Balance and Dizziness Issues

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.

How Does Dizziness Feel?

Some people experience a spinning sensation, called 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:

  • Difficulty walking
  • Nausea
  • Anxiety
  • Feeling tired
  • Decreased ability to concentrate
  • Depression

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.

How Can a Physical Therapist Help with Dizziness?

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.

What are 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:

  • Muscle weakness
  • Joint stiffness
  • Inner ear problems
  • Certain medications (such as those prescribed for depression and high blood pressure)
  • Lack of activity or a sedentary lifestyle
  • Simple aging

How Do Balance Problems Feel?

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 one 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.

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.

How Can a Physical Therapist Help?

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:

  • Reduce Fall Risk. Your physical therapist will assess problem footwear and hazards in your home that increase your risk of balance problems or falling. Household hazards include loose rugs, poor lighting, unrestrained pets, or other possible obstacles.
  • Reduce Fear of Falling. By addressing specific problems that are found during the examination, your physical therapist will help you regain confidence in your balance and your ability to move freely, and perform daily activities. As you build confidence in your balance and physical ability, you will be better able to enjoy your normal daily activities.
  • Improve Mobility. Your physical therapist will help you regain the ability to move around with more ease, coordination, and confidence. Your physical therapist will develop an individualized treatment and exercise program to gradually build your strength and movement skills.
  • Improve Balance. Your physical therapist will teach you exercises for both static balance (sitting or standing still) and dynamic balance (keeping your balance while moving). Your physical therapist will progressively increase these exercises as your skills improve.
  • Improve Strength. Your physical therapist will teach you exercises to address muscle weakness, or to improve your overall muscle strength. Strengthening muscles in the trunk, hip, and stomach (i.e., “core”) can be especially helpful in improving balance. Various forms of weight training can be performed with exercise bands, which help avoid joint stress.
  • Improve Movement. Your physical therapist will choose specific activities and treatments to help restore normal movement in any of your joints that are stiff. These might begin with “passive” motions that the physical therapist performs for you, and progress to active exercises that you do yourself.
  • Improve Flexibility and Posture. Your physical therapist will determine if any of your major muscles are tight, and teach you how to gently stretch them. The physical therapist will also assess your posture, and teach you exercises to improve your ability to maintain proper posture. Good posture can improve your balance.
  • Increase Activity Levels. Your physical therapist will discuss activity goals with you, and design an exercise program to address your individual needs and goals. Your physical therapist will help you reach those goals in the safest, fastest, and most effective way possible.

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:

  • An eye doctor, to check your current vision needs.
  • An ear doctor, to check your outer and inner ear status.
  • Your personal physician, to review your current medications to see if any of them may be affecting your balance.