Vertigo Treatment in Midtown

If the world is spinning when you’re not, and you are looking for vertigo treatment in Midtown, this article is all about how we can help.

A significant portion of our daily lives involves movement. From the moment we wake up, until the instant we finally close our eyes to sleep, most of us are in a continual state of motion. So, when the time comes for a break, we can usually count on taking a moment and a deep breath to allow things to slow down and hopefully come to a halt. This ability is something you might take for granted and not even think about much, but for people with vertigo, this “stopping of time” is not always so easy.

Vertigo is a sense of rotation or movement that is often experienced when a person is standing or sitting still. This means that it can feel like the world is spinning around them when there is actually no movement at all. As a result, individuals with vertigo may not be able to walk or move normally, and they are at an increased for falling and other types of accidents. Additional symptoms related to vertigo like dizziness, nausea, and fatigue can complicate matters even further and prove to be a major hindrance to daily life. Vertigo is actually quite common and there’s a strong chance you’ve at least heard of it, but what many may not realize is that physical therapy is one of the best ways to help these individuals improve and finally stop the world from spinning around them.

If You Have Problems with Your Vestibular System (That Normally Keeps You Upright and Balanced), The Vertigo Treatment Experts in Midtown Can Help

The vestibular system is the sensory system that provides the brain with crucial information about the body’s sense of balance and position in space in order to coordinate a smooth set of movements. The system detects motion of the head—mainly through the inner ear, as well as the eyes, muscles, and joints—and then uses this data to generate a specific set of reflexes. These reflexes are essential for navigating the world and include tasks like stabilizing our visual gaze and maintaining the posture of our head and body.

When the vestibular system functions normally and properly, most people are not even aware of its existence as they go about their day. For instance, you probably don’t think twice the last time you walked on an uneven surface, raced up the stairs or quickly got up from bed in the middle of the night. But when the vestibular system is damaged or something else prevents it from doing its job, these tasks become much more challenging.

As mentioned above, vertigo is the feeling that things are moving, rotating, rocking, or spinning when a person and their environment are both completely still. It occurs when there is some type of problem with the vestibular system that interferes with communication between the brain and its other components. This communication breakdown leads to the primary symptom of perceived motion, as well as other symptoms, which might include:

  • Dizziness
  • Nausea/vomiting
  • Anxiety
  • Fatigue
  • Balance issues
  • Headache
  • Ringing in the ears or hearing loss
  • Difficulty concentrating

It’s difficult to establish firm figures on the prevalence of disorders related to the vestibular system, but it’s believed that millions of Americans experience vertigo and other related symptoms each year.  One study reported that as many as 35% of adults over the age of 40—about 69 million—have dealt with a vestibular dysfunction at some point in their lives.  There are a number of conditions that can cause vertigo, such as inner ear infections, migraines, stroke, surgery, and head injuries, but the two most common issues are vestibular neuritis and benign paroxysmal vertigo disorder (BPPV).

Vestibular Rehab in Midtown Requires Expert Training for Both Vestibular Neuritis and BPPV

Vestibular neuritis is not nearly as common as BPPV, but still affects tens of thousands of individuals each year.  This type of disorder results from inflammation within the inner ear, which consists of a system of fluid-filled sacs and tubes called the labyrinth.  The labyrinth is the bony outer wall of the inner ear, and it plays a crucial part in both hearing and balance.  For balance, the labyrinth connects to the brain through a single nerve in each ear, where it sends information to the brain regarding balance and head position to keep our bodies stable.  When this nerve becomes swollen or inflamed, it disrupts the pathway of information being sent to the brain and leads to balance problems and other symptoms.

The main symptoms of vestibular neuritis are sudden and severe vertigo, as well as dizziness, balance difficulties, nausea and/or vomiting, and difficulties with concentration.  The inflammation that causes this disorder is usually from a viral infection of the inner ear or elsewhere in the body, such as herpes, mumps, measles, or the flu.  In rare cases a bacterial infection may be responsible.  Although these symptoms may only last a few days, they can make performing daily activities extremely difficult, and some patients experience symptoms that last for several months.

BPPV is the most common disorder of the vestibular system and the leading cause of vertigo.  It can affect people of any age, but is most common in adults over 60, where its prevalence is about 9%. BPPV is a disorder of the inner ear that causes brief periods of vertigo and dizziness, which usually occurs when lying down, turning over, or looking up. It may help to better understand BPPV by breaking down each word:

  • Benign: the condition is not life-threatening and usually does not progress
  • Paroxysmal: means vertigo occurs suddenly and out of nowhere
  • Positional: means vertigo is triggered by changes in the position of the head
  • Vertigo: the “spinning” sensation at rest

The inner ear contains tiny calcium crystals—or rocks—which are crucial for regulating balance. These crystals are normally located in a part of the inner ear called the utricle, but they don’t always stay there. If the inner ear undergoes any type of trauma, such as infection or inflammation, these rocks can become detached and are free to travel to other parts of the ear. BPPV occurs when the crystals break off and eventually move to another part of the inner ear called to the semicircular canal, where they cause an unwanted flow of fluid. This tricks the brain into thinking that motion is occurring when things are at rest, otherwise known as vertigo.  In addition, when the head is moved in certain directions, it causes the crystals to stimulate nerve endings in the canal, which leads to dizziness. Other symptoms of BPPV include nausea, vomiting, lightheadedness, and a resulting loss of balance or unsteadiness.

The good news for patients is that even though these disorders are very common, BPPV and other causes of vertigo are also very treatable. In particular, physical therapy is regarded as one of the most effective types of vertigo treatment that’s been proven to eradicate symptoms. And best of all, many cases of vertigo can be completely resolved in just a few treatment sessions.

Identifying the cause to determine the best course of treatment

Once a patient with vertigo comes in to see a physical therapist, the first step is to identify what’s responsible for their symptoms.  Since there are so many potential causes of vertigo, this diagnosis process is extremely important, as it will help the therapist determine what the best course of treatment is for each patient.

During the evaluation, your therapist will ask you a number of questions about your condition, such as:

  • How long have you been experiencing symptoms?
  • How long do episodes of vertigo usually last?
  • Are there any triggers that make your condition worse?
  • Do you ever experience nausea, difficulty breathing, or loss of hearing?

If your therapist suspects that BPPV may be the cause, the Dix-Hallpike test may be performed next. This noninvasive test helps confirm if your vertigo is due to the movement of inner ear crystals by having you complete simple head movements and watching your eyes for involuntary movements called nystagmus. The direction of your eyes will indicate where crystals are loose in the inner ear, which will help the therapist decide on the appropriate treatment.

After the cause of your vertigo has been diagnosed, your physical therapist will design a personalized treatment program that takes into consideration your age, condition, abilities, and goals. The specific treatments used will depend on what condition is present and what each patient is most likely to respond to, but the main focus in all cases will be to alleviate symptoms, so patients no longer have to deal with unwanted sensations of movement. Below are some of the most commonly used interventions for vestibular neuritis and BPPV:

Vestibular neuritis

  • Balance retraining exercises: these types of exercises will have the patient shift their body weight in various directions while standing to improve the way information is sent to the brain
  • Gaze stabilization exercises: these are designed to keep vision steady while making rapid side-to-side head turns and focusing on an object, which will help the brain adapt to new signaling from the balance system
  • Home-exercise program: your physical therapist will also create a program to be performed at home that includes these exercises and possibly others
  • The key is to repeat these exercises 2-3 times per day, which will help the brain learn how to adjust to movements that cause vertigo and other symptoms


Physical therapy is considered the number one treatment for BPPV, and in many cases, it may take only one or two treatment sessions to completely resolve symptoms. Most treatments for BPPV focus on moving the crystals in the inner ear back to where they belong.

  • One of the most common and effective techniques for BPPV is called the Epley maneuver
    • This intervention is used specifically to treat cases that affect the posterior canal of the ear, and it works by allowing the free-floating crystals to be relocated by gravity back to the utricle
    • The Epley maneuver has been found to resolve vertigo in approximately 90-95% of patients
  • In another simple maneuver, your physical therapist will guide you through a series of 2-4 positions, each of which should be held for up to two minutes
    • As with the Epley maneuver, these position changes are designed to move the crystals from the semicircular canals back to the appropriate area of the inner ear
  • Balance retraining exercises may be needed for some patients that continue to experience balance issues after vertigo has subsided
  • Other physical therapy techniques for BPPV include the Semont maneuver, Foster maneuver, and the Brandt-Daroff exercise
  • Your physical therapist may also recommend some of the following lifestyle changes to reduce the occurrence of symptoms:
    • Use two or more pillows in bed at night
    • Avoid sleeping on the side of your head with the ear that’s causing problems
    • Get up slowly in the morning, sit on the edge of the bed, and take a moment before standing
    • Try to avoid leaning over to pick things up or tipping your head too far back to look up
    • Be cautious when playing sports that require you to turn your head, lean over or lie on your back

Our Vertigo Treatment Experts in Midtown Can Help – Contact Us Today

So, if you’re experiencing vertigo or any other bothersome symptoms related to your balance and are wondering where to turn, look no further than Dynamic Sports Physical Therapy in New York City. With our team of vertigo treatment experts, we will work diligently to identify the cause of your problems and then carefully design a program that’s right for you and your condition. Ultimately, our primary goal in these cases is always the same as yours: eliminate the “spinning” sensation altogether, so the world stops moving when you stop moving.

Contact us at (212) 317-8303 to schedule an appointment today and take your first step on a path to complete recovery from vertigo.