December 4, 2016

Physical Therapy Can Stop Your World From Spinning

Vertigo--if you’ve ever experienced intense dizziness or spinning, you know how debilitating it can be. Vertigo can be treated with physical therapy.
  • Nicole Reynolds photo
    Nicole Reynolds

    Nicole is an experienced physical therapist that specializes in treating orthopedic disorders and a special interest in balance and vertigo dysfunction.

Blurry photo of tree spinning round and round

Vertigo--if you’ve ever experienced intense sensations of dizziness or spinning, you know how debilitating it can be. Vertigo can make it nearly impossible to function and can also affect balance and put you at risk for falling. Even a mild case of vertigo can make it difficult to drive, perform household chores and work.

There are many causes of vertigo. The most common type, known as benign paroxysmal positional vertigo or BPPV, can be treated by a physical therapist, usually with symptoms clearing in only a few short treatments. Many people do not realize that physical therapists can help with this disorder. People often spend days, weeks, or even months, dealing with symptoms, with only mild relief from medications, because they are not aware of this more effective, non-medication based treatment.

What is BPPV? It is benign, meaning not life threatening and generally not progressive. Symptoms are often paroxysmal, meaning symptoms come on in sudden, brief spells. It is triggered by certain positons or movements of the head, such as looking up, or with positional changes of the body. The false sensation of rotation movement or spinning is referred to as vertigo and may also be accompanied by feelings of unsteadiness or nausea.

The dysfunction and cause of symptoms begins in the inner ear. There are calcium carbonate crystals (otoconia) that reside in one portion of your inner ear (the utricle). BPPV occurs when some of those crystals break off and migrate into other portions of the inner ear, usually the semi-circular canals. When these particles move into the canals, they disrupt the normal movement of fluid and stimulate nerve endings responsible for sensing head movement, sending false signals to the brain. The false information does not match what the other ear is sensing, what the eyes are seeing, and what other signals that the muscle and joint receptors are sending to the brain. The mismatch of input to the brain is what is responsible for the feelings of spinning and dizziness.

What causes the crystals to dislodge is still unknown. The crystals may become loose due to trauma to the head, infection, or prolonged positioning with your head back, such as while in a dentist’s chair or having your hair washed in a sink. Aging may be a risk factor, and BPPV is more common among females. It may even be hereditary.

Physical therapy treatment for BPPV is often very successful. Many studies have been done into the effectiveness of physical therapy treatment maneuvers for BPPV, with results showing rates of resolution well into the 90% range by 1-3 treatments.* Your physical therapist will perform an evaluation to determine if BPPV is the cause of your symptoms. You will then be guided through a series of very specific positions of the head and body that will dislodge and reposition the crystals of the inner ear.

BPPV can range from a mild annoyance to a debilitating condition. No matter the severity, it is a very treatable condition. Unfortunately, it is not widely known that physical therapy is an effective treatment for this disorder and many people just wait for the symptoms to resolve on their own. If you experience these symptoms, please contact our office and resolve your dizziness quickly and without medications that only treat the symptoms of BPPV.

*Parnes LS, et al. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). 2003 169(7):681-693.