Understanding Vertigo & How a Physical Therapist Can Help
Posted December 5, 2023
Understanding Vertigo & How a Physical Therapist Can Help
What Is Vertigo?
Have you ever felt like the world was spinning around you while you were still? Or have you felt like you were spinning when you were not moving? This is a sensation of vertigo. Vertigo can be defined as perceived sense of self or environmental movement.1 A perception of one’s self “spinning” is termed internal vertigo1. A false sense of visual motion (what you see) is termed external vertigo.1 Vertigo is most commonly associated with a spinning sensation. However, this can be perceived as other false sensations of movement such as swaying, tilting, bouncing, or sliding.1
Often positional vertigo can be experienced immediately following changes in head position relative to gravity (turning over in bed, getting up out of bed, quick movements, bending forward, bending backward, or being tilted back when getting one’s hair washed at the beauty parlor). One can experience vertigo within brief bursts for less than a minute or for a longer duration with recurrent episodes.
Vertigo can be associated with difficulty with changes in direction while walking, headaches, visual symptoms, walking in crowds, visual triggers, loud sounds, ear or sinus problems/infections. Symptoms of vertigo can also be accompanied by imbalance, nausea, loss of balance, or difficulty walking in a straight line.
Common Causes Of Vertigo
Vertigo is a symptom that can have different causes. The more common cause of a new onset of vertigo is called Benign Paroxysmal Positional Vertigo (BPPV).2 Other causes of vertigo include what are termed as peripheral vestibular disorders which can influence how the vestibular systems functions.3 A third group is referred to as central problems related to our nervous system.3
How A Physical Therapist Can Help Vertigo?
Treatment for vertigo depends on the cause of one’s vertigo. Physical therapists are trained to recognize, classify and determine the reason why one is experiencing vertigo to determine what next steps would be appropriate. If the cause of your vertigo is due to BPPV, physical therapists are trained in treatment maneuvers of which to address the cause. Physical therapists can also determine if a peripheral vestibular or central problem is present and work with you to address your symptoms and improve your function.4 Physical therapists can also determine if further testing is required or if referral to another health care provider is appropriate.
Additional resources
Additional resources can be found by visiting the links below.
- Vestibular Disorders Association (VEDA): Discover a Life Rebalanced – Vestibular Disorders Association
- Academy of Neurologic Physical Therapy: Vestibular Disorders – Dizziness (neuropt.org)
If you experience or are with someone that is experiencing sudden vertigo with symptoms of difficult talking or slurred speech, sudden weakness on one or both sides of the body, confusion, a sudden severe headache it is important for you to call 911 and seek urgent medical attention.5,6
- Bisdorff A, Von Brevern M, Lempert T, Newman-Toker DE. Classification of vestibular symptoms: towards an international classification of vestibular disorders. J Vestib Res. 2009;19(1-2):1-13.
- von Brevern M, Radtke A, Lezius F, et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry. 2007;78(7):710-715.
- Edlow JA, Carpenter C, Akhter M, et al. Guidelines for reasonable and appropriate care in the emergency department 3 (GRACE-3): Acute dizziness and vertigo in the emergency department. Acad Emerg Med. 2023;30(5):442-486.
- Hall CD, Herdman SJ, Whitney SL, et al. Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association. J Neurol Phys Ther. 2022;46(2):118-177.
- Saber Tehrani AS, Kattah JC, Kerber KA, et al. Diagnosing Stroke in Acute Dizziness and Vertigo: Pitfalls and Pearls. Stroke. 2018;49(3):788-795.
- CDC. Stroke Signs and Symptoms. Centers for Disease Control and Prevention. Published January 30, 2023. Accessed October 20, 2023. https://www.cdc.gov/stroke/signs_symptoms.htm
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