By Evie Ullman, DPT
Do you have vertigo? First of all, it is important to make the distinction between true vertigo, and simply feeling dizzy and lightheaded. We all feel lightheaded from time to time. Common causes of lightheadedness are medication, a sudden drop in blood pressure, stress or anxiety, and dehydration. Lightheadedness can make you feel as if you will faint and it can also make you feel nauseous.
Vertigo gives you the sensation that your surroundings are actually spinning or tilting around you. Vertigo can make you lose your balance, and / or feel nauseated and vomit.
Vertigo is caused by inner ear disorders, brain tumors, and vertebrobasilar artery insufficiency (decreased blood flow to the base of the brain).
Benign Paroxysmal Positional Vertigo, also known as “BPPV,” is an inner ear disorder that can be cured with Physical Therapy alone. The symptoms of BPPV are brief bouts of vertigo that last seconds to minutes and the vertigo is brought on by a change in body position, such as rolling over in bed. Nystagmus, an uncontrollable rapid rotational beating of the eyes, also occurs during the spell of vertigo.
Our inner ears contain a balance mechanism called the labrynth, which is made up of several parts: the cochlea, vestibule, utricle, saccule and three canals (superior, horizontal and posterior). Motion is detected in the inner ear via the movement of fluid and calcium crystals known as “otoconia” or “otoliths.” When this system is interrupted, it sends false signals to the brain, conflicting with other senses in the body that help with balance (vision, skin pressure, and sensory nerves in the limbs) then vertigo ensues. BPPV occurs when one of the otoconia crystals is dislodged from the normal position and migrates into one of the ear canals. The only way to get rid of BBPV is to physically move the crystal back into place. This is done in Physical Therapy with the Epley maneuver. What exactly occurs during the Epley maneuver? The therapist assists the patient from a sitting to lying position and engages them in a series of head positions so that the otoconia crystal migrates out of the canal. Once this is accomplished, symptoms disappear immediately. The procedure is painless and takes only minutes.
Dr. Ullman is a Physical Therapist at Boston Sports Medicine