It is a Monday morning, and you wake up in bed like normal. But when you sit up, the world crashes around you. The room appears to be spinning, and you can’t get it to stop. Your balance is unsteady. You feel like you might collapse or faint. What could cause this?
The causes of dizziness can be broken down into four categories, explains occupational therapist Chase Webre: Otologic (inner ear), central/neurologic (brain), medical, and psychological. If you start to suffer from dizziness, it is best to first see a physician to determine which of these categories your dizziness will fall into. If your problem falls into the central/neurologic, medical or psychological categories, a doctor is most likely the best healthcare professional to start treating the condition.
Vestibular rehabilitation therapy is most helpful for otologic problems, also known as vertigo. (The vestibular system is a group of structures within the inner ear that collects information about your surroundings to give you spatial orientation — it allows you to know where you are and how you should move through a particular space.)
The most common cause of vertigo is benign paroxysmal positional vertigo (BPPV), a condition in the inner ear, particularly in patients over 60 years old. At LaBorde Therapy Center, the Physiquality clinic in Louisiana where Chase works, therapists also see peripheral vertigo due to secondary endolymphatic hydrops, which can be attributed to food choices high in salt, sugar, caffeine and alcohol.
Along with having multiple causes, each case of dizziness can be accompanied by a number of symptoms, he notes. Occupational and physical therapists can use these symptoms to map out the root cause and provide a proper plan to help patients recover.
This is why gathering a proper and thorough patient history is one of the most important parts of the therapy process. For example, did the dizziness just start or has it been recurring for months? Is it triggered by positional changes, or when the patient lies down? Has the patient noticed a gradual or sudden loss in hearing? The answers to these questions can help to eliminate some causes and point to others.
With some causes of dizziness, the patient’s symptoms will not respond to vestibular rehabilitation exercises until they have stabilized. This is because the cause of the dizziness is rooted around an increase in inflammation levels, such as with vestibular neuritis and labyrinthitis.
Even though exercises may not help initially, says Chase, it may help to see a rehabilitation therapist in order to understand why the dizziness has not yet resolved, what are the best things to do over the following 24-48 hours as the dizziness subsides, and what should be done once the symptoms stabilize.
Are you having problems with dizziness? Use our locator below to find a Physiquality physical or occupational therapist in your neighborhood.
Thank you to our contributors:
Chase Webre, OTR, CHT, is an occupational therapist at LaBorde Therapy Center, a Physiquality member with three locations in Louisiana. Chase has developed clinical skills in the treatment of outpatient orthopedics, acute care and in-patient rehabilitation, and developmental pediatrics. He earned his Certified Hand Therapist designation in 2016.
Special thanks to Rebecca Callais, OT, LOTR, CBIS with the Culicchia Neurological Clinic in Marrero, LA, for some of the information in this article.
- Diseases and conditions: Balance. May 17, 2018.
- Diseases and conditions: Dizziness. March 8, 2018.
- Diseases and conditions: Benign paroxysmal positional vertigo. May 28, 2015.
The human balance system. Vestibular Disorders Association.