You roll over in bed to silence your alarm clock when suddenly, the room begins to spin. You roll quickly back towards the center of the bed with significant fear of not knowing up from down or if you may fall out of bed. The spinning is severe, disorienting, and can even cause the uncomfortable sensation of nausea. However, within a minute or so, it seems to settle until you try to get up again. There are lots of types of dizziness experienced by millions of people daily, but this sensation is true vertigo. Vertigo is characterized by spinning dizziness, and you will first want it to be verti-gone. In this case, a physical therapist is one of the best professionals for you to visit.
True, room spinning vertigo most often accompanies a condition of the ear called Benign Paroxysmal Positional Vertigo or BPPV- more commonly discussed as “loose rocks” or crystals in one’s ear.1 If you experience BPPV, you will note this vertigo occurs with changes in head position: rolling to one side in bed, moving from lying to sitting, dropping your head down to tie shoes or pick up a dropped item, and/or tilting back in a dentist chair or salon shampoo bowl. The vertigo is also severe in intensity and only lasts from seconds to possibly a minute. These are all characteristics to correctly diagnose vertigo, which your physical therapist will look for in your discussion during your initial evaluation.
When experiencing vertigo, it is helpful to know there are physical therapists who have more experience and extensive training in the vestibular system where vertigo typically originates. During your initial evaluation, your physical therapist will discuss your story of symptoms, factors that make it worse, and if there are factors that make it better. Following your discussion, your answers will lead your physical therapist to choose and perform certain tests that will confirm their suspected diagnosis. Many of these tests can lead right into treatment to get that vertigo, verti-gone. A physical therapist trained in vestibular dysfunction will also spend considerable time explaining their findings, their prescribed plan of care, and how it will assist you in the most important aspect, which is reaching your goal for your quality of life.
A few things that are important for anyone dealing with vertigo to know. The most effective and efficient treatment is done by a skilled clinician. Treatment moves the “rocks” or otoconia in your ear, which does reproduce your symptoms. Please remember that this technique is designed to move and clear those “rocks” from their position so that symptoms should be better after treatment, despite feeling vertigo throughout. Your vestibular system will fatigue, so if you can tolerate more rounds of the treatment, it should be performed until symptoms subside entirely. Vertigo and BPPV can reoccur- 1 in every 2 people that have it will have it again. It is more likely to reoccur within the first year you have it, with age, and more often for women. Resolution can occur in anywhere from 1-4 visits, but if it is not resolving by then, and your therapist hasn’t altered their plan for your care, you may consider following up with a therapist or return to your doctor/ENT for a follow-up. Finally, please be aware that the vestibular system ages as any system ages and symptoms may not fit the definition we discussed above. However, the American Neurological Physical Therapy Association states you should be tested for BPPV if you are above 65 and experiencing vertigo, dizziness, lightheadedness, or falls.1 It is a simple test to rule in or out this diagnosis easily and keep your world righted with you on your feet.
If you are looking for solutions for your vertigo, look no further. Schedule your free assessment in clinic or virtually through our Telehealth platform. Our team of experts will help you find a vestibular therapist and have you feeling better before you know it.
*Per federal guidelines, beneficiaries of plans such as Medicare, Medicaid, Tricare, VHA and other federally funded plans are not eligible for free assessments.
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1: Bhattacharyya N, Gubbels SP, Schwartz SR, et al. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update). Otolary–Head and Neck Surgery 2017;156(3S):S1–S47.