A sudden attack of vertigo can lead to dangerous falls and a disrupted life. Vertigo, a form of vestibular dysfunction, is the sensation of external spinning in the body. Those with vertigo often describe the room around them as spinning or tumbling, resulting in dizziness and danger. Something as simple as loading the dishwasher or picking up your grandchild could have disastrous consequences. According to researchers from Johns Hopkins, one-third of American adults over the age of 40 are at greater risk for falls, as a result of vertigo. The good news is that once vertigo has been identified, there are ways to treat your symptoms and prevent future vertigo attacks.
Vertigo is a symptom rather than a specific illness or disease which means it can be caused by a variety of things. Vertigo is often a result of some form of inner ear dysfunction or disorder, the most common cause including BPPV. Also known as benign paroxysmal positional vertigo, BPPV is a form of inner ear disorder that occurs when tiny crystals in the inner ear become dislodged from where they are supposed to be and travel to other parts of the inner ear. These crystals are what help us detect certain kinds of motion when our head is in motion. For example, they detect the motion when we accelerate in a car or move up or down in an elevator. When these crystals are disrupted, due to trauma or other circumstances, and travel to other parts of the inner ear, they can trigger the sensation of the room spinning or tumbling.
“Imagine it’s someone’s birthday, they just blew out their birthday candles, and the smoke from the candles sets off the smoke detector. Even though there’s no actual fire, the smoke detector is still beeping as if there is an emergency. We know the smoke detector isn’t broken, it is just responding to a stimulus,” said physical therapist, Michael Bolosan of TPMG Physical Therapy in Newport News. “The same way the smoke can trigger a response from the smoke detector, the displaced crystals can trigger the inner ear, causing a sensation of the room spinning or tumbling.”
For those with BPPV, physical therapists will perform an initial evaluation involving positional testing which will try to reproduce your vertigo symptoms. Once they can reproduce symptoms of vertigo, a physical therapist can perform a canalith repositioning procedure, in which your body is positioned in ways that navigate the crystals back to the parts of your inner ear where they belong. For those people with a history of pain or surgery in their neck or back, specific canalith repositioning procedures will be selected to minimize pain or discomfort.
Fortunately, people with BPPV can see results from the vestibular treatment within the first visit. Oftentimes, a physical therapist schedules a follow-up appointment a few weeks after the canalith reposition procedure to ensure there are no residual vertigo symptoms.
For those whose vertigo is not related to BPPV, such as disorders resulting in damage to the inner ear, treatment might take several weeks of vestibular rehabilitation and will focus on specific impairments resulting from vestibular dysfunction such as dizziness, impaired balance, and blurred vision with head movement. Although physical therapy cannot fix the damage to the inner ear itself, it can retrain the brain to compensate for the vestibular system.
Vertigo can begin suddenly and without warning, which can have dangerous consequences. You don’t need to live in fear of a vertigo attack. Talk to a TPMG physical therapist about vertigo treatment today and find relief from your symptoms.
About Michael Bolosan, PT, DPT
Michael Bolosan, PT, DPT, is a licensed physical therapist with TPMG Physical Therapy in Newport News. In 2022, Michael earned his Vestibular Rehabilitation Therapy (VRT) Certification. Experienced in orthopedic, acute, and neurologic care, as well as sports medicine, Michael provides outpatient services to a wide range of patient groups with a special interest in vestibular and balance rehabilitation.