What is it?
There are several theories regarding the cause of vertigo or BPPV but all start with the basic parts or anatomy of the inner ear. Each inner ear is composed of canals, which are filled with fluid and contain crystals lining the walls, which are attached to a collection area. As we age the crystals in the system degrade and some or all of a crystal may break and separate from its normal position. Whether these particles stay floating or settle among other crystals is debated but this change in the surface inside the ear causes an imbalance that the body senses. When the brain gets differing information from left to right you can become dizzy. This is similar to one wheel on a shopping cart dragging on the ground pulling the cart to the left or right.
Who can get it?
Anyone can get dizzy from the very young to the very old. As we age we are more likely to have BPPV. Only 3% of people from 10-29; one quarter of those 60-69; and half of those 90-99 years old who are dizzy have BPPV.
Why do people get it?
People can get vertigo for many reasons including trauma, infection, loss of blood supply to the inner ear, or most commonly as part of the normal aging process.
What are the symptoms?
BPPV consists of brief (most often under one minute) episodes of vertigo (sense of the world spinning) which generally happen when the head is moved into certain positions. Most people say this happens with lying down; rolling over in bed; bending over – including something as simple as brushing your teeth; or looking up such as when getting a glass out of a cupboard. There are many other symptoms of vertigo including balance problems – sometimes for days after the episode, nausea, blurred vision, trouble walking, and / or sweating.
How is it treated?
Most often vertigo is treated simply by a medical doctor or physical therapist. He or she will assess you and then may treat you with a series of body and head movements. These treatments will likely make you better in as little as one visit but generally in three to six visits.
Is there anything to be careful of?
Be cautious of treatment if you have had: neck surgery, recent trauma, rheumatoid arthritis, vascular changes such as Chiari malformation, myelopathy / radiculopathy, or upper cervical vertebral instability. Ask your doctor or physical therapist for details.
– Keith Bluel, PT, DPT, COMT
