Physical therapy often best treatment for vertigo

Peggy Ussery
Media General News Service
Published: June 25, 2008

It’s been years since Boots Dutton first experienced vertigo.
She was in her 50s. It came on with nausea and the sensation of the room spinning. There didn’t seem to be a trigger for it, and she still feels the sensation from time to time. And when the vertigo returns, she becomes limited in what she can do.

 

Do you have a balance disorder?

 

A balance disorder can affect someone’s orientation.
  They can experience a room spinning, dizziness or staggering. While individual symptoms can be caused by other disorders, here’s a list of some symptoms that are common with a balance disorder: 

 

• A sensation of dizziness or vertigo (spinning)
  • Falling or a feeling of falling
  • Lightheadedness or feeling woozy
  • Visual blurring
  • Disorientation
  • Loss of balance
  • Sensitivity to light
  • Poor depth perception
  • Tinnitus (ringing, roaring, buzzing or other noises in the ear)
  • Difficulty concentrating
  • Forgetfulness and short-term memory lapses
  • Mental or physical fatigue out of proportion to activity level
  • Nausea or vomiting
  • Ear pain
  • Sensation of fullness in the ears
  • Headaches
  • Slurred speech

Sources: Vestibular Disorders Association, http://www.vestibular.org; National Institute on Deafness and Other Communication Disorders.  

“I can’t walk straight, and I don’t drive,“ Dutton said. “It’s just an awful sensation ... It’s just total drunkenness, and I didn’t enjoy it.“
She eventually went to see a physical therapist. After an evaluation, Dutton was taught very specific exercises to do at home to get her system back in balance.
“If I get up in the morning and feel dizzy, I do the exercises,“ Dutton said.
Often taken for granted, balance involves the body’s vestibular system — a network that relies on the eyes, brain, muscles, joints and inner ear all working together to keep us from toppling over. To do this, your body has to be able to properly take in information and then respond to it. Somebody pushes you, your balance system tells your body how to right itself.
Imbalance, dizziness and vertigo occur when this network breaks down. Most cases of vertigo are caused by inner ear problems that lead to swelling and inflammation. Head injuries can bring on vertigo, although 80 to 90 percent of true vertigo is caused by benign paroxysmal positional vertigo, known as BPPV.
“It can come from something as simple as bending down and twisting your head to get clothes out of the dryer,“ said Chris Walsh, a registered physical therapist with Physician’s Balance Center at ENTcare in Dothan.
Many people suffer with vertigo. Medication works temporarily, but that spinning returns. Some suffer believing it comes with aging. Others just figure there’s nothing that can be done. Not so, Walsh said.
“Vertigo is a completely fixable problem,“ Walsh said.
First of all, let’s clarify some misconceptions. Vertigo is not in and of itself an illness. It’s a sensation of a room spinning around you; a symptom of something else out of whack. There are limited things that cause true vertigo. Migraines and inner ear disorders, such as Meniere’s disease, mimics vertigo. And you can have a balance disorder and not experience true vertigo.
“When diagnosed with vertigo that’s like diagnosing someone with a stuffy nose,“ Walsh said.
Well-meaning doctors chock up vertigo to getting older (even though vertigo can happen at any age) and prescribe Valium, Antivert and Phenergan. Those medicines may help subdue the vertigo, but they don’t provide long-term help, Walsh said.
“They don’t fix it; they numb it,“ Walsh said. “It’s like taking pain pills for a broken leg.“
Just last month the American Academy of Neurology released a guideline that states benign paroxysmal positional vertigo can be best treated with physical therapy and specific maneuvers. Vestibular Rehabilitation Therapy (VRT), which Walsh practices, involves different maneuvers and exercises. Remaining active is key to tackling vertigo and balance disorders, Walsh said. It’s a similar concept to stroke rehabilitation. Patients can do exercises at home with evaluations done in the therapist’s office.
“It takes things not working and gets you to using them,“ Walsh said. “Most of what I do is not rocket science.“
But many patients and their doctors don’t even realize there is a physical therapy alternative to medication in the treatment of vertigo. In Alabama, you have to be referred by a physician before insurance will cover VRT.
The idea is if a particular action causes the spinning, doing that activity more often can re-train your body’s balance system to do those actions without dizziness or vertigo.
“It can re-learn things,“ he said. “You can get those sensations back to normal again.“