Vestibular Disorders (Vertigo)
Do you suffer or ever had a sudden bout of dizziness? Then read on to find out how All Care Physiotherapy can help you today.
There are numerous causes of dizziness but one cause called BPPV is common and successfully treated by our Vestibular Physiotherapists.
BPPV or Benign Paroxysmal Positional Vertigo is a term for sudden dizziness that occurs in bouts or waves. It often hits as soon as you wake in the morning, roll over or sit up and find the room is spinning uncontrollably. Nausea, imbalance and fatigue can follow.
These waves of dizziness often settle when you’re still, and recur again with large head movements, such as bending over to put shoes on, and often last between 10seconds – 2minutes. This can go on for days to weeks and if left untreated, can even last months. It often leaves people unable to work, concentrate and participate in life due to these disabling symptoms, so it’s important to treat it as early as possible, by seeing a vestibular physiotherapist. A vestibular physiotherapist can treat this condition quickly and easily, getting you back to your normal activities of life in less than a week.
BENIGN= Not life threatening
PAROXYSMAL= A sudden recurrence or intensification of symptoms
POSITIONAL= Triggered by changes in position or movement
VERTIGO= A false sense of movement/dizziness
SIGNS AND SYMPTOMS?
- Sudden, uncontrollable dizziness when head moved up/down or side/side.
- Nausea, vomiting
- Fatigue
- Impaired balance
- Inability to concentrate/work/participate in leisure activities
WHAT CAUSES BPPV?
What causes this sudden problem is a temporary, non-life-threatening issue within our vestibular system where tiny “crystals”, called Otoconia, dislodge and fall into small semicircular canals (see image below) in our inner ear. When this happens, the side that these otoconia have fallen into sends false and exaggerated messages to our brain that we are moving. This confuses the brain and causes a dizzy/room-spinning reaction. These otoconia particles must be moved back into the cavity where they belong in order for these symptoms to stop. Specialist treatment by our vestibular physiotherapist will shift these otoconia back into the correct canal which will alleviate your dizziness.
WHAT IS THE VESTIBULAR SYSTEM?
We each have a left and right vestibular system that lives within our inner ear. The vestibular system is responsible for providing our brain with sensory information about our spatial orientation, head position and movement.It also helps our brain with motor functions that allow us to keep our balance, fixate our eyes on an object while moving and stabilize our head and body during movement. Thus, the vestibular system is vital for balance, movement and equilibrium and why when you have BPPV you will be affected by dizziness and altered balance.
ASSESSMENT
Vestibular physiotherapists have extensive training in the assessment of BPPV in order to distinguish exactly which side and which canal these otoconia particles have fallen into. This is imperative to treating this condition properly, as every canal has a different treatment method.
An in-depth assessment also ensures there are no other neurological causes of your dizziness such as stroke, TIA, migraine or other vestibular disorders such as Meniere’s disease, vestibular neuronitis or labyrinthitis. At All Care Physiotherapy, our vestibular physiotherapist is highly trained in recognising these other diagnosis’s and ensuring correct management if indicated.
Here at All Care Physiotherapy, our vestibular physiotherapist uses special eye recording goggles to record eye movements that tell us the exact canal and side of issue. These help to provide a much more accurate diagnosis. The assessment process may recreate your dizzy symptoms by moving you gently into provocative positions, but is always pain-free and simple. All that it requires is for you to wear the comfortable goggles on your eyes and be smoothly guided into several positions on a physio plinth, in order to elicit a response from your vestibular system.
TREATMENT
Treatment then follows whichever canal is identified as the issue and involves the physiotherapist guiding you into very specific lying positions to move the otoconia around the canal using gravity. This is also completely pain-free and simple to perform when guided by the physiotherapist. Treatment usually takes approximately 15-20minutes in the clinic.
Afterwards you can feel a little bit wonky as the vestibular system has been corrected. We often encourage patients not to drive home themselves, just in case you feel this way. This feeling will only be temporary and nothing like the symptoms of BPPV. There are some precautions we ask you to follow for the next 24hours after treatment, mostly involving keeping the head upright to let the vestibular system settle and to not risk the otoconia moving back into the canals.
Most commonly people feel 90% improved by the next morning, and by the 2nd session of physiotherapy are 100%. Sometimes if the otoconia have travelled into deeper parts of the canals or are in multiple canals, it may take a few more treatments to fix completely, but you will always feel better each time.