Dizziness, Vertigo and Inner Ear | From a Physical Therapist and Audiologist

Dizziness, vertigo, balance issues and inner ear issues can really put you down. Sometimes patients are unsure what kind of doctor they should see for balance issues. We got with our resident audiologist Dr. Reyes as well as our neighbor physical therapist over at Get Physical Rx, Dr. Jennifer Joseph, PT, DPT, CertDN to ask some important questions about balance issues.

What causes dizziness?

From Dr. Reyes, Audiologist, Texas Sinus & Snoring

Dizziness has many possible causes, Including inner ear issues, motion sickness, and medication side effects to list some. Sometimes it caused by underlying health conditions, such as poor circulation, blood pressure irregularities, infections, or injuries (head injuries).

From Dr. Joseph, Physical Therapy, Get Physical Rx

Dizziness can be a symptom of a handful of things; low blood pressure, low blood sugar, cervical spine instability, upper cervical compression and of course, inner ear pathology where an otoconia is dislodged into one of the semicircular canals which then leads to Vertigo.

dizziness and vertigo houston

What is Vertigo?

From Dr. Reyes, Audiologist & Dr. Joseph, Physical Therapy

Vertigo is the feeling of spinning even when you are not moving. Vertigo is a symptom rather than a condition itself. Vertigo usually has an inner ear involvement. It can also be related to the cervical spine or some other underlying co-morbidity such as diabetes or hypertension.

vertigo houston spring the woodlands

How do you treat dizziness and/or vertigo?

From Dr. Reyes, Audiologist

It really depends on what is the underlying cause of the symptom. When it comes to BPPV Epley maneuvers can treat the vertigo. Majority of the time Vestibular rehabilitation assists the patient. This is completed by Dr. Joseph.

From Dr. Joseph, Physical Therapy

From a Physical Therapy perspective we have to first determine if your dizziness is truly vertigo. There are several tests we can perform to determine if a patient truly has vertigo.

One of the main tests I utilize is called Dix Hallpike. With this test, if a patient is positive they will complain of dizziness and experience something called nystagmus. This nystagmus could be rotatory, horizontal or vertical. These different positions help the physical therapist determine which semi-circular canal the otoconia (crystal) is in.

The vertebral artery test, tests for occlusion of vertebral artery, which can also reproduce similar symptoms as vertigo. Once we determine if a patient truly has vertigo symptoms we usually treat with the Epley’s Maneuver. This treatment involves positional changes of the cervical spine including 45 degrees of rotation and 30 degrees of extension once the patient lies down supine.

How does physical therapy and audiology work together to help with these issues?

From Dr. Reyes, Audiologist & Dr. Joseph, Physical Therapy

Audiologists and PTs help diagnose and treat the vertigo in addition to ENT physicians and at times Neurologists. Audiologists have the capabilities of vestibular testing and testing to see where the vertigo and dizziness is originating and PTs are capable of the Vestibular therapy for treatment of the vertigo/dizziness symptoms. Often times we work together for treatment and care.

Any final thoughts?

From Dr. Reyes, Audiologist

There are differences between dizziness and vertigo. Vertigo is true spinning sensation while dizziness encompasses other sensations like drunk feelings, wooziness, imbalance, lightheadedness etc. It's important to remember this when explaining how you feel to your doctors.

From Dr. Joseph, Physical Therapy

If you are experiencing Vertigo or dizziness the best solution is to be seen. Dr. Reyes and I work together to treat our patients and get to the root cause of their symptoms. It helps that our practices are right next door.