balance issues and the vertigo, dizziness and nausea that can often result. (Adobe Stock image)

From the time we each take our first steps as toddlers, we learn how to balance our bodies as we stand, walk and move around each day. We seldom give our ability to move around a second thought.

It’s an amazing system that works well — until it doesn’t due to a medical condition, low blood pressure, an accident, a concussion or other injury.

A specialty within physical therapy, called vestibular therapy, can help patients struggling with vertigo, dizziness or other balance issues.

Much of our sense of balance depends on our eyes and ears working in tandem. When a problem arises that compromises that system, it can be debilitating.

“It’s your automatic balance system. It tells you which way is up, which way is down and keeps your vision clear while you’re moving,” said Rene’ Crumley, senior physical therapist at UnityPoint Health-St. Luke’s Hospital in Cedar Rapids.

“If you were to stand on an uneven surface in the dark, for example, your inner ear is all you’ve got,” she said.

Problems in the system can cause dizziness, lack of balance and nausea. Vestibular therapy, which involves specific movements and exercises, can provide relief.

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“Many patients have seen five or six providers before they come in,” Crumley said. “When they can be helped by a simple treatment, it’s almost like a miracle.”

One of the most common conditions she treats is positional vertigo, which can be caused by tiny calcium carbonate crystals breaking loose and floating in the inner ear. This can happen spontaneously or as a result of trauma like a car accident.

To put the crystals back in place, Crumley performs tests to determine their location and then attempts to put them back where they belong by guiding patients through repositioning maneuvers.

Patients receiving treatment for vertigo often can be helped after just a few sessions. Other conditions take more time to treat.

Christopher Cass, a physical therapist with Rock Valley Physical Therapy in Cedar Rapids, said conditions like vestibular hypofunction, meaning weakness, might take a few weeks to treat.

“Exercises like balance training, where we ask patients to stand in a corner with their feet together, challenge the vestibular system to work a little harder,” he said.

Similar to other types of physical therapy, the focus for treating conditions like this is on improving a patient’s strength.

“Over time, this system can get stronger,” Cass said.

Other conditions that can be treated by vestibular therapy include vestibular migraines and Meniere’s disease — a rare condition resulting from problems with the fluid in the inner ear.

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Vestibular therapy also can help people recover from symptoms accompanying a concussion, when trauma to the brain interferes with the balance “signals” sent to our bodies.

Crumley helps patients determine what condition is causing their symptoms.

“It’s rewarding when you can figure out the puzzle and help people,” she said.

Treatment plans vary greatly depending on the patient, the cause of their condition and how severely they’re affected.

“Some people are very bothered, and others aren’t — it varies a lot,” Crumley said.

Even when therapy isn’t curative, physical therapists can recommend exercises — many of which can be continued at home — that help prevent further decline.

Cass said educating patients about their condition is an important part of the treatment process.

“The more we’re able to educate patients, the more empowered they feel,” he said.

Patients, he said, are more likely to keep up home exercises if they understand the importance.

Since many people aren’t aware they have this important system connecting their eyes and ears, he answers questions to help patients learn how to keep this system healthy.

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“Most patients want to know more — education helps them take control of their care.”

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