Woman with vertigo

Vestibular Rehab

Vertigo is the feeling of a rocking or rotation when you are perfectly still. It tends to last for several hours or days. Medically, it is distinct from dizziness because it involves the sensation of movement. Vertigo is often due a problem in the inner ear. An important part of the inner ear is the collection of semicircular canals. These structures are lined with cells that act like a gyroscope for the body and are responsible for providing feedback of our position.

Causes and Risk Factors for Vertigo

There are a variety of causes for this condition. The cause may be central or peripheral. Central causes occur in the spinal cord or brain, while peripheral is due to a problem with the inner ear. An illness or small crystals in the inner ear that become displaced can cause an irritation within the semicircular canals. This is a central cause and known as benign paroxysmal positional vertigo (BPPV). With Meniere’s disease, there is a fluid buildup in the inner ear that can cause vertigo. Headaches, head injuries, strokes, tumors and multiple sclerosis can also cause vertigo.

Head injuries definitely increase the risk factor for vertigo. In addition, antidepressants, aspirin, blood pressure medications and anti-seizure meds can also cause vertigo. For some, alcohol can cause vertigo.

Diagnosis and Treatment

To diagnose vertigo, a medical professional will take a full history of your symptoms and events. This includes previous medical issues, recent illnesses and medications. Then, a physical exam is performed. It includes a comprehensive neurological exam to check brain function. This allows for the determination of whether it’s peripheral or central. Signs of abnormal eye movement may pinpoint the problem. The Dix-Hallpike test or the roll test may be done. The Dix-Hallpike test repositions the head and monitors symptoms. With the roll test, the head is rapidly moved from side to side. A CT scan or MRI may be done to exclude structural problems. Sometimes, electronystagmography may be performed.

The most effective treatments if the vertigo is peripheral include partial repositioning movements. It’s known as the canalith repositioning procedure or the Epley maneuver. Specific head movements are performed to move the crystals in the inner ear. Cawthorne head exercises may also be performed. It’s a series of head and eye movements. This leads to decreased sensitivity of the nerves and improves vertigo. However, this needs to be done on a regular basis for optimal results. A trained physical therapist can perform these types of treatment. Keep in mind that medications may provide some relief but are not a cure. Meclizine is the most popular medication prescribed.

The Prognosis

Most patients with peripheral vertigo can find substantial relief with treatment; it has been suggested that the Epley maneuver in cases of BPPV can benefit as many as 90% of affected patients. Although recurrence of BPPV may be more than 15% in the first year after an episode, it is unlikely that vertigo will persist beyond a few days. When vertigo persists, evaluation for any underlying structural problems of the brain, spinal canal, or inner ear may be necessary.

Are you feeling dizzy with a sense of movement? You just might be experiencing vertigo. Make your world stop spinning with the help of our experienced and certified physical therapists. They are trained in the Cawthorne head exercises and Epley maneuver for vertigo. They can even give you instruction on how to do these exercises at home. Be sure to give us a call to set up a one-on-one consultation and full evaluation of your symptoms. We’ve helped many others and can help you too.

MEET OUR THERAPISTS

They just make work a pleasure.

Michelle Ribustello,

I came to Back to Health in 2015 from a skilled nursing facility and it's been great being able to work with my patients in their home, helping them in their own environment. It's much more rewarding to be able to see them function independently by the time you are finished with them and they are discharged. Working for Back to Health has also been great. I am a new mom so scheduling has been phenomenal. Your patients are very flexible, the office is super flexible, and they just make work a pleasure.

It feels so good to love my job each and every day!

Jodi McLean,

Back to Health gives me the opportunity to see patients in the clinic setting and in their homes. I love the connection I am able to make with my patients and their families as they welcome me into their homes. This is the most flexible, rewarding, stress-free job anyone could ever ask for as an occupational therapist. It feels so good to love my job each and every day!

Back To Health is the best PT job that I have ever had.

Patricia Verdote,

Back To Health is the best PT job that I have ever had. I am able to treat the patients the way that I want to treat, the way that I believe will be the best level of care for the patient in their own environment. I helped one patient learn how to get up off of their favorite chair in their living room – and that is not something that I have ever had the chance to do before!

You couldn't ask for anything better.

Melissa Stawinski,

I feel really lucky to be able to work for Back to Health Physical Therapy. It's allowed me to really tap into why I became an OT in the first place. Working in people's homes, in their environment, identifying what's meaningful to them, and helping them achieve their goals; you couldn't ask for anything better.

It is such a fun time and I look forward to working with you!

Jill Chroback,

The reason I love working for Back to Health is not only for working with such a wonderful staff, we have some great therapists and administrators working here, but also working with patients in their own environment so we are able to do a lot in actual situations and we have seen some great progress. It is such a fun time and I look forward to working with you!

This has been the best, professional, ethical group I have ever worked with.

Diane Hennion,

I have been working for Back to Health for three years now and out of my whole career, this has been the best, professional, ethical group I have ever worked with. They are friendly, warm and very intent on providing the best outcome and care for their individual clients.

I honestly look forward to "going to work" with Back to Health.

Stephanie Spada,

I love working at Back to Health as it allows me the flexibility to be both a hands-on involved mom to an amazing six-year-old little boy as well as a working professional. I am able to provide quality one-on-one quality care to my patient's in the comfort of their own home. I honestly look forward to "going to work" with Back to Health. They are a caring, dedicated group of special people who truly want the best for their patients!!

The flexibility is priceless to me.

Jill Friedbauer,

It was very difficult for me to find a PT position where I could send my kids off to school in the morning and to also be home to greet them when they come home in the afternoon. That flexibility is priceless to me. My patients have made a tremendous level of progress – even more than I have seen in clinical environments – which is really rewarding. I love working with Back To Health so much that I have referred clinicians that I have worked with in the past to join their team!

The most emotional and financially rewarding position that I have ever had.

Yvette Jain-Nafpliotis,

I have been working with Back To Health since 2006 and it has been the most emotional and financially rewarding position that I have ever had. The patients are so grateful for the services and I truly can see their progress in a very direct way.