Best treatment for dizziness
As we have covered in our previous blog, there can be a number of different causes and unique experiences of dizziness. The good news is that there is usually a reason for dizziness which means that it can be treated. Rarely do you have to live with dizziness. With an accurate diagnosis, effective treatment and specialist rehabilitation – you can get better!
Why do I experience dizziness?
If you experience dizziness, it is important to note that your experience will be entirely unique. Dizziness is the result of the brain not being able to make sense of our extremely complex balance system. The brain has to received, order and respond to information from lots of different sources – the eyes, ears, neck joints, muscles, etc, etc, etc. A problem with any one of these organs or indeed an issue with the brain itself can cause dizziness.
There can also many different experiences of dizziness – anything from an inconvenient background sensation to a full-blown, crippling attack.
The treatment of dizziness starts with an accurate diagnosis so if you haven’t done so already – I would encourage you to consult someone who specialises in dizziness. Physiotherapists (who have completed some additional training) are ideally placed to offer the best treatment for dizziness. They can perform an accurate assessment, make a diagnosis and get started with treatment – all in the first session!
Treatment for dizziness
Given the huge number of presentations of dizziness (no two patients present the same!) and the importance of a clinical diagnosis – it is impossible to write a ‘catch all blog’ or provide generic exercises. Whilst there are some simple tips and exercises that can help you get better, I strongly advise that you have an individual assessment and a unique treatment plan. Here are the types of dizziness we see most often in clinic and how we get them better.
BPPV
Benign Paroxysmal Positional Vertigo (BPPV for short) is a type of vertigo and produces that classic ‘room spinning’ dizziness. We cover exactly what happens with BPPV on a previous blog but essentially the dizziness is causes by calcium carbonate crystals (canalinths) spilling into the fluid-filled inner ear canals. Commonly the canaliths spill into the posterior canal and is often only on one side.
Canalith repositioning procedures, such as the Epleys manoeuvre, have been shown to be 90% effective and can become a home exercise or acute treatment strategy if required. It is important to recognise that crystal reposition is just the start of the treatment. To provide a solid, long-term recovery we need to address any factors that may be perpetuating your vertigo and most importantly, retrain your vestibular system. If you consider a bout of dizziness/vertigo as the initial injury, we must treat the injury but then return that injury to full health again by training the area. It is exactly the same with BPPV. We can (usually) easily reposition the crystals but then the hard work starts. To ensure you get completely better, we need to retrain how your eyes, ears and brain communicate with each other through vestibular rehabilitation. Do check our vestibular rehab exercises here.
Headaches & migraines
Headaches and migraines can also be a source of dizziness or vertigo. Vestibular migraine is a variant of the migraine classification system (of which there is 28!) and can produce feelings of unsteadiness, balance problems and vertigo.
Treatment begins with an accurate diagnosis and often a symptom diary helps to highlight the triggers for these headaches and dizziness (as well as providing your physio with super helpful information). Highlighting and removing the triggers can make a dramatic difference to your symptoms.
Physiotherapy treatment for dizziness can be really effective. It is important to note that the treatment for primary migraines is medication but we will discuss this (and possibly write to your GP) if required. Physiotherapy can relieve tight muscles, address issues with posture and guide rehabilitation. There are some well-evidenced exercises for headaches. As with BPPV, vestibular rehabilitation is also essential.
Neck pain and dizziness
In some cases dizziness can arise from the neck. Termed cervicogenic dizziness can produce a feeling of disorientation. This is usually associated stiffness in your neck or perhaps you dizziness occurs after moving your neck.
Physiotherapy is the best treatment for cervicogenic dizziness. Mobilisation/manipulation of the joints of the neck, massage of the surrounding soft tissues and conditioning exercises help to restore the normal movement and equilibrium (proprioception) of your neck and reduce the referred symptoms of dizziness.
A mixed picture
Dizziness is a complex condition and there can be multiple reasons why you are experiencing dizziness. As discussed above, an accurate diagnosis is the starting point for best treatment for dizziness. When I see a dizzy patient for the first time, these are longer appointments to understand the history, perform specific tests and begin the treatment process.
Each patient’s experience of dizziness is entirely unique and therefore the best treatment for dizziness has to be individualised, bespoke and unique.
