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Treating Dizziness and Balance Problems

​​​​Dizziness is a medical problem. If you experience dizziness or balance problems, see your doctor to ensure the cause is not related to stroke or medications you may be taking. 

Physical Therapist Erika Merkel (right) Marshfield Clinic Oakwood Center, is certified in special exercise to treat dizziness. Physical Therapist Erika Merkel (right) Marshfield Clinic Oakwood Center, is certified in special exercise to treat dizziness.

After those problems are ruled out, physical therapy may help.

Vestibular rehabilitation is a special exercise approach to treat dizziness or imbalance. It is treated by physical therapists with specialized training.

“Your sense of balance comes from information your brain gathers from your eyes, joints and vestibular system,” said Physical Therapist Erika Merkel, Marshfield Clinic Oakwood Center in Eau Claire. Merkel is certified in vestibular rehabilitation and uses specialized equipment to assess dizziness or vertigo. “The vestibular system is made up of five sensory organs that detect your body’s position and tell the brain whether you are moving or are stationary.”

Fluid within three semicircular canals moves when you move and is still when your head is still. The two other sensory organs contain calcium carbonate crystals that move during head motion and tell the brain about head motion relative to gravity. “The brain compares information from the five sensory organs to information it is receiving from your eyes and joints. When the information does not match, you feel dizzy,” said Merkel.

Two common disorders that cause vertigo are benign paraoxysmal positional vertigo (BPPV), and unilateral hypofunction. BPPV is caused when the calcium carbonate crystals break free and fall into one of the semicircular canals of one ear. “When this occurs you get a temporary feeling of spinning dizziness, especially after rolling over in bed, when bending over or looking upward,” said Merkel. “Treatment involves repositioning the crystals and sometimes includes exercises to improve balance.”

Unilateral hypofunction occurs when the sensory organs in one ear work at a lower rate than those of the other ear. “It may also be caused by damage to the vestibular nerve, which carries information from the sensory organs in the inner ear to the brain,” said Merkel. “With either cause, this type of vertigo can make you feel unsteady in all positions and may also make you feel like your eyes are not working together. This makes it difficult to focus when you move your head.”

Therapy includes exercises for balance and eye coordination to help the brain readjust to the conflicting information from the vestibular system.

“Early treatment of dizziness and balance problems is best to decrease risk of falls or other injury,” said Merkel. “You may no longer be participating in daily or social activities because of fear of falling. Over time, this can lead to deconditioning and muscle weakness, which can impact your ability to enjoy life and live independently.”A physical therapist trained in vestibular rehabilitation will help address these issues.​