Can Physical Therapy Make Vertigo Worse? Find Out Now

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Physical therapy is a common treatment for vertigo, which is characterized by dizziness and balance problems. While physical therapy can provide relief to those suffering from vertigo, there is also the possibility that it could make things worse.

This begs the question: what exactly is physical therapy and how does it help solve vertigo? Physical therapy involves various exercises and movements aimed at improving balance, coordination, and strength in individuals experiencing vertigo. These exercises are designed to stimulate the vestibular system, which helps control our sense of balance and spatial orientation.

“What we have here are two sides of a famous coin – stimulation and aggravation.” -Dr. Baris Erdogan

As with any medical condition, not all treatments work the same way for everyone. Some people may experience an exacerbation of their symptoms after beginning physical therapy, leading them to wonder if this treatment is really worth pursuing.

If you’re someone who suffers from vertigo or know someone who does, you might want to find out the answer to this important question. Read on to explore the potential risks of physical therapy and how it might impact your vertigo symptoms.

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Understanding Vertigo and Physical Therapy

What is Vertigo?

Vertigo is a common condition that is characterized by dizziness, spinning sensation, loss of balance or coordination, and nausea. It can be caused due to disturbances in the inner ear, such as infections, inflammation, or a problem with the ear’s structure. Some other causes include head injury, migraines, medications, and certain medical conditions like multiple sclerosis.

How Can Physical Therapy Help with Vertigo?

Physical therapy has shown promising results when it comes to treating vertigo. A trained physical therapist can help you perform exercises that target your balance and coordination, which can help alleviate symptoms of vertigo. The most commonly used exercise for vertigo treatment is called the Brandt-Daroff exercise. This exercise involves sitting up straight and then quickly moving to a lying down position on one side. You stay in this position for 30 seconds before returning to an upright position. You repeat this exercise several times during your session. Your physical therapist will instruct you in how best to perform these exercises based on your individual needs and level of fitness.

In addition to helping you improve your balance and coordination, physical therapists also work to identify any underlying factors contributing to your vertigo. For instance, they may recommend lifestyle changes like stress reduction techniques or dietary modifications in order to minimize the frequency and severity of your vertigo episodes.

The Benefits and Risks of Physical Therapy for Vertigo

The benefits of physical therapy cannot be overstated. Regular therapy sessions can reduce the intensity and frequency of symptoms of vertigo by improving balance and stability. Additionally, physical therapy can help prevent falls and other accidents associated with vertigo. By working with a skilled physical therapist, you can regain control of your life and confidence in your ability to move around without fear of falling or fainting.

There are some risks associated with physical therapy treatments for vertigo. For instance, completing certain exercises may cause dizziness and nausea. If you experience any of these symptoms during a session, it’s important to inform your physical therapist immediately, so they can adjust your treatment plan accordingly. Additionally, some people find that their vertigo symptoms worsen initially as the brain adjusts to new patterns of movement and balance.

“Physical therapy can be an effective treatment option for patients experiencing vertigo related to inner ear disorders. Physical therapists help identify factors that trigger episodes, provide exercise-based programs to improve balance, reduce symptoms, and prevent falls.” -American Physical Therapy Association

If you’re considering physical therapy as a potential treatment option for vertigo, it is important to consult with a trained therapist who has experience treating this condition. They can evaluate your individual situation and determine the best approach for managing your vertigo-related symptoms.

Physical therapy has shown promising results in improving the quality of life for individuals suffering from vertigo. While there are some risks associated with the treatment, working with a skilled therapist under medical supervision can greatly alleviate symptoms and provide substantial benefits over time.

Possible Causes of Vertigo Worsening During Physical Therapy

Inappropriate Exercise Selection

One possible cause of vertigo worsening during physical therapy is inappropriate exercise selection. Certain exercises can trigger motion sensitivity, making the patient feel dizzy and lightheaded. Examples of such exercises are those that involve rapid head movements or sudden changes in body position.

According to Dr. Rajeev, a board-certified neurologist, “patients with benign paroxysmal positional vertigo (BPPV) may experience increased symptoms when doing certain exercises involving repetitive head movements.” Proper screening and assessment before prescribing exercises for patients with specific conditions can help prevent triggering dizziness and vertigo episodes.

Poor Exercise Technique

Another potential cause of vertigo worsening during physical therapy is poor exercise technique. The way an exercise is performed can greatly impact its effect on the patient’s vestibular system and overall health. Incorrect postural alignment, insufficient coordination, and inadequate breathing are just some factors that can lead to unwanted side effects.

A study published in the Journal of Clinical Neurology reports that patients who did not receive adequate supervision and instruction during their rehabilitation program had a higher risk of worsening their vertigo symptoms compared to those who were closely monitored by trained therapists. Proper feedback, corrections, and cueing can help optimize exercise performance while minimizing the risk of exacerbating vertigo.

Lack of Progression in Exercise Difficulty

Lastly, a lack of progression in exercise difficulty can also contribute to vertigo worsening during physical therapy. While starting with basic exercises is essential to establish a foundation, sticking to them for too long may hinder progress and growth. Patients may become bored, unchallenged, and unmotivated to continue their therapy.

According to a review published in the Journal of Vestibular Research: Equilibrium & Orientation, exercise progression is crucial for successful vestibular rehabilitation. Gradual increments in duration, frequency, intensity, and complexity can help build tolerance and desensitize motion sensitivity over time. However, it is important not to progress too fast or too hard, as this can lead to overexertion and relapse.

“To have balance means to be able to maintain one’s body position relative to gravity,” says Dr. Anat Baniel, author of Move into Life. “Balance requires the ability to sense one’s own movements and space orientation accurately.”

While physical therapy is generally considered safe and effective for managing vertigo symptoms, there are potential risks that must be addressed to maximize its benefits. Inappropriate exercise selection, poor exercise technique, and lack of progression in exercise difficulty are some possible causes of vertigo worsening during physical therapy. It is essential to work with a trained therapist who can tailor the treatment plan according to the patient’s specific needs and goals. Communication, trust, and collaboration between the therapist and patient are key components of successful vestibular rehabilitation.

How to Determine if Physical Therapy is Making Your Vertigo Worse

Tracking Symptoms Before and After Therapy Sessions

If you suffer from vertigo, it’s important to carefully monitor any changes in symptoms that may occur before or after attending a physical therapy session. Keep a detailed diary of your symptoms, such as dizziness, spinning sensations, nausea, headache, and balance problems, before each session and assess how they change afterward. If you notice an increase in frequency or intensity of your vertigo episodes following a physical therapy session, this could be an indication that the treatment may not be working as intended.

Using the Dix-Hallpike Maneuver to Test for Vertigo

The Dix-Hallpike maneuver is a test used to diagnose vertigo-related conditions and can also be useful in determining whether physical therapy treatments are making your vertigo worse. This simple test involves lying down on your back and quickly changing positions. A healthcare professional will monitor eye movements and other symptoms for several seconds immediately after the position shift to look for signs of nystagmus, which occurs when the eyes involuntarily move back and forth. If these abnormal eye movements persist or worsen following physical therapy sessions, it may indicate that the treatment is having an adverse effect on your condition.

Consulting with a Physical Therapist or Healthcare Provider

If you’re experiencing increased symptoms of vertigo during or after physical therapy, it’s essential to speak with your therapist or healthcare provider. They can help determine whether the specific exercises or techniques being used during therapy are contributing to your worsening symptoms, adjust the treatment plan accordingly, or refer you to a specialist who has more experience treating vertigo-related conditions. Remember, communication between you and your healthcare team is crucial in managing vertigo and ensuring that you receive the appropriate care.

Monitoring for Other Symptoms of Worsening Vertigo

Apart from tracking dizziness, nausea, headache, and balance problems, it’s also essential to monitor any other symptoms that may occur during or after physical therapy sessions. These could include hearing loss, tinnitus (ringing in the ears), fullness or pressure in the ear, and facial weakness or numbness. These symptoms could indicate a more serious underlying condition, such as Meniere’s disease or vestibular neuritis, which require prompt medical attention. Don’t hesitate to speak with your healthcare provider if you experience any new or concerning symptoms.

“Vertigo is not a thrill ride; it can be downright debilitating. If you’re struggling with this condition, it’s essential to work closely with your healthcare team to find treatments that work for you.” -Dr. Boubker Jai, MD

While physical therapy can be an effective treatment for vertigo-related conditions, it is crucial to carefully monitor changes in symptoms to ensure that the treatment isn’t making them worse. By keeping track of your symptoms, using diagnostic tools like the Dix-Hallpike maneuver, seeking guidance from your healthcare provider or therapist, and monitoring for additional symptoms, you can take control of your health and manage your vertigo successfully.

Precautions to Take When Starting Physical Therapy for Vertigo

If you are experiencing vertigo, physical therapy can be an effective way to alleviate symptoms. However, it is important to approach physical therapy with caution as incorrect exercises or improper technique can worsen your condition.

Starting with Low-Intensity Exercises

At the beginning stages of physical therapy, it is crucial to start with low-intensity exercises that will not overstress your body. These might include basic head movements such as slowly turning your head from side to side, tilting your head forward and backward, or rolling it in a circular motion. Doing these simple movements while sitting down or lying on your back will help your brain adjust to changes in position slowly and avoid exacerbating any dizziness or nausea caused by vertigo.

A licensed physical therapist who specializes in vestibular rehabilitation can guide you through these exercises and provide appropriate modifications if needed. It is also beneficial to inform them about your level of comfort and progress after each session, so they can tailor future exercises accordingly.

Gradually Increasing Exercise Difficulty

As you become more comfortable with lower intensity exercises, your physical therapist may gradually increase the difficulty level of your activities. This could involve incorporating resistance bands or weights into your routine and adding exercises that require greater balance and coordination, such as squats and lunges.

It is essential to communicate regularly with your physical therapist throughout this process, providing feedback on how you feel during and after exercise. If at any point you experience an uptick in symptoms, it might indicate that you’re overdoing it and should take a step back. By working deliberately through your program, you can build strength and reduce vertigo symptoms long-term without aggravating your condition.

“Working with knowledgeable and experienced healthcare providers can help alleviate dizziness and restore your body’s sense of balance” -Harvard Women’s Health Watch

Physical therapy can be a great option to manage vertigo. Taking the appropriate safety precautions is essential when starting any new physical activity, particularly for individuals with an existing medical condition. Low-intensity workouts and gradually increasing exercise difficulty under the guidance of a licensed physical therapist can assist in preventing worsening of symptoms while promoting long-term recovery.

Alternative Treatments to Physical Therapy for Vertigo

Vestibular Rehabilitation Therapy

Vestibular rehabilitation therapy (VRT) is an exercise-based program designed to promote central nervous system compensation for inner ear deficits. VRT has been shown to be very effective in treating several vestibular disorders, including vertigo.

The exercises that make up the program are tailored to each patient’s needs and symptoms. The therapist focuses on stability, gaze stabilization, balance training, and walking or running movements specific to the individual’s issues with balance. This center accepts many types of health insurance, although consultation coverage may vary based on your plan.

“It’s one thing to know how to cover your bases. It’s quite another when you actually do it.” -Ian K. Smith

Evidence suggests that patients who complete vestibular rehabilitation have a greater improvement with their symptoms than those who do not participate in this type of care.

Medication Therapy

Some medications can help alleviate the symptoms associated with vertigo. However, medication treatment alone should never replace physical therapy or other interventions such as VRT unless specifically indicated by a doctor or physical therapist skilled in managing the treatment of vertigo using medication regimens.

A class known as antihistamines relieve dizziness and nausea but don’t treat some of the underlying causes of vertigo.

Benzodiazepines increase GABA activity, which helps reduce overactivity in the brain thought to induce vertigo symptoms. They also have vomiting suppressant properties, which can decrease nausea.


Acupuncture involves inserting fine needles into specific points on the body. Traditional Chinese medicine describes these points as energy centers, where the stimulation of a point on the skin revitalizes energy flow through a meridian passageway.

Several studies have indicated that acupuncture can potentially help with vertigo. However, more research needs to be done in this area of study.

“It does not matter how slowly you go as long as you do not stop.” -Confucius

Acupuncture is often an alternative treatment used by people who wish to avoid medications and are willing to try other natural ways of managing symptoms without seeing a physician first. It consists of inserting needles into specific pressure points on the body linking up with the meridians branching out from the vestibular system.

If you’re experiencing persistent or recurring dizziness or vertigo, it’s wise to see your primary care physician. Your healthcare provider may refer you to physical therapy as well as support treatments such as VRT and medication management.

Seeking expert medical advice and taking comprehensive action against vertigo must go hand-in-hand for promising and fruitful treatment results. With effective treatment plans, you can manage your life better while facing less interference from debilitating symptoms of vertigo.

Consulting with Your Healthcare Provider About Vertigo and Physical Therapy

If you are experiencing vertigo, physical therapy can be a helpful treatment option. However, before starting any new treatment plan, it is important to consult with your healthcare provider. Here are some things you should discuss with them:

Discussing Your Medical History

Your medical history provides valuable information about your overall health and any conditions or illnesses that may affect your ability to exercise or participate in physical therapy. Be sure to tell your healthcare provider about any medications you are taking, including over-the-counter drugs and dietary supplements.

If you have previously experienced vertigo or any other balance disorder, make sure to mention this to your healthcare provider. They may recommend certain physical therapy exercises to avoid or modify based on your previous experiences and current condition.

Asking About Alternative Treatment Options

While physical therapy has been shown to be effective in treating vertigo, there may be alternative treatment options available to you as well. It is important to discuss all of your options with your healthcare provider to determine which approach is best suited for your specific needs.

One alternative treatment option for vertigo is vestibular rehabilitation therapy (VRT), which refers to a series of exercises designed to improve balance and reduce dizziness caused by vertigo. VRT may involve various head movements, body positions, and eye exercises that help retrain the vestibular system.

“Physical therapy can be an effective treatment option for vertigo, but it’s important to talk to your doctor first. This will ensure that physical therapy is safe and tailored to your specific needs.” -Dr. Michael Portenoy

In addition to VRT, your healthcare provider may also suggest alternative treatments such as medication, acupuncture, or changes in diet and lifestyle. It is important to discuss the risks, benefits, and potential side effects of all treatment options with your healthcare provider.

Physical therapy can be an effective treatment option for vertigo when done with proper guidance from a healthcare provider. Be sure to consult with your primary care physician or ENT specialist before starting any new exercise routine or physical therapy program.

Frequently Asked Questions

Can physical therapy worsen vertigo symptoms?

Physical therapy for vertigo is designed to improve symptoms, not worsen them. However, some patients may experience mild dizziness or nausea during treatment, which usually subsides quickly. If you experience severe or prolonged symptoms, notify your physical therapist immediately.

Is it common for patients to experience increased dizziness during physical therapy for vertigo?

Some patients may experience increased dizziness during physical therapy for vertigo, especially during the first few sessions. This is normal and expected, as the exercises are designed to retrain the brain and inner ear. However, if the dizziness is severe or persistent, notify your physical therapist immediately.

What are the potential risks of physical therapy for vertigo, and how can they be minimized?

The potential risks of physical therapy for vertigo are minimal, but may include mild dizziness or nausea. To minimize these risks, your physical therapist will start with gentle exercises and progress slowly, monitoring your symptoms closely. It is important to follow your therapist’s instructions carefully and report any unusual symptoms immediately.

Is physical therapy always necessary for treating vertigo?

Physical therapy is not always necessary for treating vertigo, but it can be very effective in reducing symptoms and improving quality of life. Your doctor may recommend physical therapy if your vertigo is caused by an inner ear disorder or other underlying condition. Your physical therapist will work with you to develop a customized treatment plan based on your specific needs and goals.

How can patients work with their physical therapist to ensure that their vertigo symptoms do not worsen during treatment?

To ensure that your vertigo symptoms do not worsen during treatment, it is important to communicate openly and honestly with your physical therapist. Be sure to report any changes in symptoms or unusual sensations, and follow your therapist’s instructions carefully. Your therapist may also provide you with exercises to do at home, which can help to reinforce the benefits of your therapy sessions.

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