Balance & Vestibular
Symptoms of dizziness, vertigo (spinning) and imbalance are not uncommon complaints in the general population, although they most frequently present in older persons. The reasons for these symptoms can vary greatly. Head injuries, strokes, neck pain and degeneration are just a few examples of sources for these symptoms. Physical therapists are an excellent resource to assist in the diagnosis and treatment of this expansive category of disorders.
Multiple systems in our body must work together in order for us to maintain our upright posture and stability. Our brain has to work closely with and process information from the inner ear (which gives feedback about our head position in space), our eyes, sensory input to our body and limbs and feedback about our body’s position in space. Furthermore, we must be flexible and strong to allow our bodies to maintain our stability. Deficits with ANY of these systems can result in conflict that then causes dizziness, vertigo or loss of balance and stability.
Just as the problems of dizziness, vertigo and imbalance can be multi-factorial, the physical therapy examination for these problems must be comprehensive. The physical therapist will assess your posture, visual tracking and gaze stability, neck motion, reactions to head motions, reactions to positional changes, static and dynamic balance abilities and overall flexibility and strength. The results of these examination findings guide the physical therapist in determining the source of
the problems and an appropriate plan of care to address them.
Balance & Vestibular treatment at CPT
In some cases, the sensation of “vertigo” is caused by the dislodging of little stones in the inner ear called “otoconia”. This results in an intense sensation of vertigo with head motion in a particular direction that fatigues within 2 minutes. Our physical therapist can perform a gentle maneuver, called an “Epley’s maneuver”, to restore the otoconia to its proper position and relieve the symptoms, usually within 24 hours.
Many cases, however, are the result of conflict between the systems discussed earlier and result in dizziness and imbalance. In these instances, the therapist must take a more dynamic approach and incorporate activities that will expose the body to the stimulus that cause the problems. Through the processes of habituation and accommodation, the brain works to retrain itself and be less reactive. Over time, dizziness diminishes and balance and stability improve. Although very effective, this treatment requires cooperation and compliance by the patient to perform home exercises, sometimes several times per day.