We see many people at our North Oakville clinic who may be in for Physio, Massage, or Chiropody treatment for another issue who complain of dizziness or vertigo. These people may be getting up and down, onto or off of a treatment table, or simply bending over to tie their shoes, and complain of the room spinning. It then takes a few seconds to minutes to settle their symptoms.
Nearly a quarter of adults over the age of 65 report feelings of dizziness or vertigo, but a significantly smaller percentage actually receive treatment for it1. If you’ve ever experienced prolonged dizziness, you know what kind of impact it can have on your ability to do your job, enjoy your hobbies, or to simply complete the tasks necessary to maintain a life day-to-day. Some cases of dizziness or vertigo resolve spontaneously – that is, without treatment – and a person carries on as if nothing happened. Others require some form of intervention. At Palermo Physiotherapy and Wellness, our Physiotherapists are trained to assess and treat several forms of dizziness and vertigo.
What Causes Dizziness?
Dizziness can result from any number of medical reasons including an infection, vascular issues, high or low blood pressure, medication side effects, and dehydration. Even though you do not require a Physician referral to attend Physiotherapy, it is a good idea to be screened by your Family Doctor if you are experiencing dizziness, just to rule out any big problems. Physiotherapists are better trained help with inner ear issues, whiplash injuries, and dizziness related to the neck.
How this all works:
The inner ear is a complex maze of fluid, tubes, and hair cells. They all work in concert to communicate to your brain where your head is in space. Close your eyes and tilt your from head to the side – you don’t need your eyes to tell you where your head is. If things worked that way, we’d have an awfully hard time getting around at night or when doing something that demands our visual attention. Under normal circumstances, this process runs quite smoothly. Sometimes, such as after an ear infection, a car accident, or for no reason at all, this system gets confused. Essentially, the signals being transmitted to the brain do not reflect the reality of the situation. As a result, your brain enters a cycle where it is compensating for what it thinks is a change in head position – except you haven’t moved. This mismatch of information can result in the feeling of spinning, or vertigo. If you have ever been car sick, this is usually the mechanism for it.
Dizziness is a little more complicated. In our clinic, we treat primarily symptoms arising from the neck, usually as a result of car accidents or other trauma (although this can also arise for no obvious reason). Our nervous system works like a series of highways, with lanes constantly merging and exiting. Much like in traffic, a problem in one part of the system can impact other areas that do not appear to be directly connected. In our case, the first three bones in the neck share nerve pathways (highways) with many parts of the brain. This makes sense geographically as they are quite close. Stiffness or muscle tension/weakness in this area often can result in headaches, dizziness, or both, occasionally without symptoms of neck pain.
What we (Physiotherapists) do:
During your assessment, your Physiotherapists will identify the source of the dizziness or vertigo. Treatment will usually fall into one or more of three categories
Because the body’s feedback mechanisms are thrown off, clients quite often need help with balance skills. If the brain is getting bad information, it is difficult to keep the body stable.
If the inner ear is involved, we use special techniques to correct the flow of fluid through the ear. If it is the neck, we help to mobilise the joints of the upper neck and stretch and/or strengthen the muscles in the same area as needed.
This is the weirdest one and the least intuitive. People experiencing dizziness or vertigo have been consistently shown in research to have worse eye reflexes than the average person2,3,4,5. They often struggle to track moving objects, focus on something coming towards them, or shift focus from one thing to another. Imagine not being able to wear your glasses or contacts for a day and you can get an idea of what this would feel like. We use specific exercise prescription to train the eyes to operate properly again. As the ability to focus and track objects improves, symptoms decrease. Much of the new research in this area is being done on people after experiencing a concussion, as the symptoms tend to be very similar.
What you can do
If you or a loved one is experiencing dizziness or vertigo, do not simply write it off as a consequence of aging. Dizziness can be debilitating, but is very treatable. The longer you wait, the more difficult it gets to fix the problem. Have a discussion with your family doctor about treatment options, and consider an assessment by a Registered Physiotherapist.
Dizziness: A feeling of lightheadedness, faintness, or unsteadiness
Vertigo: A perception of movement or spinning, either of ones self or the environment around them
Tim Childs, PT
MScPT, BA Kin
- Collerton J, Kingston A, Bond J, et al. The personal and health service impact of falls in 85 year olds: cross-sectional fi ndings from the Newcastle 85+ cohort study. PloS one.2012;7(3):e33078
- Gimse R, Tjell C, Bjorgen IA, Saunte C. Disturbed eye movements after whiplash due to injuries to the posture control system. J Clin Exp Neuropsychol. 1996;18:178-186
- Heikkila H, Wenngren B. Cervicocephalic kinesthetic sensibility, active range of cervical motion, and oculomotor function in patients with whiplash injury. Arch Phys Med Rehabil. 1998;79:1089-1094.