Dizziness and Physiotherapy

April 15, 2017 | By | Reply

– Dr. Prajakta Kudalkar

Dizziness is one of those symptoms which is fairly common in a number of conditions and is certainly debilitating. It basically indicates there is an issue with the balance and coordination system of the body, and when that happens, the brain is unable to perceive the orientation in space leading to altered input to the brain, making one feel dizzy.

The balance and coordination system of our body involves the following structures:

  • Vestibular canals – located in the middle ear
  • Vision – eyes
  • Proprioceptors – balance sensors located in every joint of our body
  • Cerebellum – hind brain
  • Core muscles of the cervical spine

Dizziness and Physiotherapy

All these systems when working in synchrony lead to a well-balanced and stable perception of our body in space.

As mentioned before, dizziness can be a part of several conditions, however it is essential to identify the cause of it. If all the systemic causes like low blood pressure, arterial dysfunction/thrombosis in the brain, middle ear infections etc, have been ruled out, it is vital to explore if there are any mechanical problems leading to dizziness.

Mechanical problems associated with the cervical spine (neck) could lead to dizziness. Usually in such a case, the dizziness is associated with sudden neck movements and sustained postures. It may also be associated with previous traumatic neck injuries.

Factors responsible for causing dizziness associated with cervical problems are

  • Weak core muscles of the neck
  • Poor proprioception of the joints between vertebrae and head and neck
  • Segmental instability and faulty postures
  • Severe degeneration of spine due to aging

Let’s look at each of these in some detail:

Core muscles of the neck are the ones which are responsible for providing stability during movement of the neck or during impact. These muscles control small segmental movements of the vertebral bones allowing the neck to move the head on a stable platform. Weakness of these muscles results in greater imbalance of the head movement which in turn can make a person feel dizzy. Think about a roller coaster ride!

Dizziness and Physiotherapy

Proprioceptors are sensors located on joint surfaces which sense the amount of pressure being put on the joint surfaces. This feedback is in turn sent to the brain to determine the orientation of a joint in space. Sometimes due to injuries or prolonged pain, these proprioceptors become inefficient. As a result, the brain receives a morphed feedback because of which the alignment of the head over the neck is in a constant state of conflict. This results in dizziness. Eg: feeling dizzy while reading in the car.
Dizziness and Physiotherapy

Segmental instability arises when there is excessive mobility in one segment over the other. Ideally when we move, the spine follows a smooth curvature of movement where the bones of the neck move one over the other. In some cases, this smooth movement is altered, resulting in excessive stress in one part of the spine compared to other.

Dizziness and Physiotherapy

Consequently, it leads to the head not being controlled in a particular direction of movement. Instead of the head being held nicely on the spine, it moves ahead leading to kinking of the spine at a particular segment. This kinking leads to compression of vertebral arteries which supply blood to the hind brain. It may also cause excessive compression at the head neck junction.
Dizziness and Physiotherapy

People with such issues usually complain of dizziness while moving in a particular direction.

Detailed analysis of posture, movement and balance can accurately determine what mechanical cause is responsible for the symptoms. As physiotherapists, we can help you with strengthening your muscles, correct ways to move effectively, improve posture and help retrain your proprioceptive deficits with tailor made exercises. A physiotherapist will also advice you on the right ergonomics for work needs, gadget use, and activities of daily living, like lifting weights, bending forward etc. This can help you alleviate your dizziness and hence improve your quality of life.

Dizziness as a symptom should not be ignored. It is critical to get it assessed by medical experts like an ENT specialist (for middle ear issues), Ophthalmologist (vision issues), Neurologist (brain and nerve related issues), Orthopaedician (bone and muscle related issues), in order to rule out any major illnesses.

To know more, contact our physiotherapists today.

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