Vertigo: BPPV- it will make your head spin
Have you ever suffered from an insidious onset of dizziness? It’s hard to imagine having the feeling of spinning without intentionally provoking it on a merry go round or a carnival ride. Dizziness affects 15-20% of adults annually. Being off balance, feeling like you're spinning and or the sensation that the world around you is spinning are the most common characteristics of vertigo. Vertigo is a symptom of a range of conditions including those of the inner ear, brain, or the central nervous system. Tension in the cervical spine can mimic a vestibular condition. This is known as cervicogenic dizziness and is often misdiagnosed as an inner ear condition. Luckily there’s a slew of tests you can do to help determine the cause of your spinning.
With the official start of monsoon season here in Arizona, I wanted to specifically discuss an inner ear condition that is more common this time of year than most people realize. This condition is known as Benign Paroxysmal Positional Vertigo-most commonly referred to as BPPV. This is a mechanical problem in the inner ear. It occurs when the otoconia (fancy word for tiny crystals) that are normally embedded in a gel-like substance within a utricle become dislodged and migrate into one or more of the 3 fluid-filled semicircular canals. When enough of these crystals accumulate in one or more 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. These are highly sensitive canals that don't tolerate any sort of disruption well. Think of a massive boulder affecting the flow of a small stream. See image.
The hallmark sign of BPPV is an episode of dizziness that typically feels like the room is spinning. Symptoms are typically provoked with head movements. It usually occurs when you turn in bed or look up into a cabinet. In most cases your dizziness does not last more than a couple minutes. Having bouts of dizziness that don’t ease up or go away are typically signs of a different condition. Lightheadedness, unsteadiness, loss of balance, and nausea are other symptoms often associated with BPPV. So what causes BPPV?
There is no definite answer as to what causes BPPV but anything that dislodges the crystals from the utricle can cause BPPV. Having a past head injury is a major cause, car accidents, and even roller coasters. You are at a higher risk of developing BPPV if you have a history of migraines, high blood pressure, and high cholesterol. There have even been correlations with episodes occurring when the barometric pressure changes. Since I’ve been a physical therapist, I myself have noticed an increased rate of patients coming to PT with BPPV during monsoon season here in Arizona. There's even evidence of emotional stress causing inner ear dysfunction. There is good news, though. This is very treatable and often only takes 1-2 visits to completely resolve it. What many people do not realize is that Physical Therapists can treat BPPV. Treatment involves very specific positioning and head movements that help to migrate the crystals out of canals. Symptoms often resolve within 24 hours of treatment.
If you or anyone you know has an episode or insidious onset of dizziness, you should seek out a profession. Dizziness is not normal and you should not try to wait it out. If you are in the greater phoenix area, I provide vertigo treatments in your home. If you are not in Arizona, I provide online video appointments as well. Drop us a chat in the chat box below of text 575-499-4249 to set up an appointment.
Yours Truly,
Savannah Torrez, PT, DPT, COMT
“Success doesn’t stop when you get there.”-Michael Jordan
