Feeling Off Balance - Spinning With Vertigo

Benign Paroxysmal Positional Vertigo ( BPPV) is one of the most common causes of vertigo and accounts for around 50% of people over the age of 65 who complain of dizziness. However it is also found in younger patients, mainly with no known cause but sometimes there is a history of head trauma or whiplash.

In BBPV, dizziness is generally thought to be due to debris which has collected within a part of the inner ear. This debris or crystals can detach and fall into the semicircular canals. These canals are party responsible for your balance and the crystals change the way the fluid in them moves. This in turn gives the brain false information about the movement of your head. Some patients will report that for many years they have avoided looking up or sleeping flat without realising there is a simple management available.

BPPV is Characterised by:

  • Sudden and severe vertigo when the head is moved around
  • Common triggers of rolling over in bed, getting out of bed or lifting the head to look up
  • Spinning sensation often for a few minutes only
  • Can be accompanied by severe nausea
  • Shampooing hair, dental visits and yoga or gym positions are often triggers
  • Vertigo coming and going for no apparent reason
  • Attacks of disabling vertigo for a few weeks, then a period of time with no symptoms at all

BPPV Treatment

Careful differential diagnosis by our experienced Physiotherapists is important and will involve several tests to diagnose BPPV followed by treatment to relocate the ear debris. Not all Physiotherapists are trained in the assessment and treatment of BPPV. The treatment is very effective and in many people only one treatment is required to relocate the crystals. It involves sequential movement of your head into four positions. A follow up session is required to determine the effectiveness of the procedure and suitable instruction in home treatment options as recurrence is not unusual.

During your follow up visit self management techniques can be learnt. After your treatment it is important to follow the directions given but it is not unusual to feel an exacerbation on the day of treatment.

In some people, the positional vertigo can be eliminated, but imbalance persists. In this case it may be necessary to undertake a course of vestibular rehabilitation.

Vestibular rehabilitation is also indicated when there is imbalance due to vestibular loss or when the diagnosis may be unclear. A detailed questionnaire and functional testing are then used to measure the success of therapy.

There are other causes of Vertigo but if your symptoms sound like it is BPPV, the easiest way to diagnose and treat your symptoms is to book an appointment with a BPPV trained Physiotherapist.

When you are booking for specialised treatment in this area, please request one of our Physios with training in this area.

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