by Shelley Dumais, Active Balance Physiotherapy Studio
Vertigo can be frightening. Did you wake up one morning and find the room was spinning? Are you continuing to experience dizziness when you roll over in bed or when you lie down or look up? This false sensation of spinning is called vertigo, and it’s a warning sign that your vestibular system is out of balance.
The vestibular system in our body provides our brains with information to keep our body balanced and coordinate its movement. The vestibular system is complex and requires sensory input from our eyes, ears, proprioceptors in the body, and our brain. When this system is out of balance, you can experience the symptoms of dizziness or vertigo.
Dizziness is a general feeling of unbalance whereas vertigo is the feeling of the room spinning. While vertigo is a symptom of many conditions, the most common cause is Benign Paroxysmal Positional Vertigo, or BPPV for short. If the small calcium-rich crystals called otoconia (“ear rocks”) in our inner ear become dislodged, they can travel into the semicircular canals, sending a message to our brain that the head is spinning when it is not.
Movement and changes in position trigger vertigo, which causes the person to feel unsteady or dizzy. This condition is not life-threatening and yet is very disabling. Feeling unsteady can alter a person’s balance and put them at risk for falling and thus injuries. People with vertigo become fearful of movement and tend to avoid activities that affect their physical and mental health.
Here are answers to some common questions about BPPV.
What does BPPV stand for? Benign: does not harm. Paroxysmal: symptoms come and go. Positional: related to changes in your body position. Vertigo: the false sense of spinning.
How Common is BPPV? BPPV is one of the most common causes of vertigo. 2.5% of the population will experience BPPV at some point in their lifetime.
What causes BPPV? Usually, BPPV presents with no specific cause; however, BPPV is more common in people over 70 years old; in females; in people who have had a recent decline in activity level; in individuals who have undergone surgery or had a procedure involving sustained head position; in people who have experienced head trauma or concussion; and in individuals with known hormone imbalance, vitamin D deficiency, or a family history of BPPV.
Are there treatments for BPPV? The good news is that vestibular therapy is highly effective in treating BPPV. Many studies have shown vestibular therapy for BPPV can result in a 90% improvement of symptoms within only one to three treatments.
What can you expect at your first vestibular therapy appointment? Your physiotherapist will conduct a thorough assessment of your vestibular system. Your physiotherapist will do several tests including, the Dix-Hallpike test, nystagmus tests, eye-tracking tests, balance tests and gait assessment. With the results, they will develop a customized treatment plan to maximize your body’s ability to alleviate your symptoms. This could include a canalith repositioning manoeuvre, gaze stability exercises, balance retraining, hands-on treatment, aerobic exercise prescription, and recommendations on lifestyle changes to help plan and pace your activities and gradually return to your normal activities.