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2 Ways Physical Therapy Can Diagnose Vertigo

When you were a child, you may have spun in circles for fun until you were dizzy and lost your balance, enjoying watching your surroundings spin around you after you stopped. For adults though, experiencing dizziness can be frightening, not fun.

In fact, symptoms of vertigo, with the possibility of also having nausea or vomiting, can be frightening.

“The traditional diagnosis of vertigo is an inner ear problem that people can get very abruptly,” said Susan Mulhern, an Abington – Jefferson Health physical therapist. “It's very scary for a patient; they often don't understand what's going on.”

Although you may associate physical therapy with rehabilitating an injury, it can actually be used to treat some cases of vertigo.

“We can treat [vertigo] in physical therapy...very often we'll get a patient sent to us from a doctor with a diagnosis of vertigo,” she said. “We have specialized equipment that helps us with assessment and treatment.”

Infrared Goggles

One such assessment to determine the presence of vertigo involves infrared goggles and canalith repositioning maneuvers.

The infrared goggles have a camera attached to one eye and a shield over the other eye.

“We assess both sides of the patient – so if the patient comes in and feels that she’s been dizzy when she looks to the right or turns to the right in bed, we’ll look at the ‘good’ side first,” Mulhern explained. “We turn the head and on the count of three [lay the patient] down into a head back position.”

While moving someone into this position, the goggles display his or her eye on a screen for the physical therapist to observe.

“I can look at the screen and see how her eye is responding to this change in position,” she said.

You remain in this head back position for about 20 or 30 seconds to see if there’s a late onset of vertigo symptoms on this side. If this maneuver is performed on the side affected by vertigo, a physical therapist can confirm the diagnosis with the infrared goggles.

“If it’s the side that’s affected, I would likely see some torsional eye movement – the eye would be bouncing around in a circular fashion,” Mulhern said. Involuntary movements of your eyes from side to side or the inability to control your eye movements are both signs of vertigo.

If you have vertigo, these positions can also be used to treat you – the goal of simply and slowly maneuvering of your head is to move particles of calcium out of the ear canal into an inner ear chamber, where they can be absorbed by the body.

“Very often, the patient feels better in about a week or so. Often, patients feel much better after one or two sessions,” Mulhern said, noting that she teaches patients how to perform these maneuvers at home to speed up recovery and reduce the number of times they need to return.

Computerized Dynamic Posturography Machine

Another tool used to assess vertigo is called a computerized dynamic posturography machine (CDP).

“This is a machine we use to assess how much vestibular function the patient is exhibiting,” Mulhern said. The CDP evaluates three sensory systems you use for balance: the sense of touch in your feet and legs, vision, and the inner ear and brain balance system called the vestibular system.

“Generally, with people whose primary problem is balance or if they’re having a lot of ocular motor problems, we can work on different visual strategies with them using that equipment,” she said.

What this means is that you don’t have to suffer through or tolerate vertigo.

“If you're having any symptoms of vertigo certainly I encourage you to see your doctor and you can discuss your symptoms with him or her and decide if physical therapy would be an appropriate intervention for you,” Mulhern said.

For more information, visit or call the Balance Center at 215-441-6777.

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