In this blog, I discuss the topic of vertigo exercises that are given to a patient without a proper root cause assessment.
Two months ago, I had the honor of presenting my third UCSD Stein Public Lecture, this one with the title, “Dizziness and Vertigo, Part II – Research in Aging.”
My goal was to offer an integrated perspective of root causes of dizziness and vertigo from different body systems to empower patients to advocate for themselves, and to offer healthcare providers a new approach to resolving these uncomfortable symptoms.
At the end of my public lecture, there was time set aside for questions from the audience.
The Question
One of the questions that was asked by an audience member was: “My doctor gave me a sheet of vertigo exercises to do and I have been doing them every day but they don’t help. Should I continue with these vertigo exercises?”
My answer to her was that for some mild cases of vertigo, certain exercises may reduce if not completely eliminate the symptoms. However, if vertigo exercises are not helping at all or feel like they may be making vertigo symptoms worse, then they are likely not appropriate for that particular patient at that time.
In her case, there was a lack of Root Cause Evaluation and that was the reason that the vertigo exercises prescribed were not effective.
No one had actually assessed her for the cause of her vertigo symptoms, but instead she was given a generalized set of vertigo exercises for treatment.
When she realized that the exercises were not helping, this woman did not know what other options were available.
My guidance in cases like this is to find a healthcare provider who is a Vestibular Expert and advocate for a specialty evaluation for dizziness and vertigo. Providers who offer Vestibular Rehabilitation should be able to recommend appropriate vertigo exercises, if needed, for anyone who suffers from dizziness or vertigo.
The exciting fact is that in many cases, skilled care by the right provider can resolve dizziness and vertigo without any need for further vertigo exercises.
It depends on the root cause of the vertigo, which will determine which vertigo exercises are needed, if any.
The first step is the find the right healthcare provider.
Disclaimer
This blog is provided for informational and educational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.
Right now I am doing therapy to help resolve my dizziness, but it seems like it’s not working
Because I still get sudden attacks ..
The last one was terrible and lasted over an hour
Hi Fareeda,
Vertigo can happen to anyone at any time!
The question you and your therapist must sort out is what is causing these attacks.
For example, a virus, BPPV, vestibular migraines, and Meniere’s are all potential causes of sudden vertigo attacks.
However all those vertigo attacks will have different characteristics.
My suggestion is that you record your observations in the format that I share in this blog.
Then find a provider using the directories in this article.
That might be a good next step if you feel the therapy is not working.
In this article and this article, I share barriers to vestibular recovery that may be slowing down your progress. If you think any of those apply to you, you can discuss with your therapist or doctor.
I hope that helps and I hope you find some answers soon!
Sincerely,
Kim Bell, DPT
The exercises make my vertigo worse so I don’t do them because it doesn’t work on a 70 year old man. I am taking a medication but it’s just not strong enough. So I just go on having episodes after episodes with nothing to help me. It’s ugly to have this problem because I had to give up golf and pickle ball. They tell me soda pop and energy drinks make it worse. So now I trying drink more water but I still get episode here and there. Nothing seems to work. It has ruin my life and got worse as I get older. 70 years old and still plugging along.
I am glad i read the article as i myself was given a set of exercises to do by a Dr that i spoke to during a telephone consultation. The exercises made me feel much worse and at one stage i fell off my bed and hit my head. i got back in touch with Dr’s surgery and another Dr also said it sounds like vertigo/ BPPV yet neither of them asked to see me, do any tests etc..a friend of mine asked how on earth they diagnose without seeing a patient and says i need to see someone about this.
Very good site thank you.
I have dizziness ALL the time since coming out of hospital after having an appendectomy 5 weeks ago.
It began with dizziness 10 days following the operation.
It makes me think of coincidence that perhaps it was from the 6 iv bags of antibiotics that were pumped into me over 24 hours before and after the op.
Anyway my doctor did nothing expect give me Betahistine which I’ve since found after for Ménière’s disease. I don’t have any hearing loss.
The tablets gave me stomach ache so I didn’t take for more than three days.
I saw a specialist Physio who also couldn’t tell me what it is but said she thinks it’s not vertigo!
I have very pronounced oscillopsia and having read about my symptoms it seems I could have BVH or worse BVL.
Would specific vestibular rehab exercises help me? If so which ones?
No one here in Australia is willing to help unless they can do surgery. I’m at my wits end. Thank you.
I’ll continue to do my gaze stabilisation exercises all the time.
Hi Jane,
IV antibiotics can cause bilateral vestibular hypofunction, or bilateral vestibular loss, due to ototoxicity.
Patients with this condition typically don’t experience true vertigo, but they have severe oscillopsia and unstable walking.
I have not yet written an article on this topic that I can share with you. However, I think this is a great topic for a future blog article that I can write.
In the meantime, this article by the Vestibular Disorders Association at Vestibular.org may be helpful to learn more.
This article may help you search for a vestibular rehab provider in your area, so you can seek individual medical advice.
I have had dizziness and balance issues for 2 years, Standing in one place for any period of time causes me to sway and feel like I am going to fall over, I have done many sessions of PT with some short term relief but never complete relief. I am on a wait list to see a neurologist at the UW in Washington state. At 58 years old I cannot function like a normal person.
I had vestibular neuritis 12 years ago, I eventually visited a highly recommended VRT specialist & VRT helped me tremendously.
Over the years I have had reoccurring vertigo & VRT has ALWAYS come to my rescue. I recently went two whole years with no symptoms at all.
However, it has returned & now VRT is not working anymore, I’m at my witts end. I’ve been doing VRT on & off for 6 months now.
After having eye laxer treatment some 25 years ago, I now have one long sighted & one short sighted eye, my short sighted eye has definitely got worse over the past year. I thought this was the culprit, but if it is, why I’m I still dizzy with my glasses on?I do VRT exercises with my glasses on.
IN DESPERATION!!!
Hi Sue,
That’s a bummer! Sorry to hear this.
Maybe you have something else going on this time?
If VPT isn’t helping as usual, maybe some other factor is at play.
You can use the questions I ask in this blog to present your case to your doctor and providers for a root cause analysis.
For cases that are not responding well to VPT, I might consider getting a:
(1) neurologist consult,
(2) neuro-optometrist consultation, and (3) an upper cervical evaluation.
Frequently those steps can shed light on what else might be going on.
Best wishes!
I really thought that I was having problems inside my head because it was a chain of vertigo every time I moved my head. Usually it’s just one episode but this was at least 20 episodes in row and then I had 3 in ambulance 3 out side the hospital and 7 in the emergency room plus 2 in X-ray room.
I had been slowly developing balance problems at age 65. Two years later, it was too much to ignore, so I saw a specialist (ENT) doctor who sent me to a PT who had me do vestibular therapy exercises. They didn’t work, but I put much effort into about eight sessions. I had severe reactions, getting more dizzy and feeling like I was falling much more often, and even symptoms in the bathtub, so the PT and I decided to stop them. I started to get better, but now I am worse than ever. I walk around my house constantly, feeling like I am reeling or falling. I hate the feeling and am concerned about the future.
I have severe vertigo. Nothing helped until I read about antihistamines. The non drowsy ones don’t work. The pills keep my vertigo for 24 hours.
I mainly get vertigo when I go to bed and turn to the right side.
They have gotten rid of it in the past.
The therapist says I don’t have any loose crystals now.
I’ve been doing the exercises but I don’t like it.
It is definitely still worse when I do the exercises on the right side.
I can function ok enough during the day.
I want to feel better.
What should I do?
Hi Mary,
I am sorry to hear that! If your exercises are not giving you relief and you still feel symptoms persisting or lingering, I suggest you go back to a re-assessment.
Sometimes you can have crystals in a different canal or a different segment of a canal they already treated.
The tests for BPPV are not 100% sensitive, so it does not ALWAYS show up.
It’s appropriate to get re-tested if you still feel like the right side is still a persistent problem.
Even if it is clear as they said last time, they may be able to advance your home exercise program further to help you get relief.
I hope you feel better soon!
Following a fall 3 weeks ago I have episodes of dizziness they were mainly lying down and turning over. I was asked to do Brandt Daroff exercises 3x a day by my GP but now I’m dizzy during the day as well! I assume I need to stop.
Hi Elaine,
I’m sorry to hear this!
This blog may help regarding what to do when vertigo exercises don’t work.
This blog may help you find the right provider to help you professionally.
Best wishes!