As a Vestibular Physical Therapist, I am a physical therapist that specializes in helping people with dizziness, vertigo, balance problems, and falls.
A Vestibular Physical Therapist Will Look for the Root Cause
When I get a dizzy patient, I look at the symptoms and the problems, but then I look deeper for the root causes.
I want to find what is causing the dizziness. The root causes are often connected and there are often multiple causes.
I believe that the lack of root cause analysis for dizziness is one of the reasons why so many people are dizzy. Many cases go unsolved.
That is one of the reasons why dizziness is the number one complaint to physicians from people over 65.
The first step is to notify your doctor, and comply with whatever tests and referrals your doctor orders.
Next, I suggest is to seek a consultation with a Vestibular physical therapist.
Vestibular physical therapy is also called:
- Vestibular Rehab
- Vestibular Rehabilitation
- VPT
- Vestibular physiotherapy
Those terms are synonyms.
The Unanswered Question is “Why”
Many health professionals are not taking the time to figure out WHY a person is dizzy.
For example, in my blog How Incontinence Contributes to Falls, I discuss dizziness as a symptom of purposeful dehydration if you have incontinence.
Another example, in my other blog I discuss that dizziness with standing can be a symptom of foot neuropathy. If you stand up and the blood vessels in your legs don’t have the proper response to standing because of neuropathy, you could get dizzy when you stand up.
Those are just two examples of conditions that can cause dizziness and there are countless others. So, the question with dizziness that really has to be answered is “Why?”
Track Your Triggers to Help Identify the Cause
You can help your healthcare provider or your Vestibular Physical Therapist in the diagnostic process of your dizziness by tracking your symptom onset, triggers, and duration.
I have written this article about common triggers for vertigo and dizziness, to help you organize your thoughts before you visit with the vestibular physical therapist.
What does this mean? This means to make a summary in a timeline format of when you have been dizzy.
Note when you got dizzy. Then describe the onset, the possible trigger, and how long you felt dizzy.
For example — maybe you bent down to tie your shoe and sat up and felt dizzy for 20 seconds. Keep this information as a summary of all the episodes of dizziness you have had.
When you present this type of summary with this data to someone who specializes in dizziness, they should be able to fast-track your diagnostic process and treatment plan because this helps them do their root cause analysis.
Even if you can’t explain exactly how you felt with the dizziness, that is OK. Don’t stress about the exact description.
All we really need to know is the data – the onset, the trigger, and the duration – of any symptoms of dizziness. This will help with determining the root cause.
Keep note of your triggers but do not let it become an obsession.
Gather your Test Results
If you have seen other specialists, you can bring those reports with you to your Vestibular Physical Therapist.
Bring a copy of any tests like MRI, CT scan, X-rays, hearing tests, or bloodwork.
The vestibular physical therapist will look it all over, but they will also do their own hands-on exam.
A hands-on exam is a unique quality in healthcare these days.
A lot of healthcare providers are no longer putting their hands on a patient to test anything, and are just relying all on diagnostic tests. But dizziness and inner ear problems, or vestibular problems, are actually superiorly assessed by a hands-on exam.
Vestibular Physical Therapists Love Dizzy Patients
There are many reasons why it is important to get to a Vestibular Physical Therapist who can help you figure out the root cause.
Many healthcare providers are confused, or feel helpless, when trying to treat dizzy patients. This can limit the results of your care.
However, vestibular physical therapists live for these difficult cases and challenging patients.
If you are having trouble with dizziness, don’t lose hope. Vestibular physical therapists love dizzy patients like you!
This article can help you to find a Vestibular Physical Therapist in your area who can give you proper treatment to reduce, if not completely resolve, the dizziness.
Disclaimer
This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.
I have continual dizziness for several years. Been to many doctors and no one has a clue as to the cause. I live in a small town of about 80,000 people in Washington State.
Hi Jerry,
In rural areas and within a small population, it may be hard to find a Vestibular physical therapist.
I hear from many people who live on islands in various parts of the world with no vestibular provider on the island.
You can search for a Vestibular provider using the links in this blog.
Also, you can possibly schedule a telehealth consultation with this doctor’s office. Please tell them I referred you.
I hope that helps!
Best wishes,
Kim Bell, DPT
Hi Jerry I was shocked to read your comment “small town of about 80k people”
My small town has @ 400 people, 80k ppl sounds HUGE
🙂
I looked your information up to see if I could do anything to help my dog who was just diagnosed with this a few days ago..I even reached out to 3 different therapy clinics here in San Diego to see if anyone would consider helping her & much to my disappointment was turned down. I then came across your blog re: foot neuropathy & started reading more because I have that problem due to spinal stenosis. I had spacers put in my lower back three years ago that were supposed to help but unfortunately did not. I’m hoping to check out your class on line & get some help. Hopefully I will come across something that will help me And my dog. Thank you for the information!
Hi Nancy,
I am sorry to hear about your dog!
The term is “old dog vestibular disease” so I suggest researching that specific term. You can learn more using this link.
This is the link to my E-course for people with foot neuropathy, although it is not necessarily helpful for people neuropathy due to spinal stenosis.
Usually the solution is to have an orthopedic manual therapist treat your back for the spinal issue, and that may improve the neuropathy. I would recommend this local provider in Encinitas for your spinal care.
Best wishes,
Kim Bell, DPT
I found this article very interesting, thanks for sharing
I have many different symptoms that you have talked about and my primary care dr. hasn’t really addressed them to my satisfaction and now she is retiring. I have had low back surgery, wear hearing aids, have dealt with IBS over many years, I am 76, dizzy spells a few times in the past, I am taking Synthroid, have acid reflux, Had migraines until going through menopause but now for the last year have a . headache almost every day and dr. says it is stress. Now after 3 days of diarrhea last week i am now feeling dizzy, have a headache. I don’t know where to start to find a dr to make me feel less toxic. We are in Sun City, AZ (snow birds) and I don’t have a Dr. here. I feel like a hypochondriac. Am I ??
Hi Catherine,
I suggest that you contact my colleague Lesley Bludworth in Phoenix, AZ.
Her website is here.
You deserve one-on-one care and directed attention to your concerns.
I hope that helps!
Sincerely,
Kim Bell, DPT
I am so glad to find you online. My recurrent Vertigo has been really disheartening and you have given me hope. There is so much contradictory information online, that’ it gets overwhelming and you present facts in a way that are really useful to me.
I am 72 years old and had my first episode at the dentist last year. I saw a physical therapist who did an assessment and diagnosed BPPV. We worked together for several weeks and it resolved. He taught me to do the Epley at home also.
On Christmas Eve, it returned and I have been doing the Epley, but don’t know how often to do it. Some days are better than others, but I always have it when I lie on my left side, look down, and some of the other triggers you listed.. ,I fear that I will never be normal the spells are only a couple of seconds and when I am in a certain position, but it is psychologically distressing. At my age, I dont need any more limitations.
I plan to see my PT again, but I’m not sure he can do anything else.
I am so grateful for your online presence and would appreciate any tips or suggestions you have.
Hi Cathie,
I am sorry for what you are going through!
I definitely suggest for you to return to your physical therapist who helped you last time.
Here are some articles that may help also:
Reasons why Epley Maneuver does not work
BPPV recurrence
BPPV prevention
Dizziness Lying down
Vertigo Home Remedies
I agree – at your age that you need to get any BPPV recurrence treated as soon as possible!
I hope that is helpful!
Best wishes,
Kim Bell, DPT
Hello Dr Bell I live in chico
California and I have vertigo and I am
Looking
For a vertigo doctor or some answers here in chico I spend 5 days in the hospital and did MRI cr scan heart XR and all bubble scan of the heart and nothing negative normal
Labs test and all they call me
Medical mistery due to my exam normal
No heart attack no stroke no cancer nothing pls help to get to the root of this giving me a name of dr close mine place Tks you
Hi Minerva,
I think this is the article you are looking for.
It has links to directories that you can search to look for a provider in your area.
Best wishes!
Dr. Bell: I have been struggling with dizziness and lightheadedness for years. I literally thought it was due to age-related loss of muscle mass and I was just becoming weaker. Then I watched your UCTV program on YouTube and understood quickly that it was something else. It was like the content of the program was created for me. I want to see a specialist immediately but have no clue about who to call. Here are a few things about me that may help clarify my situation: Diet: Good but could always be better. Alignment: Not Good because of a bilateral hip replacement and one leg slightly shorter than the other. Flexibility/Range of Motion: Poor. I’m about an hour from Philadelphia. What kind of doctor should I see?
Hi Gil,
I am glad that you found our lecture to be helpful!
I suggest you go see Dr. Susan Whitney at University of Pittsburgh or Dr. Michael Schubert at Johns Hopkins in Baltimore, for a vestibular physical therapy evaluation and treatment plan.
I suggest the vestibular consultation first.
You can also look for someone closer to home on using this article.
Then you will likely need an orthopedic physical therapist for a longer term treatment plan to address the musculoskeletal issues.
You can look for someone on this directory.
So you will likely need two providers: Vestibular PT first and Orthopedic PT for a longer term.
I hope that helps!
I wish you all the best.