Vertigo and Dizziness
Dizziness can be caused by a variety of conditions, but typically occurs from poor perception in the joints / muscles combined with visual tracking problems and inner ear coordination with your vestibular system. When the brain receives all these mixed signals, it becomes confused and dizziness occurs. Vertigo is a spinning sensation that typically occurs because of problems between the visual tracking and balance systems in the inner ear.
Benign Paroxysmal Positional Vertigo (or BPPV) is the most common cause of vertigo, a false sensation of spinning
- Benign – it is not life-threatening
- Paroxysmal – it comes in sudden, brief spells
- Positional – it gets triggered by certain head positions or movements
- Vertigo – a false sense of rotational movement
BPPV is a mechanical problem in the inner ear. It occurs when some of the calcium carbonate crystals (otoconia) that are normally embedded in gel in the utricle become dislodged and migrate into one or more of the semicircular canals, where they are not supposed to be. When enough of these particles accumulate in one of the canals they interfere with the normal fluid movement that these canals use to sense head motion, causing the inner ear to send false signals to the brain.
Fluid in the semi-circular canals does not normally react to gravity. However, the crystals do move with gravity, thereby moving the fluid when it normally would be still. When the fluid moves, nerve endings in the canal are excited and send a message to the brain that the head is moving, even though it isn’t. This false information does not match with what the other ear is sensing, with what the eyes are seeing, or with what the muscles and joints are doing, and this mismatched information is perceived by the brain as a spinning sensation, or vertigo, which normally lasts less than one minute. Between vertigo spells some people feel symptom-free, while others feel a mild sense of imbalance or disequilibrium.
It is important to know that BPPV will NOT give you constant dizziness that is unaffected by movement or a change in position. It will NOT affect your hearing or produce fainting, headache or neurological symptoms such as numbness, “pins and needles,” trouble speaking or trouble coordinating your movements. If you have any of these additional symptoms, tell your healthcare provider immediately. Other disorders may be initially misdiagnosed as BPPV. By alerting your healthcare provider to symptoms you are experiencing in addition to vertigo they can re-evaluate your condition and consider whether you may have another type of disorder, either instead of or in addition to BPPV.
BPPV is fairly common. Many people describe that they simply went to get out of bed one morning and the room started to spin. However associations have been made with trauma, migraine, inner ear infection or disease, diabetes, osteoporosis, intubation (presumably due to prolonged time lying in bed) and reduced blood flow.
Physical therapy plays a crucial role in helping dizziness and vertigo, by performing several key treatments. Physical therapists can help you feel more in control and in some cases can achieve instant results with specialized procedures. In other cases, balance and coordination training diminish the symptoms and allow you to move without dizziness or vertigo.
Our expert physical therapists have years of training in movement and balance analysis. We perform a thorough evaluation to determine where your dizziness/vertigo/balance problem lies and then formulate a complete treatment plan that will improve your balance, reduce your dizziness and train you on what you can do to maintain the improvement.
Some of the Common Conditions We Treat:
- Benign positional vertigo (benign paroxysmal positional vertigo)
- Injury (such as head injury)
- Inflammation of the vestibular nerve (neuritis)
- Meniere’s disease
- Multiple sclerosis