Dizziness is a common problem, especially among older adults. In fact, for people over the age of 65, dizziness is one of the most common reasons for physician visits and hospitalizations. Regardless of the cause of dizziness, the sooner you get help, the better.
Dizziness – and the balance problems that may come with it – can be caused by a number of factors:
Some people have a spinning sensation (“vertigo,”) which happens when you change the position of your head). Others have a general feeling of unsteadiness, a rocking sensation as if on a boat, or as “lightheadedness.’ Dizziness can result in:
Above all, dizziness can increase the risk for falls, which can be a serious health concern among older adults.
The earlier you get treatment, the better. That’s because your brain and inner ears are more likely to be able to work together during the early stages, so that’s when you have your best chance for full recovery.
The good news: most dizziness and balance disorders can be successfully treated – and they are not an “inevitable” part of aging. Your physical therapist can perform tests to determine the causes and also to assess your risk of falling. Often, there is more than one reason for dizziness and falls in the same person. Depending on the results of the tests, your therapist may recommend further testing or consultation with your physician.
Based on your physical therapist’s evaluation and your goals for recovery, the therapist will customize a treatment plan for you. Your therapist’s main focus is to help you get moving again and manage the dizziness at the same time. Exercise and new ways to perform daily activities are the primary treatments.
During your recovery, your physical therapist will teach you strategies to help you cope with your symptoms:
Physical therapy treatments for dizziness can take many forms. The type of exercise that your therapist designs for you will depend on your unique problems and might include exercises to improve your balance, to improve your ability to focus your eyes and vision, and to “correct” differences between your brain and your inner ears. The inner ears tell the brain how the body is moving in relation to gravity. They also communicate information about head motion, which is used to coordinate eye motion.
In addition to those exercises, your physical therapist might prescribe exercises to improve your strength, your flexibility, and your heart health – with the goal of improving your overall physical health and well-being.
Balance problems make it difficult for people to maintain stable and upright positions when standing, walking, and even sitting. Older people are at a higher risk of having balance problems; 75% of Americans older than 70 years are diagnosed as having “abnormal” balance. Older women are more likely than older men to develop balance problems, although the difference between the genders is small. Balance problems increase by almost 30% in people aged 80 years or more. Mexican-Americans have the highest rate of balance problems among all Americans. Physical therapists develop individualized physical activity plans to help improve the strength, stability, and mobility of people with balance problems.
A balance problem exists when an individual has difficulty maintaining a stable and upright position. A range of factors can cause balance problems, including:
Balance problems can also be caused by medical conditions, such as:
Balance problems occur when 1 or more of 4 systems in the body are not working properly:
Poor vision can result from age, eye tracking problems, or eye diseases. Inner ear problems, also called vestibular problems, can develop from trauma, aging, poor nutrition, or disease. Body-position sense can become abnormal as a result of trauma or a disease, such as diabetes. Muscle strength and flexibility can decline due to lack of exercise, a sedentary lifestyle, or disease.
The brain coordinates impulses from the eye, inner ear, and body-position senses, and sends signals to the muscular system to move or make adjustments to maintain balance. If one or more of the senses is not sending correct signals to the brain, or if the muscular system cannot carry out the necessary movements, a person may not be able to maintain or correct their balance.
A person with balance problems may experience tripping, swaying, stumbling, dizziness, vertigo, and falling. Although a person’s “static” balance may be fine when standing still or only performing a single task at a time, “dynamic’ balance problems may become apparent when the person is moving about or trying to do more than 1 thing at a time (i.e., walking, while turning the head to talk to another person), or when there is not much light (at night, or in a darkened room). If someone’s dynamic balance is abnormal, it can cause a fall and possible injury.
Balance problems can make a person fearful of performing simple daily activities. As a result, they may lose muscle strength and become frail because they avoid strenuous or challenging movements. A person who has balance problems may start to feel frustration about the condition, and become depressed.
If you see your physical therapist first, the physical therapist will conduct a thorough evaluation that includes taking your health history. Your physical therapist will also ask you detailed questions about your condition, such as:
Your physical therapist will perform tests, such as motion, strength, coordination, visual tracking, and balance tests, to help assess your overall physical ability. Your physical therapist may collaborate with your physician or other health care providers, who may order further tests to rule out any underlying conditions that may exist.
Physical therapists offer numerous options for treating balance problems, based on each person’s needs. They are trained to evaluate multiple systems of the body, including the muscles, joints, inner ear, eye tracking ability, skin sensation, and position awareness in the joints (proprioception). Physical therapists are experts in prescribing active movement techniques and physical exercise to improve these systems, including strengthening, stretching, proprioception exercises, visual tracking, and inner ear retraining.
Your physical therapist can help treat your balance problems by identifying their causes, and designing an individual treatment program to address your specific needs, including exercises you can do at home. Your physical therapist can help you:
Once your treatment course is completed, your physical therapist may recommend that you transition to a community group to continue your balance exercises, and maintain a fall-proof home environment. Many such community groups exist, hosted by hospitals, senior centers, or volunteer groups.
Your physical therapist may recommend that you consult with other medical providers, including:
Can this Injury or Condition be Prevented?
To help prevent balance problems, your physical therapist will likely advise you to:
Your physical therapist will also prescribe a home exercise program specific to your needs to prevent future problems or injuries. This program can include strength and flexibility exercises, posture retraining, eye-tracking and vestibular exercises, and balance exercises. For more information request a consult from one of our many locations today!
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