Do you have vertigo? We can help!

March 19, 2021

Benign Paroxysmal Positional Vertigo (BPPV) is the most common form of vertigo related to positional changes of the head. The prevalence of BPPV in the general population is low, increasing as we age and is more common in women than in men. BPPV is due to changes in the vestibular system (the inner ear) when a normally fixed crystal(s) becomes dislodged and moves beyond its normal location in the inner ear. The loose or ‘rogue’ crystal will give incorrect information to the brain about how the head is moving, creating the sense of spinning, abnormal eye movements and often nausea.

In the majority of cases there is no known cause for the crystals to become dislodged. Other sources of BPPV can be trauma to the head, minor or major, which can dislodge crystals with an immediate or delayed onset of vertigo (days to months). There is a higher incidence of BPPV in persons who experience migraines. There are also some dysfunctions of the inner ear system as well as ear surgery that can also create BPPV.

Physiotherapists trained in the assessment and treatment of balance problems will ask specific questions to the individual suffering from dizziness, in order to have a sense of what is the nature of the dizziness. Following, a comprehensive physical exam will be given starting with assessment of neck movements and flexibility and strength of the legs. Assessment of the brain and spinal cord control of balance, is performed by testing coordination of movements when sitting stationary, standing and when walking. This is followed by testing eye movement without and with neck movement. After which, the inner ears are tested by doing quick movements of the trunk when reclined, including flopping backwards and rolling, while assessing for abnormal eye movement and symptoms. This will test the 3 semi-circular canals, which are positioned at different angles within the inner ear, for the potential ‘rogue’ crystal(s).

Following the examination, an individualised home exercise program will be provided, with improvement often quickly achieved. Unfortunately, in order to be successful, the exercise must provoke the symptoms of spinning, which can be challenging to self-induce. Follow-up with the physiotherapist is crucial in order to maximize results.  Many studies have found success rates of 80% in one treatment, while some people require multiple treatments and rarely the BPPV can be difficult to resolve. BPPV can resolve on its own, but may take a long time.

There are multiple potential sources for balance problems. A physiotherapist trained in Vestibular Rehabilitation will provide a comprehensive examination and guide you in the right direction.

Trish Sennett, PT

Trish is a physiotherapist at the Human Performance Centre who is pleased to help you with your balance problems.
 You can contact her at 738- 8299