Have you ever felt dizzy when getting out of bed? Or only when you roll or turn your head in one direction? Ever feel like the room is spinning for no reason? You may have BPPV.
Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo symptoms. BPPV is characterised by episodes of sudden and severe vertigo (dizziness) when your head changes position suddenly. For example, such as rolling in bed, reaching down, getting out of bed and lifting your head to look up. Why does this happen you may ask? When your head moves, signals from three semicircular canals surrounded by fluid in the inner ear provide information to your brain about how your head is moving. These semicircular canals have small crystals in them that are free to move around the canals to provide these signals. BPPV is caused when the small crystals within the semicircular canals escape or become dislodged into the balance organ of the inner ear.
SIGNS AND SYMPTOMS
Potential signs and symptoms of BPPV include the following:
Intermittent episodes of vertigo that are usually short in duration (less than 30 seconds)
True sensations of vertigo (room is spinning around you, or you feel as if you are spinning)
Triggered by specific movements of the head, e.g. rolling in bed to one side or looking up
Irregular eye movement that occurs with the vertigo
Mild or no symptoms when your head is still
Occasionally associated Nausea, vomiting and lightheaded-ness or feeling of uneasiness following an episode
An intermittent pattern is common. Ie. BPPV may be present for a few weeks, spontaneously stop, and the returns weeks/months later.
CAUSES
For most people, the exact cause of BPPV is unknown. However in some cases, it can be due to the following:
Rapid acceleration/deceleration of the head (e.g. Following concussion or whiplash)
An existing vestibular problem (e.g. Neuritis, Labyrinthitis, Meniere’s Disease)
Natural age-related changes to the organs within the inner ear
Following significant periods of inactivity or bed rest
Following surgical/dental procedures involving specific positioning of the head
ASSESSMENT
Correct assessment is important in determining whether your symptoms are from BPPV or from another cause and to target treatment at the canal in the inner ear which is affected. Your physiotherapist will use specific tests including eye function and reflexes as well as checking your balance and looking for the presence of nystagmus (jerking of the eye movements).
TREATMENT
After confirming that you have BPPV and which part of the inner ear is affected, your physiotherapist will apply specific techniques to reduce symptoms as well as provide you with advice and exercises to do at home where required. For over 80% of people, treatment is highly successful and results are immediate. Treatment is aimed at positioning the head and body using simple but specific techniques to enable the correct positioning of crystals back into the semi-circular canals in the inner ear. Once the BPPV is resolved some patients may require further exercises or physiotherapy to address residual dizziness which can occur if the vertigo has been ongoing or particularly severe. Your physiotherapist will also liaise with your GP where needed to discuss management and whether medications may be needed.
If any of this sounds familiar to you, please don’t hesitate to make an appointment to see one of our Physiotherapists by making an appointment on 47877656. **NOTE** it will be important to state when making an appointment that you’re experiencing dizziness as we have a particular treatment protocol to follow.