What do you do when the world is spinning?
By Eileen Casey
You roll over in bed or you bend over to tie your shoes and suddenly you feel like the whole room is spinning around you. You feel nauseous and unbalanced afterwards.
You’re not alone. Every year millions of people in the U.S. develop vertigo, a spinning sensation in your head that can be very disturbing. Benign paroxysmal positional vertigo (BPPV), or vertigo brought on by position changes, is the most common type of vertigo. It is estimated that 9 out of every 100 adults are affected by BPPV. The good news is that vertigo is often treatable and physical therapy can help.
So what causes BPPV? Benign paroxysmal positional vertigo is an inner ear problem that causes dizziness when your head is moved in certain positions. Most commonly it may happen when lying down in bed, rolling over in bed, or looking up. The dizziness may be intense and frightening. Because of this people may start to restrict their movements and activities to avoid prompting the dizziness again. Unfortunately this can actually cause the symptoms to worsen as you can become even more sensitive to changes in position. Everyone has a layer of calcium carbonate crystals naturally present in the inner ear. BPPV occurs when pieces of this material break off and move to a different area of the inner ear. These tiny calcium crystals are sometimes called “ear rocks.”
When you move your head a certain way the rocks move inside the fluid filled inner ear and stimulate nerve endings causing you to feel dizzy or that the room is spinning. These ear rocks can become loose due to trauma to the head, infection, or aging. But in many cases there is no obvious cause. Some folks report that their symptoms recur predictably, perhaps seasonally or with changes in the weather.
So what can physical therapy possibly do for you inner ear you may ask? Treatment first starts with an evaluation. You will be asked questions as to what specifically causes your dizziness. Then the therapist will move you into certain positions and will look to see if your eyes display a particular kind of reaction called “nystagmus.” Based upon the evaluation results the therapist can perform certain movements that reposition the ear rocks back into the proper position. Although the testing and treatment initially causes the vertigo to come on, many patients often feel immediate relief after treatment. The therapist can then show you things you can do at home to help decrease any residual dizziness you may still have. In some cases the therapist may recommend certain eye exercises or head or body movements or even standing balance exercises for you to perform at home that can further reduce or correct the vertigo.
Dizziness is one of the most common reasons people over the age of 65 seek medical care. Even for patients who have been dealing with these feelings for weeks or months, one treatment can often make them feel better, allowing them to get back to driving their car, doing their own shopping and living life more independently.
Eileen Casey, PT, is the Director of Rehab Services at Brattleboro Memorial Hospital. She can be reached by calling 802-257-8255.