Dizziness & Vertigo

Goals of Vestibular Therapy

Vestibular rehabilitation is an exercise-based program, designed by a specialized physical therapist, to improve balance and reduce dizziness-related problems.

After a confirmed diagnosis, most people can recover from vestibular disorders with a selection of exercises and treatments. We will work with you on a program specifically for your condition.

By performing the exercises or movements, most patients experience relief in just a few short visits. Physical Therapy of Melissa has a dedicated physical therapist for our balance-challenged patients. Dr. Pamela Berner, PT, DPT is a member of the Neurology Section and Vestibular Special Interest Group of the APTA and the Vestibular Disorders Association. Pam has completed a high level education program in vestibular dysfunction evaluation and treatment through Emory University.

  • Improve your balance
  • Strengthen your body
  • Improve your mobility
  • Increase your level of activity
  • Reduce your fear of falling
  • Establish confidence in yourself and your body

If you’re experiencing problems with balance or dizziness, our team will provide you with a full vestibular assessment. From there, we can establish a personalized regimen for you, providing you with the confidence you need to get back to the activities you love.

Screen Shot 2018 04 09 at 2.34.39 PM Dizziness & VertigoAfter suffering from Vertigo for three plus years, visiting multiple doctors, trying different medications, and exercise routines, Vestibular Rehabilitation Therapy was recommended to me. I went online to check this out and found PTM had a specialist in this area. I began working with Pam and what a difference she has made! She is most knowledgeable in vestibular issues and communicates in a personal, professional, and most understandable way. She welcomes questions at any time and is a great encourager as you meet your goals, and always challenges you to go to the next level. It is so comforting to be able to talk to someone who understands vertigo and balance issues and how to manage the effects of each. Everyone as this facility is friendly and efficient. If scheduling problems arise, they are happy to offer solutions. My drive there is one hour twenty minutes, but it was well worth the time and distance. I have already recommended Pam to a friend and she is beginning her pt in two days. Thank you, Pam, and everyone at Physical Therapy of Melissa for your exemplary service. My doctor in Dallas has added you to their recommended list of physical therapists. – M.C.


What is Vertigo?

Vertigo is the feeling of a rocking or rotation when you are perfectly still. It tends to last for several hours or days. Medically, it is distinct from dizziness because it involves the sensation of movement. Vertigo is often due to a problem in the inner ear. An important part of the inner ear is the collection of semicircular canals. These structures are lined with cells that act like a gyroscope for the body and are responsible for providing feedback on our position.

Causes and Risk Factors for Vertigo

There are a variety of causes for this condition. The cause may be central or peripheral. Central causes occur in the spinal cord or brain, while peripheral is due to a problem with the inner ear. An illness or small crystals in the inner ear that become displaced can cause an irritation within the semicircular canals. This is a central cause and known as benign paroxysmal positional vertigo (BPPV). With Meniere’s disease, there is a fluid buildup in the inner ear that can cause vertigo. Headaches, head injuries, strokes, tumors and multiple sclerosis can also cause vertigo.

Head injuries definitely increase the risk factor for vertigo. In addition, antidepressants, aspirin, blood pressure medications and anti-seizure meds can also cause vertigo. For some, alcohol can cause vertigo.

Diagnosis and Treatment

To diagnose vertigo, a medical professional will take a full history of your symptoms and events. This includes previous medical issues, recent illnesses, and medications. Then, a physical exam is performed. It includes a comprehensive neurological exam to check brain function. This allows for the determination of whether it’s peripheral or central. Signs of abnormal eye movement may pinpoint the problem. The Dix-Hallpike test or the roll test may be done. The Dix-Hallpike test repositions the head and monitors symptoms. With the roll test, the head is rapidly moved from side to side. A CT scan or MRI may be done to exclude structural problems. Sometimes, electronystagmography may be performed.

The most effective treatments if the vertigo is peripheral include partial repositioning movements. It’s known as the canalith repositioning procedure or the Epley maneuver. Specific head movements are performed to move the crystals in the inner ear. Cawthorne head exercises may also be performed. It’s a series of head and eye movements. This leads to a decreased sensitivity of the nerves and improves vertigo. However, this needs to be done on a regular basis for optimal results. A trained physical therapist can perform these types of treatment. Keep in mind that medications may provide some relief but are not a cure. Meclizine is the most popular medication prescribed.

The Prognosis

Most patients with peripheral vertigo can find substantial relief with treatment; it has been suggested that the Epley maneuver in cases of BPPV can benefit as many as 90% of affected patients. Although recurrence of BPPV may be more than 15% in the first year after an episode, it is unlikely that vertigo will persist beyond a few days. When vertigo persists, evaluation for any underlying structural problems of the brain, spinal canal, or inner ear may be necessary.

Are you feeling dizzy with a sense of movement? You just might be experiencing vertigo. Make your world stop spinning with the help of our experienced and certified physical therapists. They are trained in the Cawthorne head exercises and Epley maneuver for vertigo. They can even give you instruction on how to do these exercises at home. Be sure to give us a call to set up a one-on-one consultation and full evaluation of your symptoms. We’ve helped many others and can help you too.