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If the Room is Spinning, Physical Therapy Can Help

by Athletico9 Comments

Have you ever woken up and felt dizzy? Did you feel like the room was spinning? Chances are, you thought something was seriously wrong and possibly went to the ER. Once all the medical tests were done and it was cleared that you were not having a stroke, you may have been given an anti-vertigo medication and sent home. What many people do not know is that this condition is something that could easily be treated without medication and can be cleared in as little as one session with a physical therapist. I am talking about positional vertigo, one of the most common reasons that people visit their primary doctor.

Benign Paroxysmal Positional Vertigo, or BPPV, is the most common cause of vertigo. It often develops very suddenly and causes a spinning sensation with head movements or changes in position. BPPV is a disorder of the vestibular system in the inner ear. The vestibular system has fluid-filled canals that sense movement when your head changes positions. When the fluid moves, your vestibular system sends a signal to your brain that you have changed position.

BPPV happens when small pieces of bone made of calcium break free and float around the canals. These bones, or crystals as they are often called, cause movement in the fluid, and the brain gets confusing signals that you are moving even though you are not. This is what causes the spinning sensation. Usually the sensation lasts a brief period of less than a few minutes and happens only when you change positions or move your head. Once those crystals settle at the bottom of the canal and are no longer moving the fluid in your ear, the spinning sensation stops.

Majority of the time, BPPV comes out of the blue with no way of predicting it. Occasionally it may result from a bump to the head, such as a car accident or a fall. An inner ear infection may also make an individual more susceptible to BPPV. Although the causes of BPPV are mostly unknown, the evaluation and treatments are very well documented. There are some simple treatments that can be done by a trained physical therapist with a success rate of almost 80% in as little as 1-2 sessions. The Epley Maneuver involves moving the head in such a way to reposition the crystals so that they are not floating in the canals. Once these crystals are repositioned, the vertigo symptoms should subside. There is always a chance the symptoms may return so the Epley Maneuver can be taught as a home treatment if the patient wishes.

If you have experienced brief bouts of dizziness with position changes, ask your doctor if you may benefit from treatment from a physical therapist trained in vestibular rehabilitation. You may be amazed by the results and may be able to go on vertigo-free.

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  1. Cindy Nissen

    I saw a PT for 2 sessions of vestibular rehabilitation and the results were phenomenal! The episodes of vertigo have been virtually eliminated. The symptoms of vertigo are frightening and I was glad to learn I didn’t have a stroke or a brain tumor..just an inner ear problem that could be “trained” to behave better. I also try to drink more water.

  2. Liz Hoobchaak

    So glad to hear that it helped you so well! Pass on the word to others you may know with similar symptoms since many people do not know that therapy can help to eliminate vertigo.

  3. Karen Nielsen

    I developed vertigo from getting a severe concussion. I slipped on wet ice on the road and fell straight backward, suffering a significant head injury that knocked me out. When I told my doctor, and I was able to drive, she sent me to a physical therapist who was able to resolve the vertigo with positional exercises. It was quite remarkable.

    He also tested how well my eyes track from side to side, asked me if I am prone to falling (which I am even though I’m in my 40s), and told me that I have vestibular___. What was he referring to? When I tried to keep focused on his fingertip as he moved it, he and I noticed that my eyes didn’t move smoothly: they seemed to stop and them jump ahead a couple of times. What is that? Is there anything I can do about it? Thanks.

  4. Liz Hoobchaak

    Karen, I am glad to hear that you had great results with Physical Therapy for your vertigo. It sounds like the doctor was testing your ‘smooth pursuit’ which is your ability to track an object back and forth with your eyes. The inability to track an object can be due to many different things including: eye muscle weakness, age, medication, visual disorders or changes in your brainstem processing. You can try some simple eye exercises such as keeping your eyes on a target and moving your head back and forth or up and down for 30-60 seconds.

  5. Jack Reed

    I’m glad to see that PTs are taking this up, and offering it to the public. Years ago I encountered the Epley Maneuver when I was recommended to see Timothy Hain, MD (Northwestern Memorial) for this problem, but it proved ineffective in my case, so we proceeded to another home treatment on his list, the Brandt-Daroff Maneuver, which takes longer for me but does the job. Do PTs offer this too?

  6. Liz Hoobchaak

    In response to Jack, yes the Brandt-Daroff Maneuver can be taught by a PT. This is an exercise that is usually given to a patient that has not responded to the Eply Maneuver. The goal is to help the body compensate for the symptoms of vertigo. It is not as quick of a fix as the Eply maneuver can be, but it can be effective in some causes.

    In response to Jerry, Tinnitus is not typically a diagnosis that is seen in PT. There are certain treatments, such as sound therapy, that have been found to be effective for symptoms of tinnitus. An Ear, Nose, Throat (ENT) doctor or Audiologist would be a better medical professional to assess your tinnitus and help formulate a plan for treatment.

  7. Carolyn

    Thank you for this information. I had a brief episode of the spinning in the night after I had used the toilet and returned to bed and chose to not wake my husband and went comfortably back to sleep. When I awoke a couple of hours later, got up and walked to the bathroom, it was like a tornado turning me around and I ended up on the ground without any injuries. After moving around a little I felt fine but am glad to hear that it most likely is not a tumor or stroke. My bp was really high when I took it and I may well check it out with a pt, and my bp has continued to return to normal.

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