Balance Awareness Week: Vertigo

September 18th starts off Balance Awareness Week, which is sponsored by the Vestibular Disorders Association.  The purpose of this week is to raise awareness about different vestibular disorders that may cause individuals to be unbalanced or have dizziness.  In the spirit of balance awareness week, we wanted to talk about vertigo and dizziness.

Vertigo and/or dizziness are very large concerns for the elderly population.  It is a debilitating problem.  Initially people will notice they get dizzy when they move their head or turn certain ways. Balance and depth perception become altered.  They begin falling and injuring themselves.  Before long, people stop driving, do not go to the store, and eventually become home bound for the fear of when the dizziness will occur!

True vertigo is different from “dizziness”.  Vertigo is when it looks like the room is spinning in circles while dizziness is a light headed feeling with no spinning sensation.  This article will talk about only true vertigo.  While true vertigo can be caused by many different things, surprisingly physical therapy can help eliminate it!  Two common causes of vertigo are Benign Paroxysmal Positional Vertigo (BPPV) and Vestibular Ocular Reflex.

Benign Paroxysmal Positional Vertigo

BPPV is when an excess of particles builds up in your inner ear canals.  It is normal to have particles in your ears.  These particles stimulate your hair cells to tell your eyes to follow your head as it moves.  This flex, called you Vestibular Ocular Reflex, allows you to keep seeing what is in front of you as your head turns.  when you have more particles in one ear canal, say the left side, it tricks your brain into thinking that your head is constantly turning to the left.  Therefore, you would have true vertigo and feel as if the room was spinning.  The “Epley Maneuver” can be performed by a specialized physical therapist to correct the particle imbalance.

The Epley Manuever

This technique is a precise series of rolling, head turns, and other movements that will cause the excess particles to be dislodged and removed from the inner ear.  The procedure will take about 20 minutes to complete.  Once the particles are removed, the vertigo will subside.  Most people are better in 1 to 3 visits.  This procedure currently has a 97% success rate!

Sometimes true vertigo is caused by a decreased Vestibular Ocular Reflex (VOR).  This means that the reflex that causes your eyes to follow your head movements is not working correctly.  To correct for this, the reflex must be retrained.  VOR is a much longer rehab process than BPPV. It usually takes 1 to 2 months and actually aims at retraining this reflex.  This is done with various balance exercises.  The body is slowly introduced to situations that would cause the vertigo to occur. As you progress, the body will become accustomed to certain activities and it will take more to initiate the vertigo response.  After the vertigo is corrected, patients will likely return to physical therapy for the neck pain and stiffness that resulted from avoiding turning the head for an extended period of time.

Dizziness and vertigo can be caused by various different things such as blood pressure changes, inner ear disorders, infections, malnutrition, and many others.  The first step is always to see your doctor if you experience these symptoms to rule out anything more serious.

Blogger: Dr. Sara Morrison, PT, DPT, CDT, FCE, CFT, Cert DN, Cert FMT