Vertigo

Vertigo is often used as a "blanket term" to describe dizziness however true vertigo is the sensation of spinning. Either you feel like you are spinning or the world around you is spinning. If you've had this, you know it can be a very debilitating issue. It will often cause nausea, vomiting, imbalance, and sensitivity to motion; which makes doing everyday things very difficult.

There are many things that could cause vertigo however the most common is something called BPPV.

  • Benign: not malignant or life threatening
  • Paroxysmal: comes on suddenly
  • Positional: occurs immediately following change in position. Most often with head movement
  • Vertigo: sensation of spinning

Most often people with BPPV will complain of spinning following:

  • Rolling in bed or getting out of bed
  • Rinsing hair in shower
  • Rending over
  • Movements that combine looking up, down, or turning from side to side

The cause of BPPV is most often insidious; meaning it happens without cause or event. However it can also happen after a head trauma, inner ear infection, result of lack of blood supply of the vestibular artery.

Most people wake up with BPPV and the feeling of vertigo. This is believed to be from your body shedding and rebuilding otoconia (crystals within the inner ear). Typically we shed these crystals every 30-90 days however sometimes they will not dissolve and travel into a semi-circular canal where they should not be. The extra debris (weight) will cause your inner ear fluid to move much faster than normal, thus causing confusion of your inner ear and balance systems and in turn causing the spinning sensation. The spinning can last seconds to minutes at a time following movement.

Determining if you have BPPV is a very quick and simple method which includes your therapist laying you back and tilting your head in a specific motion depending on what side and canal we are looking at. If you have BPPV thankfully it is a relatively quick fix; usually 1-3 visits is the norm.

Maneuvers called canalith repositioning maneuvers (CRM) guided by the therapist will place the otoconia debris (often referred to as crystals), back where they should be.

The maneuvers are quite simple however determining which ear, canal, and type of BPPV is important. So we do not advise people to attempt self maneuvers that can be found online.

Most often after only 1-3 physical therapy visits your vertigo will have been resolved. Some people do require follow up exercises to help retrain your eye movement (oculomotor function) as well as balance which we can help with and also provide. The reason some people have lingering unsteadiness or visual sensitivity can be from a few factors, however it's important to know that you have three balance systems in the body and they work together simultaneously at all times (even when sleeping) to gain your equilibrium. So if one system is "sick" it will often affect the others.

Vertigo is often resolved very quickly with skilled physical therapy. If you have any signs of vertigo and would like help, please give our office a call.