Is Your World Spinning?

By Grace Lucuab, DPT

Did you know that at least 10 percent of emergency visits are related to dizziness or vertigo? What’s the difference? Vertigo is described to have a rotational and spinning component and is the perception of movement described as the rotation of the self or the surrounding objects. Where dizziness is a sensation of lightheadedness, faintness, or unsteadiness. These symptoms are a result of a disturbance to your vestibular system, which is responsible for your ability to balance in everyday activities. Studies have shown that more than a third of the adult population over 40 have experienced symptoms of a vestibular system disorder and the most common cause of dizziness and vertigo is BPPV.

Benign Paroxysmal Positional Vertigo (or BPPV) is the most common cause of vertigo.  Studies also have shown that 2.4% of individuals will experience BPPV at least once in their lifetime.  Vertigo is triggered by changes in the position of your head and can be brief or long lasting and can occur with simple daily movements like looking up, picking up items from the floor, rolling over in bed, or moving from laying down to sitting up.  You may also experience nausea along with the vertigo.  The good news is that BPPV can be successfully treated with your physical therapist!

The cause for BPPV is when the vestibular organs housed in your inner ear detect dysfunctional changes in head position. There are otoconia (small calcium crystals) within your inner ear, and when they move from the vestibule and into one of the semicircular canals, the result is the spinning sensation of vertigo.  This usually happens spontaneously but may also be the result of a head injury.  These canals have connections to the muscles that move our eyes.  Physical therapists can detect the presence of BPPV by watching your eyes as you move and as your body changes position.  When BPPV is present, a nystagmus (rapid involuntary eye movement) will occur at the same time as you feel the vertigo.

Physical therapists use specific tests to help determine which ear is affected and which canal within that ear is the source of the problem, and with the knowledge of the anatomy of the inner ear, they can guide the crystals out of the semicircular canals and back to their proper place within the vestibule.  In most cases, vertigo can be completely resolved within 1-4 treatments of physical therapy and depending on severity usually resolves within 2-4 weeks.

Your physical therapist is here to help you determine if you have BPPV based on your symptoms. They can also redirect you to an appropriate healthcare professional if your symptoms are more severe. Let us help you bring you back on track.




3) Vestibular Disorders Association