Finding Balance: Dizziness and PT
Dizziness is common in people over 20 and it can be a big problem in your daily life. Feeling unsteady, lightheaded, or like the room is spinning is alarming, and makes day to day tasks difficult. The good news is that dizziness often has treatable causes, and your physical therapist can be the perfect person to help.
Understanding Dizziness
Dizziness isn't a specific problem - it's a symptom that can come from a lot of different issues. Feeling dizzy most commonly comes from issues with your inner ear, but it can also come from your vision, joint or muscle issues in your neck, migraines, changes in blood pressure, head injuries, or other neurological problems.
How Physical Therapists Help
To understand dizziness and how a PT can help, you have to know a little about how balance works. Your brain uses information from your inner ears, your vision, and input from your joints about their position and movement to keep you balanced and stable. Typically all of this information paints the same picture for your brain. If your brain gets conflicting information - say your inner ear sends different information than vision and your joints - that often results in a feeling of dizziness, unsteadiness, or vertigo. Your physical therapist will ask questions about your history, then perform testing on all of the systems that help you stay balanced to figure out the cause of your dizziness. Your treatment plan will vary depending on what your PT finds. Some typical examples include:
● Exercises: Your PT may prescribe specific exercises to improve your balance, strengthen or stretch specific muscles, or to help retrain your brain to interpret sensory information. These can include gaze stabilization exercises which help your eyes and inner ears work better together, habituation exercises that help your brain get used to different types of input, and balance training on different surfaces.
● Canalith repositioning maneuvers (CRM): If your dizziness is caused by benign paroxysmal positional vertigo (BPPV), a specific type of inner ear problem, your therapist may perform maneuvers to reposition tiny crystals within your ear canal, alleviating your vertigo. They can also teach you how to do these at home.
● Education: Your therapist will educate you about your condition, how to manage dizziness, and exercises you can perform at home. They may also help you modify activities that cause dizziness, or train you on ways to work through it.
Dizziness doesn't have to interfere with life. Physical therapists can help reduce your dizziness, improve your balance, lower your risk of falls, and improve your confidence in your daily activities.
References:
1. Cervicogenic Dizziness: A Review of Diagnosis and Treatment
a. https://www.jospt.org/doi/10.2519/jospt.2000.30.12.755
2. Physical therapy interventions for older people with vertigo, dizziness and balance disorders addressing mobility and participation: a systematic review. BMC Geriatr 20, 494 (2020).
a. https://doi.org/10.1186/s12877-020-01899-9
3. Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Evidence-Based Clinical Practice Guideline: FROM THE AMERICAN PHYSICAL THERAPY ASSOCIATION NEUROLOGY SECTION. J Neurol Phys Ther. 2016 Apr;40(2):124-55. doi: 10.1097/NPT.0000000000000120. PMID: 26913496; PMCID: PMC4795094
a. 10.1097/NPT.0000000000000120
4. Between Cognitive Assessment and Balance Measures in Adolescents Referred for Vestibular Physical Therapy After Concussion. Clin J Sport Med. 2016 Jan;26(1):46-52.
a. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856020/
5. Physical Therapy lowers falls by 68% after Dizziness
6. Physical Therapy Guide to Dizziness
a. https://www.choosept.com/guide/physical-therapy-guide-vertigo
7. Vestibular Rehabilitation Therapy
a. https://my.clevelandclinic.org/health/treatments/15298-vestibular-rehabilitation
Relief Through Movement: Physical Therapy for Chronic Pain
Chronic pain can be a debilitating condition, limiting your mobility and impacting your daily life. The CDC estimates that around 50 million Americans experience chronic pain, and 17 million have substantial reductions in activity because of pain. Beyond limiting activity or your ability to work, chronic pain has been linked to depression, Alzheimer’s disease, and substance abuse.
Chronic pain can be a debilitating condition, limiting your mobility and impacting your daily life. The CDC estimates that around 50 million Americans experience chronic pain, and 17 million have substantial reductions in activity because of pain. Beyond limiting activity or your ability to work, chronic pain has been linked to depression, Alzheimer’s disease, and substance abuse.
Chronic pain is complex. There’s no single intervention to treat it, but physical therapy should be part of the mix. Here’s why:
How PT Approaches Pain: Physical therapy often provides relief that’s just as effective as medication but without the potential side effects. Here's a breakdown of how PT tackles pain and its effectiveness:
Identify the Root Cause: PT goes a step further than medication that masks pain. Therapists assess your posture, muscle strength, flexibility, and joint mechanics to pinpoint the source of your discomfort.
Address the Underlying Issues: Based on the evaluation, PT focuses on strengthening weak muscles that support your joints, improving flexibility for a better range of motion, and correcting any imbalances or postural problems that might contribute to pain.
Use A Multi-Faceted Approach: A PT treatment plan will be customized based on the evaluation. In addition to therapeutic exercise, a PT might use various techniques. Examples include:
· Manual Therapy: PTs use massage, joint mobilization, and trigger point therapy to address muscle tension, improve circulation, and alleviate pain.
· Modalities: Techniques like ultrasound, heat therapy, or electrical stimulation can reduce inflammation, promote healing, and manage pain.
· Aquatic Therapy: A warm, therapeutic pool supports your body and joints while offering gentle resistance. This can often make it easier to start moving again after being in pain for an extended time.
Educate and Empower Patients: PTs equip you with the knowledge and tools to manage your pain independently. This might include learning a new exercise routine, how to modify activities, or how to modify your daily schedule when you’re feeling better (or worse) than normal. It’s also becoming increasingly likely that you’ll learn how pain works. Research shows that combining pain education with physical therapy is an effective treatment.
If you're struggling with chronic pain, call your physical therapist. They might have the key that will unlock a pain-free life.
References:
1. Chronic Pain Among Adults — United States, 2019–2021 | MMWR (cdc.gov)
2. The impact of combining pain education strategies with physical therapy interventions for patients with chronic pain: A systematic review and meta-analysis of randomized controlled trials, Physiotherapy Theory and Practice, 37:4, 461-472 DOI: 10.1080/09593985.2019.1633714
3. Preferred Communication Strategies Used by Physical Therapists in Chronic Pain Rehabilitation: A Qualitative Systematic Review and Meta-Synthesis, Physical Therapy, Volume 102, Issue 9, September 2022, pzac081 Preferred Communication Strategies Used by Physical Therapists in Chronic Pain Rehabilitation: A Qualitative Systematic Review and Meta-Synthesis - PubMed (nih.gov)
4. The Influence of Cognitive Behavioral Therapy on Pain, Quality of Life, and Depression in Patients Receiving Physical Therapy for Chronic Low Back Pain: A Systematic Review https://onlinelibrary.wiley.com/doi/abs/10.1016/j.pmrj.2018.09.029