Health Matters 9/13: Don’t let dizziness or vertigo throw you off balance

By Kelly Gray, P.T.

If you’ve ever experienced a bout of dizziness, you’re not alone.

In fact, more than 40% of Americans will experience an episode of dizziness sometime during their lives that is significant enough to send them to a doctor, according the National Institutes of Health.

And while dizziness can throw you off balance, once a cause is determined, it can often be treated.

At Princeton Rehabilitation, a division of Penn Medicine Princeton Health, physical therapists with specialized training evaluate and treat dizziness, vertigo and loss of balance associated with inner ear or neurological dysfunction.

Common in Older Adults

The terms dizziness and vertigo are often used interchangeably. However, there are slight differences between the two.

Dizziness is characterized by feelings of lightheadedness, faintness or unsteadiness. Vertigo is described as feeling as if you or your surroundings are spinning.

Both, however, can cause you to feel off balance and impact your daily activities as well as increase the risk for falls.

In addition, older adults are more susceptible to dizziness and vertigo, with 80% of people aged 65 years and older having experienced dizziness at some point, according the Vestibular Disorders Association.

A Wide Range of Causes

Dizziness can be caused by a wide variety of conditions ranging from dehydration to cardiovascular problems to certain neurological conditions such as multiple sclerosis and stroke.

Dizziness – and more often vertigo – can also be linked to a problem with the vestibular system, which comprises the parts of the inner ear and brain that process the sensory information involved with controlling balance.

Common vestibular disorders include:

  • Benign paroxysmal positional vertigo (BPPV), a condition in which the small calcium particles in the inner ear become displaced and disrupt the inner ear balance sensors, causing brief, intense dizziness when you change the position of your head. BPPV is the cause of approximately 50% of dizziness in older people, according to the Vestibular Disorders Association.
  • Ménière’s disease, which involves abnormal pressure in the ear due to a change in fluid volume in the inner ear. Symptoms of Ménière’s disease include intense vertigo, hearing loss, nausea, tinnitus and a feeling of fullness in the ear. The disease normally affects only one ear.
  • Labyrinthitis and vestibular neuritis, inflammations caused by a viral infection.
  • Orthopedic problems such as inflammation in the joints of the neck or jaw or a muscle imbalance in those areas can put pressure on the vestibular nerve and interfere with the vestibular system.

Physical Therapy Can Help

The first step in treating dizziness and vertigo is determining the cause of the condition by testing the cardiovascular, musculoskeletal, vestibular, visual and sensory systems.

Once a diagnosis is reached, specific exercises and physical therapy techniques, available through Princeton Rehabilitation, can help alleviate dizziness, vertigo and other symptoms that can lead to falls.

Treatment may include balance training, visual exercises to help stabilize balance and, in cases of BPPV, a specialized equilibrium realignment technique known as the Epley maneuver to return the inner ear crystals to their normal positions.

Physical therapy can also help strengthen muscles and improve joint flexibility so patients are better able to maintain balance.

Additionally, therapists at Princeton Rehabilitation may provide instruction for how to adapt daily living activities such as bending forward to retrieve an object from the floor or turning your head to look at something while walking to prevent dizziness and vertigo.

Tips For Maintaining Balance

If you experience regular episodes of dizziness or vertigo, see your doctor. Ignoring symptoms could lead to more serious complications, including falls.

One of the best ways to maintain balance and prevent falls is through regular physical exercise to help you stay strong.

Moreover, the National Institutes of Aging offers these tips:

  • Have your eyes and hearing tested often. Always wear your glasses when you need them. If you have a hearing aid, be sure it fits well, and wear it.
  • Ask about the side effects of your medications. If a drug makes you sleepy or dizzy, tell your doctor or pharmacist.
  • Get enough sleep. If you’re sleepy, you’re more likely to fall.
  • Limit the amount of alcohol you drink. Even a small amount can affect balance and reflexes.
  • Stand up slowly after eating, lying down or sitting. Getting up too quickly can cause your blood pressure to drop, which can make you feel faint.
  • Wear rubber-soled, low-heeled shoes that fully support your feet. Wearing only socks or shoes/slippers with smooth soles on stairs or floors without carpet can be unsafe.

For more information about Princeton Rehabilitation or to find a physical therapist call 609.853.7840 or visit

Kelly Gray, P.T., is a physical therapist and a rehabilitation manager with Princeton Rehabilitation, a division of Penn Medicine Princeton Health.