Vestibular Physiotherapy vs. Medications: Which Is Right for Dizziness Treatment?

If you've ever been dizzy, you know how unsettling it can be. Even reading, walking, or standing can become complicated. The good news is there's a way to get back to solid ground. Medication and vestibular physiotherapy are two typical options. But how do you know what's right for you?

This article simplifies each approach and how they work so you can better understand vestibular therapy versus medication for dizziness.

What is Dizziness?

Dizziness is a general term for several sensations. Faintness, lightheadedness, feeling woozy, unbalanced, or like the room is spinning are often used to express dizziness. 

There are several reasons why you may feel dizzy. Common causes of dizziness include 

• Ear-related issues 
• Migraines 
• Head injury 
• Ear or brain infections 
• Low blood pressure 
• Stress and anxiety

Dizziness relates to a person's vestibular system of the inner ear. For example, if the vestibular system is not functioning correctly, it may send signals to the brain alerting it that the person is in motion when a person is standing still.

What is Vestibular Physiotherapy?

Vestibular physiotherapy, also known as vestibular therapy or vestibular rehabilitation, is specialized physiotherapy administered to individuals with balance or dizziness-related problems. It must be conducted by a specialized and trained physiotherapist.

This therapy is suggested when feelings of dizziness relate to conditions associated with the inner ear or brain that impact balance.

How Does Vestibular Physiotherapy Work?

Vestibular Physiotherapy involves specialized exercises aimed at decreasing dizziness symptoms and increasing balance. This field of physiotherapy takes a mechanical and scientific approach to how the brain communicates with the rest of the body, learning pathways, and relearning them through gentle movements.

Some vestibular physiotherapy exercises include eye and head coordination exercises. These allow the brain to reconcile the difference between what the eyes see and what the balance system feels. For example, if a person's head turns rapidly, the vestibular system may get confused as it senses certain things and sees others. These exercises can help minimize feelings of dizziness during everyday head turns.

Balance exercises are a significant part of vestibular physiotherapy. The more the patient can stand still or walk without falling over, the more comfortable they will become over time. During later phases of vestibular physiotherapy, gait training occurs. Gait training emphasizes how a person walks and can help instill a more balanced, confident gait that may have been lost due to dizziness.

Habituation exercises gently expose a patient to degrees of movements that would usually cause dizziness. Over time, such motions in gradual exposure teach the body to accommodate and minimize the severity and frequency of symptoms to restore confidence in similar motions in other areas.

Through practice, vestibular physiotherapy can decrease dizziness, vertigo, and nausea symptoms while increasing balance effectiveness and quality of life.

What Happens in Vestibular Therapy

During your first appointment, your vestibular physiotherapist will take the time to understand your symptoms and how they’re affecting your daily life. They’ll ask detailed questions about your dizziness, assess your balance and eye movements, and observe how you walk and move.

Based on this evaluation, they’ll develop a personalized treatment plan tailored to your specific condition and needs. Therapy may involve regular sessions scheduled weekly or biweekly over several weeks or months, depending on the nature of your disorder and how you respond to treatment.

To support your progress, you’ll likely be given specific vestibular exercises to do at home. These are typically performed for at least fifteen minutes a day. Staying consistent with your daily routines is key to achieving lasting results and reducing your symptoms over time.

What Are the Benefits of Vestibular Physiotherapy?

Vestibular physiotherapy is a drug-free, safe, and effective way to treat and learn to cope with dizziness, balance problems, and other related symptoms from vestibular disorders. It does not rely on drugs that target areas where symptoms stem from. Vestibular physiotherapy instead teaches the body and brain to compensate for what's going on so you can work better. 

The benefits include: 

No Medications 

Vestibular physiotherapy is drug-free and does not come with adverse side effects such as drowsiness and addiction related to medications. This treatment is rehabilitation, and the body and brain can retrain themselves to adapt and function more effectively.

Improved Functionality

Your body learns how to interpret balance signals properly, and with continued therapy, you're likely to experience fewer instances of dizziness and an increased capacity to move and function in the world. Patients feel more coordinated, less dizzy, and more proficient in their activities of daily living.

Customized Treatment Based on Your Symptoms

You will not necessarily be doing the same thing as someone else with the same diagnosis because vestibular therapy is based on you. Instead, you will be evaluated based on your diagnosis, your symptoms, your lifestyle, and your desired treatment goals, and provided with what's best for you and you only. 

Better Self-Esteem with Less Anxiety

Dizziness often leads to anxiousness about carrying out activities such as crossing a room, bending down, etc. Vestibular rehabilitation teaches you how to relearn specific movements with confidence and decreases anxiety. 

Less Chance of Falling

Many older patients experience balance problems, which contribute to falls, one of the highest injuries sustained within this population group. Vestibular therapy decreases the chances of falling by reinforcing balance and coordination systems so that patients feel more sure-footed and stable.

Conditions Vestibular physiotherapy Can Help With:

Vestibular therapy is effective for a wide range of conditions affecting the inner ear and balance system, including:

• Benign Paroxysmal Positional Vertigo (BPPV)
• Labyrinthitis or Vestibular Neuritis
• Post-Concussive Dizziness
  Meniere’s Disease
• Age-Related Dizziness and Poor Balance

What About Dizziness Medication? 

When medication is indicated for dizziness, typically some and/or all of the following are used; 

• Meclizine, an antihistamine, can be used to reduce the sensation of spinning.
• Anti-nausea medication is given to combat vomiting associated with dizziness.
• Sedatives like diazepam can be used to depress the central nervous system and reduce anxiety related to dizziness.
• Diuretics are used in specific cases with Meniere's disease, as these medications reduce excessive fluid in the inner ear that causes spinning episodes.
• Migraine medications can also be used for headaches or migraines that cause dizziness, as they decrease episodes of vestibular migraines. 

These particular migraine medications are helpful for patients to find fast relief during sudden, severe episodes of dizziness, as it's important to ease symptoms immediately.

Pros and Cons of Taking Medications

There are advantages and disadvantages to medicating for dizziness. Medications are essentially a quick fix for symptoms, which is ideal for someone who may be dizzy for the first time or in an urgent situation. Plus, they're ideal for someone on the go.

The disadvantages are that medicating does not temporarily relieve the cause of dizziness, just the symptoms. It causes daytime drowsiness, dry mouth, and blurred vision as side effects. Unfortunately, this does not help people get less dizzy. People can also become reliant on such medication after extended use, and such medication becomes less helpful over time. 

Thus, medication is suggested as a temporary fix combined with vestibular physiotherapy or treatment for chronic dizziness.

When Should You Seek Physiotherapy? 

You should seek physiotherapy for dizziness that lasts longer than a few days, is worsened by certain movements, impacts balance and personal safety, or is experienced after a concussion or head injury.

Dizziness doesn't have to be your new normal. A physiotherapist can assess your symptoms and their root cause, improve your stability, and help you regain your sense of health and safety in movement so you can return to your regular self.

Can You Use Both Methods? 

Yes! And many do! Medication can help with symptoms while starting vestibular therapy. And while in vestibular therapy, you may find that you need less medication. The multidisciplinary approach gives temporary relief with long-term solutions.

Conclusion

Dizziness happens to many people, not just you. Whether it's a little or a lot, there are safe and effective ways to get you feeling better.

Vestibular physiotherapy teaches your brain and body how to compensate and manage balance, offering you a more permanent solution. In contrast, medications are a temporary band-aid for urgent situations, particularly when symptoms of dizziness become acute or too much to handle.

Consult your doctor or an experienced physiotherapist to discover which course of action regarding dizziness is right for you. You'll be stable in no time and resume your usual routines without feeling off.