Tag Archive for: dizziness

Vestibular Therapy: The Safer, More Cost-Effective Treatment for Vertigo Sufferers

If you’ve ever suffered from an episode of vertigo, then you know how debilitating and scary it can be: Room spinning, loss of balance, barely able to walk or move… The traditional route of treatment is to get yourself rushed to the emergency room (ER), undergo a myriad of diagnostic tests to rule out anything serious (like a stroke or heart attack), and then, if they can’t find a “cause”, you’re typically sent on your way with medication and a referral to a specialist. 

Medications typically don’t do anything to resolve your vertigo but they will mask your symptoms.

And it can often take months to get an appointment with either a neurologist or ears, nose, throat (ENT) doctor. If, after this whole ordeal, you’re still suffering from dizziness/vertigo – you’re not alone. ER’s are notoriously bad at diagnosing and managing dizziness. Not only that, but it’s expensive. According to Dr. Newman-Toker, researcher and professor of neurology at John Hopkins University, the cost of emergency room visits due to dizziness now exceeds $10 billion per year. And almost half (43%) of all dizziness-related ER diagnoses are wrong. They are corrected once you get to a specialist who knows how to properly diagnose you.

So… if going to the ER when you’re suffering from a debilitating episode of dizziness/vertigo is not the best or most cost-effective treatment option… then what should you do? Enter Vestibular Therapy. It’s safer, more cost-effective, and it leads to long-term solutions that help you resolve your dizziness without medications or procedures. It’s not something a lot of people know about or fully understand – so let’s go through it to see if this is a treatment option you need and/or what’s been missing for you.

First – what exactly is vertigo – and how do you know if it can be treated with vestibular therapy?

Vertigo is a collection of symptoms, and not its own diagnosis. The symptoms you experience (dizziness, room spinning, disorientation, loss of balance) are the result of disturbances within your vestibular system, which is responsible for helping you maintain balance and spatial orientation. There are two distinct categories of vertigo: peripheral and central. Peripheral vertigo occurs when the peripheral components (located in your inner ear) of your vestibular system are affected. It’s caused by conditions such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, or Meniere’s disease – and can lead to sudden episodes of dizziness, nausea, and imbalance. Central vertigo, on the other hand, arises from problems within your central nervous system (aka brain). Causes of central vertigo include things like stroke, multiple sclerosis, or tumors – and it manifests as a more sustained form of dizziness, typically accompanied by neurological symptoms. You need the correct diagnosis of vertigo in order for treatment to work. But the good news is that 80% of all vertigo is peripheral – and can be treated naturally with vestibular therapy. Plus, when you’re first examined by a vestibular therapy specialist, they will rule in or out any vertigo that could have a central cause, and you’ll be referred to the correct medical specialist immediately.

So what is vestibular therapy and how does it work?

Vestibular therapy is a specialized form of physical therapy designed to address specific components of peripheral vertigo within your inner ear , as well as enhance the communication between your brain and vestibular system to improve your overall balance. Vestibular therapy starts with an examination (by a trained vestibular physical therapy specialist) that includes various maneuvers and specialized vision and balance tests to determine the exact type of peripheral vertigo you’re dealing with. From there, the correct treatment plan can be developed. For those that are vaguely familiar with vestibular therapy, it’s often associated with full body maneuvers such as the Epley, Semont, or Foster – which can be scary and ineffective if you haven’t been examined properly. It’s important to note there are many more components to vestibular therapy – so if you’ve tried and failed at one of these in the past – there is still hope. A good vestibular therapy specialist will incorporate interventions to work on all three of your balance systems, as well as give you additional strategies for home, lifestyle, and diet – all aimed at improving the areas of your balance and coordination system that might not be working as well as they could be. 

Vertigo is a common condition that many people are forced to face alone and without proper treatment, primarily because the education and awareness around vertigo is so limited. If you or someone you know wants to avoid medications and procedures (that typically don’t work), and treat vertigo naturally and in a more holistic way – then vestibular therapy might be exactly what you’re looking for. If you need help finding a qualified vestibular therapy specialist, don’t hesitate to reach out.

If you are local to Portsmouth, NH – click here to speak with a vestibular specialist.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, email her at [email protected].


Vertigo and Fall Risk: 5 Ways to Safeguard Yourself Against Unexpected Falls

Vertigo is often described as a distressing sensation of spinning that makes you feel as if the world is moving around you – or that you are spinning yourself. It’s an unsettling experience – and can be dangerous – as it puts you at a greater risk for falling. Over 3 million older adults are treated in the emergency room every year due to fall-related injuries. One out of five of those falls causes serious injury – like a broken bone or head trauma. 

If you are suffering from vertigo, it’s critical that you take time and due diligence to get to the bottom of what’s causing it so that you can safeguard yourself against unexpected falls. The good news is this is entirely possible. But first, it’s important for you to know that vertigo is a symptom, and not a diagnosis. Vertigo is the result of a disturbance in your inner ear (vestibular system). It can be caused by various things, namely, Meniere’s disease, benign paroxysmal positional vertigo (BPPV), vestibular neuritis, and cervicogenic dizziness… just to name a few. Once you’ve identified the root cause of your vertigo – the correct treatment approach is possible. I can’t tell you how many horror stories I’ve heard from people suffering from vertigo longer than they needed to – all because they didn’t get the right tests to diagnose the cause – or were prescribed medication they didn’t actually need. All the while, continuing to live with a constant fear of falling and never knowing when their next vertigo attack would occur.

The reason suffering from vertigo puts you at such risk for falling is because when it comes to balance, we rely on three bodily systems. One is your vestibular system, which vertigo disrupts. The other two systems are your vision and proprioception. All three systems are responsible for helping you orient and visualize yourself in space. When you have vertigo – you’re forced to rely on (and train) the other two. 

The good news is there are strategies you can employ to compensate for a mal-functioning vestibular system.

If you suffer from vertigo – here are five simple and effective strategies that can help minimize your fall risk and enhance your safety:

  1. Remove Hazards: Roll Up and Stow Away Rugs

In a home environment, even seemingly harmless elements like rugs can pose a significant risk. Rolling up and storing rugs minimizes the chance of tripping or slipping, providing a safer space to move around, especially during vertigo episodes. Smooth, obstacle-free floors reduce the likelihood of unexpected falls and help maintain stability.

  1. Illuminate Pathways: Install Night Lights for Nighttime Mobility

Navigating through the house at night, especially when experiencing vertigo, can be daunting. Installing night lights along hallways, staircases, and near the bathroom provides essential visibility and helps prevent accidental falls. With well-lit pathways, you can confidently move around during the night, reducing the risk of missteps or collisions with objects.

  1. Exercise Caution: Walk with a Companion and Use Hiking Poles

Engaging in physical activity is crucial for maintaining health, but doing so alone when experiencing vertigo can be risky. Pairing up with a friend for walks provides both companionship and an added layer of safety. Additionally, using hiking poles offers stability and support, especially when dizziness strikes unexpectedly, allowing for more secure movement during outdoor activities.

  1. Focus and Reorient: Lock Your Gaze on a Steady Object during Dizziness

During vertigo episodes, it’s common to feel disoriented and unsteady. A practical technique to regain stability is to lock your gaze on a stable and fixed object. This method helps recenter your focus and gradually reduces the sensation of spinning or imbalance, allowing you to regain control of your body and surroundings.

  1. Safe Driving Practices: Stabilize Focus and Minimize Distractions

When vertigo strikes while driving, it’s essential to prioritize safety. If feeling dizzy behind the wheel, fixate your gaze on a stationary object—such as the dashboard or the road ahead—to regain a sense of stability. Additionally, reduce all distractions by turning off the radio and refraining from engaging in conversations with passengers. Prioritizing focus and minimizing external stimuli can help mitigate the risks associated with vertigo while driving.

While these strategies can be helpful – please know that you don’t have to let vertigo keep running your life and stop you from doing what you love. With proper treatment, you can stay out of the hospital, stop taking medication and move out of the fall risk category with the support of a good vestibular specialist. Diagnosing vertigo is a step-by-step process that starts with a detailed medical history and extends to various physical examinations. Vestibular specialists will employ a range of tests, including specialized balance assessments for fall risk, to pinpoint your exact cause of vertigo. Navigating through these diagnostic tools is crucial for developing a treatment plan that works. Once the correct diagnosis is made, treatment can begin immediately to start retraining your brain. The key is to train your brain to stop relying on the damaged part of the inner ear (that leads to vertigo and dizziness) – and help it to rely on your other two balance systems instead so that you can stay safe and improve your balance.

Interested in learning more about Vertigo?

Join us for our Free Online Masterclass for Vertigo Sufferers! It’s happening January 23rd, from 6-7pm via zoom – click here to reserve your seat before they’re all out.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or seat in her upcoming Masterclass for Vertigo Sufferers – visit www.cjphysicaltherapy.com – or call 603-380-7902


6 Tips for Managing Debilitating Vertigo at Work

“Vertigo” is the sudden onset of dizziness, spinning and nausea that often stops you in your tracks without any visible signs or warning. If you’ve ever experienced vertigo, then you know the debilitating effects it can have on your daily life and ability to work. For those that haven’t experienced vertigo – it can be difficult to explain. Your co-worker will never understand why you missed that deadline. Your boss won’t understand why you had to miss work for the past three days.  All because for 72 hours, the room has been spinning on and off, and you couldn’t spend more than five minutes reading on your computer before you felt the vertigo coming back on. 

Perhaps the most challenging aspect of suffering from vertigo is the unknown. By definition, vertigo is a symptom that occurs due to a miscommunication between your vestibular system (responsible for balance and spatial orientation) and your brain’s interpretation of those signals. When the signals are mismatched – the result is vertigo – that awful, uncontrollable sensation of spinning or dizziness.

What does this look like in real life? 

You could turn your head slightly too far or slightly too fast and bam – here comes the dizziness. You could get up from a chair or out of bed too quickly and suddenly the room is spinning. Vertigo has the ability to quickly and without notice turn the ordinary, mundane parts of your day into the scariest parts of your day… Suddenly everything from driving, working at a computer, walking to lunch, or getting up to go to the bathroom become debilitating and unreliable. Every single one of these tasks not only becomes difficult – but often the scariest parts of your day as well.  becomes the scariest part of your day. Why? Because every single one of these tasks requires balance and coordination – and when your vestibular system and brain don’t cooperate – these things become extraordinarily difficult.

While there are many underlying causes to vertigo, and only a vertigo specialist can determine this, there are some things you can do to mitigate the onset of vertigo so that it doesn’t continue to impact your work day. 

Here are tips for managing debilitation vertigo at work:

1. Utilize Blue Light Filter Glasses

Prolonged screen time can exacerbate vertigo symptoms, and these glasses work to block harmful blue light emitted by digital devices. By alleviating the eye strain associated with screen time, these specialized glasses create a more comfortable visual experience, potentially lessening the likelihood of triggering or worsening vertigo episodes during your work day – especially if your work involves extended use of the computer.

2. Wear Noise-Canceling Headphones

Noise sensitivity often accompanies vertigo. Using noise-canceling headphones can create a quieter work environment for you, minimizing any overstimulation that might trigger or worsen your vertigo episodes. When you reduce auditory input, you’ll find it easier to focus, and it will be a calmer sensory experience for you at work.

3. Opt for a Swiveling Computer Chair

A swiveling chair offers the flexibility to rotate your body when shifting between screens or tasks. This minimizes abrupt head movements, which can trigger vertigo. The ability to turn your body rather than constantly turning your head can significantly reduce the risk of a debilitating vertigo episode happening during your work hours.

4. Find a Stable Focus Point During Physical Activities

Engaging in physical tasks that might induce dizziness can be challenging. If you experience vertigo during physical movements, find a stable object or point in your surroundings and focus on it. This fixed reference point can help recalibrate your balance and reduce the sensation of dizziness.

5. Be Mindful or your Movement and Pace

Sudden and quick movements are known to trigger episodes of dizziness and spinning from those suffering from vertigo. When you mindfully and purposefully slow down – you alleviate the stress on your vestibular system. This can go a long way in helping to minimize triggers that may exacerbate your vertigo symptoms.

6. Ensure Adequate Lighting

Aside from your vestibular system, your vision also helps significantly with balance. By ensuring ample lighting in the workspace – you can help compensate for the disruptions caused by vertigo. Well-lit environments provide clearer visual cues, assisting in maintaining balance and reducing the risk of falls during a vertigo episode.

If you’re currently suffering from vertigo – or have been dealing with vertigo on and off for years – perhaps it’s time to consult with a physical therapy vertigo specialist. The right practitioner will perform specialized tests to identify if your root cause is movement based – and can determine if you need to see a neurologist or eye specialist instead or in conjunction. By going this route first, you can determine if the cause of vertigo can be successfully treated naturally , and avoid treatment approaches that involve medications or procedures that you might not need. But in the meantime, hopefully some of these strategies help you create a more manageable work environment if you suffer from vertigo on a regular basis.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or seat in her upcoming Masterclass for Vertigo Sufferers – visit www.cjphysicaltherapy.com – or call 603-380-7902

3 Signs Balance Problems are all “In Your Head”

As we get older – balance problems tend to creep up on us.

Everything from poor vision to weak muscles to stiff joints can have an impact on how steady we are on our feet.

Activities like Yoga and Tai Chi are great for improving balance because they help you to focus and become more aware of how your body is moving. Having a strong core and leg muscles are also key.

But what if you’ve been working on all of these areas and your balance problems still haven’t improved?

There’s one other huge contributor to balance and it’s called your vestibular system. It’s one of our three major balance systems and it’s located in your inner ear – literally in your head.

Your vestibular system is responsible for sensing movement and changes in your head position and when it’s not working properly, it will definitely impact your balance.

How do you know if your vestibular system is dysfunctional?

One of the most tell-tale signs is dizziness, commonly known as “vertigo”, and it’s more common than most people think. Approximately 35% (that’s 69 million) of adults over the age of 40 have experienced some form of vestibular dysfunction.

This number gets even higher as we age and recurrence becomes more common with 80% of people over the age of 65. It doesn’t matter how strong you are, or how many times you practice standing on one leg – if your unsteadiness is from vertigo – you remain at a high risk of falling until you get this sorted out.

Vertigo is no fun and it can be extremely debilitating.

While medication can be used to reduce the sensation of dizziness, it tends to only mask the symptoms.

When the medication is stopped many people are faced with the same symptoms they started with.

The most common form of dizziness among older adults is from BPPV (Benign paroxysmal positional vertigo) and is only benign to those that haven’t experienced the debilitating impact it has on your daily functions. BPPV happens when a clump of crystals move within the inner ear-control center for balance, causing a severe spinning sensation when moving your head. It’s treated by moving the crystals in a specific pattern to get them back in proper alignment.

This condition becomes more common over New England winters when we do not get as much sunlight or vitamin D– which can make you more susceptible to changes in the inner ear crystals.

Vestibular hypofunction can also be a reason for dizziness or unsteadiness, and it typically happens after something like a whiplash injury or sudden attack that leaves you feeling scared and unsteady. Vestibular problems can be challenging to accurately diagnose.

Here are three signs that indicate your balance problems might be due to a vestibular dysfunction:

1. Things Spin When You Bend Over

Ever been in the middle of gardening, or getting in and out of bed, and things start spinning for no good reason?

People often mistake this for dehydration or low blood pressure. These are certainly possibilities, but it could also be from a dysfunctional vestibular system. Because this system is located deep within your inner ear, it’s most affected by large head movements. Movements such as bending over. If the system in your ear doesn’t keep up with how fast your body is moving – things start spinning.

While it’s common for this to happen from time to time, if it’s happening a lot, or gets so severe that you can’t stand up, then it’s worth getting looked at.

2. It’s Hard to Walk Around in the Dark

As we get older, vision is one of the first things to become impaired.

Vision is another major player in how well you balance. It becomes critically important that your other two systems – vestibular and proprioception – are in good shape.

If you have strong legs and typically don’t have a problem with balance during the day you may notice that at night or in dim lighting your balance always seems to be off. This could be a sign that your vestibular system is dysfunctional.

3. Crowds Make You Unsteady

Many of us dislike crowds.

Is the reason you avoid them is because you’re afraid of falling or you find that crowds make you dizzy? This could mean that your vestibular system is off.

Public, busy settings can overstimulate our nervous system, making it more difficult for your brain to coordinate with your inner ear.

Do you find that every time you’re in a busy grocery store you have difficulty remaining steady while looking around? But you’re always fine in your quiet home? It could be a sign that your vestibular system needs to be checked.

Do you notice any of these signs? Are you finding yourself off balance and more dizzy than usual? You could have a vestibular problem.

The good news is that vestibular dysfunction can be helped without medication. It’s done by training the brain to accommodate for these changes in your inner ear.

Are balance problems like Vertigo getting in the way of your everyday life?

It just so happens that we have a Vestibular Specialist on our team!

CLICK HERE to request a FREE Discovery Call with one of my specialists.

Someone from my client success team will call you right away. They’ll see if you are a good fit for what we do and figure out a plan to get you back to doing the activities that you love. So you can be pain free and reduce your stress levels the right way to be your best and most healthy self 🙂

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or request a free copy of one of her guides to back, neck, knee, or shoulder pain, email her at [email protected].