Common Types of Dizziness and Vertigo

By Tyler Guymon, DPT
AZOPT Buckeye Clinic Manager and Doctor of Physical Therapy

If you have ever woken up one day experiencing symptoms of dizziness and vertigo without knowing why, you are not alone. While many cases of dizziness and vertigo can be traced to a specific incident, many times, patients can’t recall the moment these symptoms began. Dizziness and vertigo can be caused by many different factors. Today, we will discuss the two more common types we see at AZOPT.

Benign Paroxysmal Positional Vertigo (BPPV)

Symptoms: dizziness, a sense of spinning, loss of balance, nausea, vomiting – most commonly caused by change in position.

Cause: small crystals in the inner ear becoming dislodged or out of place possibly due to some type of head trauma, or in rare occasions, prolonged head positions, such as being in a dentist chair.

Treatment: a licensed physical therapist will assist the patient through a series of positions to help move the crystals back into place where they belong.

Hypo-functioning of the Inner Ear

Symptoms: similar to the symptoms you will experience with BPPV – dizziness, spinning, loss of balance, nausea. However, these symptoms are usually not affected by specific movements of the head. They can come and go at any moment. Most patients will feel that their equilibrium is off.

Cause: ototoxicity, meningitis, sequential vestibular neuritis, progressive disorders, autoimmune disorders, chronic inflammatory peripheral polyneuropathy, congenital loss, and neurofibromatosis. This type of condition is considered idiopathic, meaning it is too hard to determine an actual “cause” of the condition.

Treatment: a licensed physical therapist will treat through balance activities and exercises, habituation exercises to retrain the brain to compensate for the altered input into the brain, visual tracking exercises, and complex exercises to help with multitasking and to challenge the inner ear.

Thankfully, both types of dizziness are treated by a Doctor of Physical Therapy. If you are experiencing dizziness or a loss of balance, please contact any one of our AZOPT locations to schedule an appointment. For more information on BPPV, please follow the link by clicking here. In the meantime, try the exercises below to help with a hypo-functioning inner ear system. These exercises attempt to sync the visual system and vestibular system, and are important for our equilibrium.

Seated Horizontal Smooth Pursuit


Setup:
Begin sitting upright in a chair. Extend one arm out in front of your face holding a notecard with a letter written on it.

Movement: Slowly move the notecard side to side in front of your face. Focus your eyes on the letter as it moves through this motion.

Tip: Make sure keep the letter in focus and try not to change your head position during this exercise.

Seated Gaze Stability with Head Rotation


Setup:
Begin sitting upright with one arm holding a notecard with a letter written on it out in front of your face.

Movement: Keeping your eyes focused on the letter; turn your head side to side.

Tip: The notecard should stay stationary. Make sure to keep your neck straight. Move your head as fast as you can while keeping the letter in focus.

Seated VOR Cancellation


Setup:
Begin sitting upright holding a notecard with a letter written on it out in front of your face.

Movement: Move your head from side to side while moving the notecard in the same direction as your head.

Tip: Make sure to move the notecard and your head at the same speed. Move your head as fast as you can while keeping the letter in focus.

Standing on an Unstable Surface with Eyes Closed

Setup: Begin in a standing upright position on a foam pad with your feet hip width apart and arms at your sides.

Movement: Close your eyes and stand as still as you can.

Tip: Gently pull your belly button in to engage your core and do not hold your breath during the exercise. Stand in a corner, or with your hands hovering over a counter or your walker for safety. MAKE SURE THAT YOU HAVE SOMEONE NEARBY THE FIRST FEW TIMES TO PREVENT FALLING!