by Deborah Bodin, PT
Wake Up Spinning?
Did you wake up one morning and feel like the room was spinning when you tried to get out of bed? Did this make you feel like you might throw up? Unfortunately, you’re not alone. This sensation is called vertigo and it is very common–it is experienced by 40% of US adults in their lifetime.
It is likely that you have Benign Paroxysmal Positional Vertigo (a.k.a. BPPV) as it is the most common cause of vertigo. Almost 1 in every 10 older adults (75 or older) has BPPV. This is important because BPPV increases your chance of experiencing a dangerous fall up to 12 times.
Now for some good news! BPPV is very treatable with physical therapy. Many times your current symptoms can be resolved in one or two physical therapy sessions.
What is BPPV?
There are 3 semicircular canals and 2 balance organs in each ear.
- Benign: not life-threatening
- Paroxysmal: recurrent, sudden, intense symptoms
- Positional: related to a change in the position of the ear
- Vertigo: sensation of rotation or spinning
BPPV is a problem where “crystals” (actually small pieces of calcium carbonate) break loose from where they normally belong in your inner ear. They get stuck in a part of your inner ear where they are not supposed to be. This can be related to a blow to the head, recent illness, or, more commonly, no reason at all.
When the crystals are in the wrong place, a short, often intense, sensation of dizziness called vertigo can occur with a change in your body’s position. The most common activities that cause vertigo are: rolling over in bed, getting out of bed, bending forward, or looking up.
What are the symptoms of BPPV?
Symptoms of BPPV include:
- Dizziness
- Vertigo – the sense that you or the room is spinning
- Loss of balance or unsteadiness
- Nausea
- Vomiting
What can physical therapists do?
The physical therapists at CoreBalance Therapy have specialized training in the assessment and treatment of dizziness. They will take a detailed history of your symptoms that may include:
- when they started
- what you were doing when they began
- how long your dizziness lasts
- what makes it worse/better
- other recent illnesses or injuries that may be contributing to your symptoms
To evaluate for BPPV your therapist will be looking at how your eyes move when you are both sitting still and when your head is moving or you are changing position. Special video goggles may be used to record how your eyes move. The testing involving putting you in a variety of positions is designed to recreate your symptoms to help your therapist decide what maneuver is appropriate for treatment of your BPPV.
Physical therapy evaluation is also checking for other possible causes of your symptoms. Dizziness can be caused by many other issues and if your therapist does not think that BPPV is your problem, they may offer you different physical therapy treatment exercises or refer you to another medical specialist.
How long does it take to feel better?
BPPV is treated by a series of maneuvers designed to put the crystals back where they belong. This is usually effective in a few treatment sessions. As the crystals move back to where they belong, you may experience your familiar symptoms. Your therapist expects this and will help you get through them.
What happens if I don’t do anything?
If you do nothing, the symptoms of BPPV can sometimes decrease or resolve without any treatment; this can take only a few days or up to several months. In general, it is not recommended to leave this condition untreated. Falls, imbalance and depression are more common in individuals with untreated BPPV. There are some medications that may decrease your acute dizziness symptoms, but they don’t fix the problem and may lead to worsening of your symptoms if taken long term.
How effective is treatment?
Physical Therapy maneuvers are very effective at eliminating your current episode of BPPV and, many times, it only takes a few treatment visits. Your therapist can also teach you how to self-manage any future episodes if your BPPV returns. We understand how frustrating it is when vertigo occurs and we want to get you back to your life as quickly as possible!