Vertigo is a very common problem, especially in the elderly population. It is a sensation of spinning dizziness and often causes balance problems, which in turn increases the chance of falls for many people. It usually occurs when you move your head up or down, or get in or out of bed, and episodes last around a minute. Vertigo can occur to any age group, but is much more likely to be an issue for those over 72. Someone experiencing vertigo may report lightheadedness, nausea, ringing in the ear, a feeling of motion sickness, headaches, or nystagmus (when eyes move uncontrollably from side to side).
Vertigo is not an illness itself, but is a symptom of conditions that usually affect the inner ear or central nervous system. For example, patients that have had a stroke, cervical spine issues, or inner-ear infections can develop vertigo. Benign paroxysmal positional vertigo (BPPV), or “loose crystals” is one common cause of vertigo that Physical Therapists can diagnose and treat. BPPV occurs when crystals in the inner ear become loose and disrupt the fluid in the semicircular canals. This creates a false sense of movement when one moves their head. About 2%-3% of the population are at risk for BPPV, particularly elderly females.
If you suspect you have loose crystals, it is simple to diagnose and treat. You should get an assessment from a physical therapist, in which they can perform a diagnosis using the Dix-Hallpike test. During this non-invasive test, they will ask you to sit on the exam table and turn your head to one side. You will then lie back quickly and hang your head slightly over the end of the table, which may trigger symptoms of vertigo. Your physical therapist will watch your eyes to see how they move. Depending on how your eyes are moving, the physical therapist will be able to determine if you have BPPV, and where to perform the treatment. Therapists will treat these symptoms using the Epley Maneuver, and will usually resolve the issue in one or two visits. This noninvasive maneuver uses gravitational techniques to allow floating particles to move back into the utricle of the ear canal, so that they do not cause any more stimulation of the cupula.
After these issues are resolved, you would not need to come back for additional treatment. However, many individuals will continue with balance training. At Beyond Physical Therapy, our therapists will help these patients with balance issues relating specifically to the inner ear, such as eye tracking, balancing on various surfaces, and walking with head turns.