Vertigo is a sensation of spinning or feeling as if your surroundings are spinning, even when you are still. This specific type of dizziness can be disorienting and may be accompanied by nausea, vomiting, or balance problems. While vertigo is a symptom rather than a disease, certain exercises can help manage and reduce these symptoms, often as part of vestibular rehabilitation.
How Exercises Help Vertigo
The body’s balance system, known as the vestibular system, is located within the inner ear. It includes structures like the semicircular canals and otolith organs, which send signals to the brain about head movements and spatial orientation. The brain combines this input with information from the eyes and body to maintain balance.
Issues within this system, such as dislodged calcium crystals, can lead to vertigo. Exercises for vertigo work in two primary ways: by physically repositioning these dislodged crystals or by retraining the brain to compensate for vestibular deficits. Canalith repositioning maneuvers move crystals back to their proper place. Other exercises, part of vestibular habituation and adaptation, help the brain process confusing signals more effectively, reducing dizziness and improving balance.
Exercises for Positional Vertigo
Benign Paroxysmal Positional Vertigo (BPPV) is a common cause of vertigo, characterized by brief, intense spinning sensations triggered by specific head movements. This occurs when tiny calcium carbonate crystals, called otoconia, detach from their normal location and move into the semicircular canals of the inner ear. Specific maneuvers are designed to move these crystals out of the canals.
The Epley Maneuver is a widely used series of head movements for BPPV. To perform it for an affected left ear, sit on a bed with legs extended, then turn your head 45 degrees to the left. Quickly lie down on your back, keeping your head turned, and maintain this position for 30 seconds.
Next, turn your head 90 degrees to the right, so it faces 45 degrees to your right side, and hold for another 30 seconds. Finally, roll onto your right side, keeping your head turned, and then slowly sit up. If your right ear is affected, reverse the head turns.
The Brandt-Daroff Exercises can also help reposition these crystals, though some research suggests they might be less effective than the Epley maneuver. To perform these, start in an upright, seated position on a bed. Turn your head 45 degrees away from the side causing vertigo, then quickly lie down on the opposite side, with your nose pointed up. Stay in this position for about 30 seconds or until the vertigo subsides, then return to the seated position. Repeat this sequence on the other side. A session typically involves five repetitions on each side, performed three times a day for up to two weeks, or until vertigo is gone for two consecutive days.
Exercises for Balance and Gaze Stability
Beyond positional vertigo, other exercises improve balance and stabilize vision, key components of vestibular rehabilitation. These exercises retrain the brain to process sensory information more effectively, reducing general dizziness and unsteadiness.
Cawthorne-Cooksey Exercises are general exercises designed to encourage the brain to adapt to vestibular imbalances. These include simple head movements like bending the head forward and backward or turning it side to side, gradually increasing speed. Eye movements, such as looking up and down or side to side while keeping the head still, are also part of these exercises. As symptoms improve, more complex movements like shrugging shoulders, bending to pick up objects, or marching in place can be incorporated.
Gaze stabilization exercises train the eyes and brain to work together to keep vision clear during head movements. A common technique involves focusing on a stationary target, such as a letter on a wall, while slowly moving the head from side to side or up and down. The goal is to move the head as fast as possible without blurring vision, gradually increasing speed and range of motion. These exercises improve the vestibulo-ocular reflex, which stabilizes images on the retina during head movement.
Balance training exercises improve stability and reduce the risk of falls. Simple exercises include standing with feet close together (Romberg exercise), progressing to standing on one foot or walking heel-to-toe. Practicing these exercises near a wall or chair for support is advisable. As balance improves, challenges can be added, such as performing exercises with eyes closed or on uneven surfaces.
Important Considerations and When to Seek Help
Consistency is important for better outcomes when performing vertigo exercises. Temporary dizziness during these exercises is common and expected as the brain adapts. Take your time between movements, waiting about 30 seconds or until dizziness subsides before proceeding.
Always perform these exercises in a safe environment, such as near a bed or wall, and consider having someone present, especially when starting. It is recommended to consult a doctor or a physical therapist specializing in vestibular rehabilitation for a proper diagnosis and personalized exercise plan. Self-treatment should not replace professional medical advice. Seek immediate medical attention if vertigo symptoms persist, worsen, or are accompanied by other neurological symptoms like severe headache, numbness, weakness, or changes in vision or speech, as these could indicate a more serious underlying condition.