The Most Common Cause of Dizziness or Vestibular Dysfunction
Waking up to dizziness with the room spinning is a scary sensation. This is called BPPV (benign paroxysmal positional vertigo). This is a condition caused by a problem in the inner ear when a calcium crystal gets dislodged and moves through the canal. This condition has to do with moving your body or head through different positions in space and at times this can cause dizziness. More than 35% of adults will experience vestibular dysfunction at some point.
Who Treats BPPV and How Is It Treated?
Physical therapists (PTs) receive training in treating this condition. We learn to spot symptoms of BPPV and how to test to determine if the client has this condition. The test is called the Dix-Hallpike test, named after the doctors who came up with the test. The treatment is the Epley maneuver. This is the most common treatment and 80% of people who receive this treatment can end their misery with one session. The Epley maneuver is a series of head movements flowing from one position to the next to try to dislodge the crystal from the ear canal and move it along, so the dizziness no longer occurs. ENTs treat this on occasion and some MDs may know about this too, but the training for treatment is not commonly taught in schools. In Georgia, BPPV sufferers with most insurances can book directly with a PT at ProHealth unless they are relying on Medicare. Then, they’ll need a referral from a physician.
What To Expect During the Appointment
The first step is to do positional testing to determine what is causing the dizziness and if it is BPPV. If positional testing is negative, that is not the cause of their dizziness. The next step is goggle testing. The goggles are placed on the client, and it magnifies one eye on the screen to show the eyeball in high magnification. Signs of vestibular disorders will show up this way and specifically nystagmus. Nystagmus is involuntary rhythmic eye movements. The direction that the eyeball is moving is diagnostic as to what part of the inner ear could be damaged. Once this is known appropriate treatment can be done or it could lead to a referral for the client to have further testing through an audiologist, a doctor of audiology.
Recently, one of our clients who has been coming in after she had low back surgery, just happened to be scheduled for dry needling for a morning appointment, and she woke up with vertigo. It was good timing that she had an appointment. After the Dix-Hallpike test confirmed BPPV, she had treatment. She was slightly wobbly leaving the clinic, but the next day, she emailed to let ProHealth know she was all better.
Often, we have success stories like that. Sometimes it may take up to three visits to resolve a stubborn case of BPPV.
What Is the Cause of BPPV?
There is research that shows if someone tends to sleep on one side only, like only the left side, they are more at risk of having BPPV than someone who moves side to side in bed. It is a gravitational mechanical issue. It is a disorder that can potentially pull the tiny calcium carbonate crystals down into a semicircular canal. It is very complex, but essentially is a sort of positional issue that can cause BPPV.
The other known cause is head trauma. If someone hits their head and is dizzy it could be a concussion, dizziness from the concussion, or it could be that the trauma set off some BPPV.
The recurrence of BPPV is likely, but at ProHealth we teach our clients how to test and self-manage at home if it happens again. They learn about positional testing to determine which is the affected ear. They receive handouts with information on how to test and how to apply the Epley maneuver. If a recurrence happens and self-treatment does not help after a couple of days we advise clients to call and schedule an appointment. When clients call with spinning sensations and dizziness we do our best to get them in for treatment within 48 hours.
If you are experiencing dizziness and you live within easy driving distance of Peachtree City, Georgia, consider calling ProHealth Physical Therapy and Pilates Studio for an appointment. Our PTs are experts with knowledge of BPPV, and appointments fill fast, so call today at 770-487-1931.