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Is Your World SPINNING?

April 13, 2015

Dizziness is a common symptom of a vestibular disorder, and 35% of adults over age 40 experience a vestibular disorder. (1) Potential causes include certain medications, viral infections, head injury, cardiovascular disorders, or a reason may not be identified. Dizziness often limits people’s daily activities and significantly increases the risk for falls. Nausea, vomiting, neck and shoulder tension, fatigue, and headaches are also common. The good news is that vestibular rehabilitation can alleviate these symptoms.

Vestibular rehabilitation is a specialized form of physical therapy that uses individualized exercises to resolve symptoms of dizziness. Therapists usually ask questions regarding your specific sensation of dizziness, past medical history, current medications, and lifestyles changes as a result of dizziness. Various tests are used to determine the specific motions and/or positions that cause dizziness (this is the unpleasant part!) Other measurements include strength, range of motion, sensation, coordination, balance, and so forth. Specific exercises based on the findings may include canalith-repositioning maneuvers, head and eye coordination, vestibular desensitization, and walking and balance activities.

The most common vestibular disorder is Benign Paroxysmal Positional Vertigo (BPPV). (2) In this case, small crystals in the inner ear become dislodged and send false messages to the brain regarding head position. People with BPPV frequently experience a spinning sensation, nausea, and vomiting with head movements (like looking up, rolling over in bed, or standing up). Treatment involves canalith-repositioning maneuvers that move the crystals back into place. Many research studies have shown excellent resolution of symptoms using these techniques, (3) often with only a few sessions of vestibular rehabilitation.
Regardless of the cause of dizziness, vestibular rehabilitation will address the specific symptoms and help restore normal daily activities. So stop the spinning, stop the dizziness, and feel better! For more information check out the Vestibular Disorders Association (online at or contact your physical therapist.


1. Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB. Disorders of balance and vestibular function in US adults. Arch Intern Med. 2009;169(10):938-944.

2. von Brevern M, Radtke A, Lezius F, et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry. 2007;78:710-715.

3. Helminski J, Zee D, Janssen I, Hain T. Effectiveness of particle repositioning maneuvers in the treatment of benign paroxysmal positional vertigo: a systematic review. Phys Ther. 2010;90(5):663-678.

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