While this seems like a simple question, dizziness as a symptom can be much more complex. So, if you went to a doctor and said that you felt pain, what would the doctor ask? In most cases he would tell you to describe your pain. Is it sharp, dull, aching, burning, radiating, etc.? You see, with pain, the pattern or description of it often helps the doctor determine the cause of it and the likely treatment. With dizziness, it is the same.
Common Dizziness Symptoms
For most, the most common dizziness symptom is vertigo. Vertigo is a feeling like you are turning or moving in a rotational manner. It is often caused by an imbalance between your right and left ears. It is similar to the feeling after you have purposefully spun in a chair or played that funny game you see at the baseball games where they turn quickly around a baseball bat 10-15 times and attempt to stand. With vertigo, there are two types: subjective and objective. Subjective vertigo is felt inside you body, while objective is seen with your eyes and movement.
The second type of dizziness symptom is imbalance. This is a feeling like you are tilting or going to even fall. Like vertigo, the subjective form is when you feel it inside and the objective is when you are losing your balance.
The third type of dizziness symptom is a little more vague and is called lightheadedness. This is also described by patients as a wooziness or even a feeling of fogginess. In many cases, this is caused by a issue with blood flow to the head, but it also comes on with inner ear issues. Like the others, the subjective form is felt within while an objective form can be seen with a change in your heart rate and even blood pressure.
Next is motion sickness as a form of dizziness. This is a feeling of an irritated stomach like you might experience as a passenger in a car or after coming off a boat. Subjectively, it is felt inside and objectively, well, it can be experienced as actual vomiting.
The last form of dizziness is also vague and sometimes hard to understand. When you feel dizziness, your behavior can sometimes make it worse or it can increase your dizziness symptoms. Imagine the last time you were on a boat and you experienced dizziness and then you are told you are going to go on the boat again. This can evoke dizziness symptoms. Anxiety or fear can also make the dizziness symptoms feel more intense.
Now that you understand the many symptoms, let’s explore the systems within the body that influence dizziness.
What is the Vestibular System?
Located in the inner ear, the vestibular system tells the brain about the movements and position of your head. These organs sense motion when small hairs, called cilia, are moved by microscopic calcium crystals. When we sit, stand, move, or experience motions (such as in a car or elevator) the crystals move the hairs. Those signals, along with other information from your eyes and your somatosensory system (sense of touch in your muscles, tendons, joints, and skin) is relayed to your brain, which uses it to interpret motion, equilibrium, and your orientation in space. A disruption in any one area or multiple areas of this extensive system causes problems and unfortunate symptoms. However, the positive note is that many vestibular dysfunctions can be fixed with Vestibular/Balance Retraining Physical Therapy.
What is Vestibular/Balance Retraining Physical Therapy and how can it help me?
Vestibular/Balance Retraining Physical Therapy is a very specialized form of therapy that helps alleviate symptoms caused by vestibular dysfunction. The FYZICAL Model utilizes an exercise-based therapy program to reduce and eliminate vertigo, disequilibrium, motion sensitivity, visual instability, lightheadedness and the risk for future falls.
The goals of Vestibular/Balance Retraining Physical Therapy are:
1. Decrease dizziness and visual symptoms.
2. Increase balance and walking functions.
3. Increase general activity levels.
When one part of your balance system is injured, your brain will begin to overcompensate using the other two systems. Additionally, you may begin to alter your lifestyle in order to avoid any movements or activities that are dizzying. These mal-adaptive strategies, although helpful during dizziness episodes, actually prevent normal healing. FYZICAL Therapy uses specifically prescribed movements to initiate, restart, and complete the natural healing process.
How important is my Personalized Plan of Care?
The best Evidence Based Practices show that a combination of therapy and home exercises are required to achieve normal vestibular function, decreasing dizziness and improving quality of life. Your Physical Therapist and other doctors have completed extensive screening, testing and measures to expedite your healing process. The best and fastest way to resolve your balance and/or dizziness problem is to adhere to the prescribed frequency of therapy and complete your highly customized FYZICAL home exercise program.
What can I expect during therapy?
After your Initial Evaluation, a combination of Physical Therapist and Physical Therapist Assistants will help guide you through your Plan of Care, update your home exercises, periodically re-evaluate your progress and eventually assist you in discharging from therapy.
During therapy you will complete various balance, gaze stability and general conditioning/strengthening exercises with the intent to stimulate your balance. Know that these exercises may actually increase short term dizziness. THIS IS THE DESIRED EFFECT. Much as strength training will produce muscle soreness, balance retraining may produce imbalance and dizziness. Each time that you complete a balance task or exercise, your brain is re-learning and perfecting how to maintain equilibrium, stabilize your eyes during head and body movement and normalize balance reaction. When normal vestibular function is reestablished, your dizziness will begin to improve and even resolve.
How long will it be until I am back to normal?
This is a very individualized answer. Each person is unique, including their symptoms and cause of their root issue. In addition, many people have one or more additional conditions also occurring along with your primary condition. Every different set of circumstances associated with your symptoms and each case has to be considered on individual basis. However, the average length for a Plan of Care is 10 visits over 4-6 weeks. Generally speaking, rehabilitation that requires direct therapy in conjunction with home exercises may take from 1 month to 3 months to complete.
We reassess your progress near your 10th visit. At that time, we will decide if we need to make alterations to your Plan of Care based on your progress, or if you may be ready to discharge. You will likely need to continue your home exercises independently after therapy has ended to maintain the progress you have made throughout your Plan of Care.
Call us at (530) 274-2320 to schedule an evaluation with one of our expert therapists.