Transcription:

Scott Webb: Vertigo and dizziness are common conditions that may be caused by a serious medical condition or something less serious. And in those cases, a physical therapist may be able to help in just a few sessions. And joining me today to tell us more and explain the role of physical therapists in treating vertigo or dizziness is Mary Grace Dy. She's a physical therapist with Franciscan Health.

This is the Franciscan Health Doc Pod. I'm Scott Webb. Mary Grace, thanks so much for joining me. Tell us a little bit about yourself and what you do.

Mary Grace Dy: Yes. Thank you, Scott, for having me. I'm Mary Grace Dy, humbled for the opportunity to be a physical therapist for 26 years and work with Franciscan for 19 years. In my years here at Franciscan, I obtained my certification for neurodevelopmental treatment for stroke and brain injury, Lee Silverman Voice Treatment for Parkinson's Disease and vestibular rehabilitation treatment for vertigo and dizziness. It is a blessing to be able to work with different people with different cases of physical imbalance. Now, dizziness is the most common complaint in medicine. One recent study estimated that as many as 35% of adults aged 40 years old in United States is going to experience some sort of vestibular dysfunction. And 42% of US population will complain of at least one in their lifetime.

Scott Webb: Yeah. And obviously, you're imminently qualified and I've heard that, Mary Grace, that dizziness is such a common complaint. So, let's talk about this. What is the difference between vertigo and dizziness?

Mary Grace Dy: Vertigo and dizziness are two of the symptoms that is common with vestibular disorder. So, vertigo is a sensation of self-motion when no motion is happening. It could be spinning or non-spinning. Dizziness is a sense of disturbed or impaired orientation of the environment or space without a false or distorted sense of motion. Other vestibular symptoms also include gait instability, unsteadiness, pulsion or imbalance with tendancy to fall in a particular direction, like falling backward, falling forward or sideward.

Visual vertigo or dizziness is provoked with complex moving objects or objects around that is moving or in motion, such as walking in the grocery aisle or driving. Pre-syncope is the feeling of faintness or passing out.

Scott Webb: Yeah. And you mentioned that, you know, dizziness is so common, right? And I'm sure there could be a multitude or perhaps hundreds of things that could be causing dizziness in folks. But what are the most likely common causes of dizziness?

Mary Grace Dy: The symptoms of vertigo resulted towards international classification of vestibular disorder or the two main causes of vertigo, which is central and non-central. Central is caused by brain, such as stroke, traumatic or non-traumatic brain injury, toxicity, migraine, basilar insufficiency among others.

Non-central means brain is not the cause such as dizziness, accompanied with neck pain, viral or bacterial infection, allergies, autoimmune disease, diabetes, motion sickness, and BPPV. BPPV or benign paroxysmal vertigo is the most common cause of vertigo and dizziness. With BPPV, the calcium carbonate particles or crystals in the inner ear are moved out of the utricle to the semicircular canals.

Scott Webb: Yeah. And we're going to talk more about how you help folks related to their crystals. And, you know, it was interesting to learn in preparing for this, you know, the role of PTs in helping folks with dizziness and vertigo. I want to, before we get there though, ask you, you know, what should I do? You know, what should a listener do if they're having dizziness or experiencing vertigo? And who do they see?

Mary Grace Dy: When you are dizzy, watch for the red flags that include double vision, difficulty of talking, difficulty swallowing, fainting, nystagmus or involuntary movement of the eyes, nausea and impaired sensation of the face. This should be treated with high level of suspicion as central or caused by the brain until proven otherwise. That being said, go to the urgent care or emergency room as soon as possible. Twenty-five percent of the older patients presenting to ER with acute isolated vertigo have cerebral infarction or stroke. And more likely, after that, you go to the ER, then the doctor or your physician will more likely refer you to a physical therapist.

Scott Webb: Yeah. As you say, it's better to be safe than sorry, because, you know, the symptoms people might be experiencing, the causes of those symptoms might be something very serious, like a stroke or something like that. So now, let's talk about that. When we end up, you know, in your office or meeting with you, working with you, what does a physical therapist do for dizziness?

Mary Grace Dy: The physical therapist will rescreen for red flags and evaluate the patient to identify other factors contributing to the patient's symptoms and determine the correct diagnosis. Correct diagnosis is very crucial to proper treatment protocol. Here at Franciscan Health, we are blessed to have the Video Frenzel goggles to be able to examine and review eye movements to better diagnose and treat patients with vestibular disorder. It is also important to schedule with a physical therapist that is trained or certified for vestibular rehabilitation treatment. And here at Franciscan, we have a team of trained and certified therapists that will work together for patients' optimal functional recovery. Once diagnosed, physical therapist will perform appropriate treatment.

Once diagnosis is made, the physical therapist will perform the appropriate maneuver to reposition the crystals back into the utricle in case of BPPV. For central vertigo or dizziness, the physical therapist will work with vestibular rehabilitation that includes habituation, substitution, and balance retraining among others.

Scott Webb: Yeah. So obviously, a lot of ways that you can help folks. And you know, wondering as we wrap up here, Mary Grace, is this problem typically temporary or long lasting? You know, is there a cure per se for vertigo?

Mary Grace Dy: With appropriate diagnosis, physical therapy can help you treat and abolish vertigo or dizziness. BPPV has very good outcome with physical therapy. In early acute intervention, it can be resolved in one to three treatment sessions. Other vertigo caused by the brain or central requires a more intensive physical therapy, vestibular rehabilitation that usually is outpatient.

Scott Webb: Well, it's certainly good to know. I mentioned in my intro that, you know, that physical therapists could help in just a few sessions. So in some cases, one to three sessions, perhaps more for others. Really educational today. Thank you so much, Mary Grace, and you stay well.

Mary Grace Dy: Thank you.

Scott Webb: Learn more about vertigo and how vestibular rehabilitation can help at franciscanhealth.org. And if you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.