Can physical therapy make vertigo worse?
Yes, Physical therapy can sometimes worsen the vertigo symptoms, especially in the initial stages of treatment or when exercises are not performed correctly. Here’s why and how this happens:
- Provocation is Sometimes the Goal: Some vestibular exercises intentionally provoke symptoms. For example, habituation exercises are designed to reduce dizziness by repeatedly exposing the patient to the movements or positions that provoke their symptoms. The theory is that repeated exposure will allow the brain to adapt and become less sensitive. However, in the short term, these exercises can intensify symptoms of vertigo
- Incorrect Diagnosis or Treatment: If the underlying cause of the vertigo is not correctly identified, then the prescribed exercises might not be appropriate, leading to worsening symptoms. For instance, exercises designed for benign paroxysmal positional vertigo (BPPV) might not be suitable for someone with vestibular migraine or Meniere’s disease.
- Overdoing Exercises: Just like any other form of physical therapy, doing too much too soon can exacerbate symptoms. It’s essential to follow the prescribed regimen and not exceed the recommended frequency or intensity.
- Incorrect Execution: If exercises, especially repositioning maneuvers like the Epley or Semont, are not done correctly, they might not only be ineffective but could also worsen the vertigo.
- Natural Fluctuation of Symptoms: Vertigo symptoms can fluctuate naturally. Some patients might mistakenly attribute a worsening of symptoms to the exercises when, in reality, it’s just the natural progression or cycle of their condition.
- Anxiety and Stress: Vertigo can be anxiety-inducing. Patients may become anxious or stressed about the exercises, anticipating that they will cause dizziness. This heightened anxiety can, in turn, exacerbate symptoms.
- Incomplete Treatment: Particularly in cases of BPPV, if a repositioning maneuver does not move all the canaliths (ear crystals) back to where they belong, symptoms might continue or potentially worsen.
It’s important to maintain open communication with the physiotherapist. If symptoms worsen or don’t improve after a reasonable period, the treatment approach should be reassessed. The therapist might modify the exercises, change the treatment approach, or suggest further medical evaluation. At Curezone Physiotherapy, we strive hard to be the best Vertigo treatment clinic in Mississauga, and take pride in the hundreds of success stories we have had with patients with imbalance symptoms.