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Tuesday Tip- Coping with Dizziness

Diane Parrish, PT, DPT Vestibular Rehabilitation Specialist

By: Diane Parrish, PT, DPT, Vestibular Specialist of Marengo Physical Therapy

Diane Parrish, PT, DPT has extensive experience treating various causes of dizziness and imbalance.  She has attended specialized training for vestibular rehabilitation and completed the vestibular competency course by Susan Hordman, PT, PhD.

Dizziness is one of the most common reasons people seek medical care. There are many causes for dizziness and the correct treatment is based on understanding the cause and diagnosis. Talking with your doctor about the symptoms, when the symptoms started, how often the symptoms occur, and when the symptoms occur is important.

The following are red flags that indicate an emergency situation. Call 911 or go to the emergency room if you experience new, severe dizziness or vertigo along with any of the following:

  • Incapacitating vertigo with nausea and vomiting
  • New tinnitus, hearing loss or facial paralysis
  • Severe headache, or a new type of headache
  • New onset coordination or gait problems
  • Chest pain, shortness of breath, heart palpitations
  • Significant head injury
  • A very stiff neck
  • Change in vision or blurred vision
  • Sudden hearing loss
  • Trouble speaking
  • Leg or arm weakness or numbness
  • Loss of consciousness
  • Falling or difficulty walking
  • Chest pain or rapid slow heart rate

Once your doctor has determined the cause of your dizziness, your doctor may refer you for further medical testing, prescribe medications, and/or refer you to therapy for specific types of dizziness or imbalance. Dizziness can cause significant balance issues and pose a risk of falling. Your safety while dealing with the dizziness is the highest priority.

Some considerations of ways to be safe while dealing with dizziness and imbalance are listed below.

  • Remove obstacles from the floor like throw rugs.
  • Have a clear path to your favorite chairs and rooms within your home, especially if you need a walker or other assistive device. Make sure you can maneuver with minimal sidestepping and turning.
  • Consider a night light, flashlight or leave a light on in the bathroom at night. Most imbalance improves in good lighting.
  • Try to make slower movements, especially with your head. Give yourself time to transition from lying in bed to sitting up.
  • If you are lightheaded with standing, allow plenty of time to stand and make sure you are steady before you start walking. Try clenching your fists and moving your arms and legs to get your circulation going before you try to change positions.
  • Try to keep doing the things you would normally do, as you can tolerate because limiting yourself to bed (unless that was your physician’s orders) leads to rapid weakness and can make balance worse. Avoid becoming isolated and inactive as much as possible.
  • Riding in a car may be difficult. It is often easier to drive because you will know when you are changing speed and direction and can anticipate the movement in the car. If you are not safe driving, consider sitting in the front where you can use your eyes to help you see changes.
  • Eliminate or decrease use of products that impair circulation, e.g. nicotine, caffeine, and salt.
  • Minimize your exposure to circumstances that precipitate your dizziness, such as stress and anxiety or substances to which you are allergic.
  • Avoid hazardous activities when you are dizzy, such as driving an automobile or operating dangerous equipment, or climbing a step ladder, etc.
  • Seek help for emotional issues. Anxiety and depression are common with dizziness.

Once the cause of your dizziness has been identified and your dizziness is stable, your physician may recommend physical therapy to improve your condition.

Physical Therapy is very effective at helping people with dizziness and imbalance. In about 45% of those with dizziness, where the inner ear or vestibular system has been affected, vestibular rehabilitation is the best treatment. Vestibular rehabilitation can help about 80% of those with a loss of the inner ear function regain their normal lives and abilities. Head maneuvers are another treatment that is effective for those with displace calcium carbonate crystals in the inner ear which is called Benign Paroxysmal Peripheral Vertigo (BPPV).

Your therapist will help you identify what aspects of dizziness and balance are affecting you. An individual assessment is important because there are many causes of dizziness and imbalance. Your therapist will work with you to address any issues and help you learn to overcome them, teach you alternative strategies, or help you learn to compensate or cope with your dizziness and imbalance. 

The balance system is very complex and depends on many systems in the body working together properly to coordinate movement. During therapy, your therapist will screen all of these systems to determine how these systems are working (or not working) for you specifically.  Through screening, your therapist will be able to customize your treatment program to address your specific needs.

For more information regarding vestibular rehabilitation, visit the vestibular rehabilitation services section of our website.  To become a patient of Diane, please call Marengo Physical Therapy at 815-568-8878.