Ask Your Physical Therapist: Why am I dizzy?
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Ask Your Physical Therapist: Why am I dizzy?

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While there are multiple causes for dizziness, such as medications, heart problems, fatigue, migraines or dehydration, one of the most common causes of dizziness is vertigo.

The most common type of vertigo is Benign Paroxysmal Positional Vertigo (BPPV), which encompasses multiple different symptoms including dizziness or light-headedness, nausea, vomiting, loss of balance and/or vision changes, such as difficulty focusing or feeling like the room is spinning.

BPPV is a disorder that starts in the inner ear. The most typical indicator of BPPV is when one notices the vertigo symptoms mentioned above with movement (especially quick movements) or changes in position of the head/neck. Many with BPPV report that the “room is spinning” when they turn their head or make quick changes in position of the body and head/neck.

This “room spinning” feeling along with the other symptoms of BPPV often cause the person experiencing this to feel severely nauseated or even vomit.

So how do I determine if BPPV is the cause of my vertigo symptoms?

A trained physical therapist needs to take you through a series of tests where they check the ability of your eyes to track in all directions – if this testing causes your eyes to be unable to focus and/or causes dizziness, this is a sign of BPPV.

Also, there is a test called the Hal-Pike maneuver that you would be taken through. This test involves specific positional maneuvers done in a particular order to see whether this causes vertigo symptoms and whether or not it is right- or left-side specific. If this maneuver causes vertigo symptoms, it is another sign that BPPV is the cause.

The physical therapists at Cardin and Miller Physical Therapy are experts in the diagnosis, treatment and resolution of BPPV/vertigo since we see and help folks with this issue get back to life without dizziness, etc., on a daily basis.

So how does BPPV and its symptoms get resolved?

Once it is determined that BPPV is the actual cause of the dizziness and vertigo symptoms you are having, then there is a specific set of positions/bodily positional changes you need to be taken through in a specific order. These specific positional changes work to re-align “crystals” within your inner ear that get out of alignment, which is what causes the BPPV in the first place.

The mal-alignment of the “crystals” in your inner ear can be caused by a virus that affects the inner ear, congestion from allergies or a traumatic head injury. Often times, you can have complete resolution of symptoms and get back to living your life within two to four treatment sessions.

Getting relief from your symptoms and getting your life back happens much quicker when you seek the treatment mentioned above as your first line of defense. If you choose to take medication, or see an ear, nose and throat specialist – the medication for BPPV provides short-term relief, if any at all, and is not addressing the cause of the problem (only treating the symptoms).

Contact Cardin and Miller Physical Therapy today for a free one-on-one screen with one of our expert physical therapists. Call 717-245-0400 to schedule your free screen so that we can tell you whether our treatment is right for you or if you should be seeking help in another direction.

If you would feel more comfortable asking me more questions first, you may email me at with any questions you have, or if you would like to speak with me on the phone, please call 717-245-0400 and request a free phone consultation with me and we will set something up!

Steve Miller is the owner of Cardin and Miller Physical Therapy and can be reached by email at His column will appear bi-monthly in the Thrive section of the Sentinel and on


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