Dizziness, lightheadedness, and loss of balance are some of the most frequent reasons why people seek medical care. Estimates reveal that more than 90 million Americans report dizziness and/or balance issues to their physicians at least once in their lifetime. Suffering from balance or dizziness issues can be severely debilitating and can negatively impact your quality of life.
Balance within the body involves a complex interaction among the eyes, inner ear, central nervous system, sensory receptors, joints, and muscles. Because there are numerous systems involved in balance control, the differential diagnosis is vast and can include inner ear infections or disease, migraines, anxiety, dehydration, aging, heart conditions, medication use, stroke, cervical spine disorders, and concussion, among others.
A thorough history and physical examination is the first step in getting an accurate diagnosis, followed by appropriate diagnostic labs and imaging.
Some physicians rely on specialized testing to diagnosis balance disorders, including:
This test provides information related to hearing, function of the middle ear and cochlear hair cell, as well as several neural aspects of the hearing-balance system.
This test evaluates for Meniere’s disease, which is a disorder of the inner ear.
This test helps to detect abnormalities in the central nervous system, as well as the vestibular system, by utilizing infrared video recording of eye movements.
This test provides information regarding functional balance capabilities, which is extremely useful when planning a personalized treatment plan.
This test helps to rule our superior canal dehiscence, and other vestibular abnormalities.
This test evaluates the auditory pathways from the ear to the brainstem.
The results of these tests can help to determine the underlying system that is contributing to your symptoms – the brain, ear, joints, and/or soft tissue. Once a diagnosis has been made, treatment is often comprehensive, involving multiple practitioners, including physical therapists.
Physical therapy plays a vital role in helping resolve dizziness and balance issues. A physical therapist will take a detailed medical history, and perform a comprehensive physical examination to assess your balance while you’re seated, standing, and walking. They will also assess your posture, and test your muscular strength and neurological responses.
Once the underlying cause of your balance issue has been identified, a physical therapist will develop an individualized vestibular rehabilitation plan. The goals of vestibular rehabilitation are to improve function and safety. Typical components of a vestibular rehabilitation program include:
This type of therapy is often used with patients that have benign positional paroxysmal vertigo (BPPV). Two commonly used maneuvers include the canalith repositioning procedure (Epley maneuver) and the liberatory maneuver (Semont maneuver).
This type of therapy is most often used with patients who suffer with positional vertigo and dizziness. This therapy reproduces the position that elicits the symptoms, repeatedly, until the patient develops a habituation to the stimulus, which eventually eliminates their symptoms.
This type of therapy is used for patients that have issues such as traumatic brain injury, stroke, etc. This therapy emphasizes safety with the use of assistive devices and home modifications to reduce the risk of accidents.
This type of therapy is used with patients that have unsteadiness or loss of balance. Balance retraining helps to reduce the risk of falls.
These exercises are used to increase the range of motion of your joints and also to improve your strength, which helps to improve your overall conditioning and reduce your risk of falls.
This type of program allows patients to continue exercises at home following supervised sessions to reinforce therapy within the clinic. Long-term wellness depends on a patient following through with a home exercise program.
Outcomes associated with physical therapy for balance disorders include:
If you’re suffering with dizziness or loss of balance, a consult with one of the physical therapists at Blue Hills Sports & Spine Rehabilitation can help to determine the cause of your dizziness. After determining the cause, your physical therapist will work with you to create an individualized treatment plan for your condition to meet your goals.