Remember when, as a child, you spun yourself around and around and around until you couldn’t walk or see straight? As adults we sometimes do the same, but because repeatedly spinning seems a bit immature for a grownup, we take the socially acceptable route: alcohol. Either way you get there, the result is the same – the world is spinning, you can’t see straight, you’re at risk of falling over, and nausea is an unwanted companion.
Now, imagine this feeling not being fixed by sitting down for a few seconds (after spinning yourself dizzy) or detoxing and suffering through a hangover (after drinking yourself dizzy). There is such a condition and it affects approximately 5% of the adult population. It’s referred to as Vertigo, defined as the feeling of movement when one is stationary. And it doesn’t just refer to a feeling of spinning, in fact, many clients report it feels more like they’re on a small boat in stormy water. If you’re really curious, you could always try spinning yourself repeatedly for some temporary vertigo.
The dizzying culprit is the vestibular system in the inner ear (note: vertigo can be the result of dysfunction in the balance centers of the brain, but this form is usually accompanied by other neurological symptoms). The vestibular system looks kind of like a wild roller coaster or a weird snail-like creature. It is in fact a tiny, complicated organ that, when dysfunctional, wreaks havoc on the affected individual’s life. It can be a complicated system to diagnose a problem in because symptoms may include any of the following: issues with vision, hearing (ringing in ears), nausea, memory, coordination, emotions and more. The fear of a vertigo attack often keeps people at home, in bed, near a bucket.
There are a number of specific conditions that can cause vertigo, but I’d like to discuss one in particular – the one that responds incredibly well to a simple treatment.
Benign Paroxysmal Positional Vertigo (BPPV), or simply known as positional vertigo, is the most common cause of vertigo AND the easiest one to fix. The vertigo occurs because of tiny crystals of calcium carbonate (or “ear rocks”) that are normally stationary within the labyrinth of the vestibular system but have come loose. These ear rocks can be dislodged from their normal resting position by head trauma, infection, age-related degeneration, or other disorders of the inner ear. Once loose, the ear rocks interfere with the normal function of the inner ear and confuse the balance centre resulting in the symptoms of vertigo. To treat BPPV, one needs only to get those darn rocks to go back where they came from.
That’s where your trained health professional comes in. If your doctor, physiotherapist or other health care practitioner is familiar with the assessment and treatment of BPPV, relief can be yours. The treatment technique, known as the Epley maneuver (or the Canalith Repositioning Procedure), is a series of movements of the head that aim to get the ear rocks back where they belong. The Epley maneuver will “fix” over 80% of BPPV cases, BUT not necessarily forever. The problem is, once those ear rocks come loose, they stay loose, and even though this treatment will put the rocks in an area of the inner ear that won’t mess with the balance system, the rocks may drift back into the wrong area. Time to recurrence is very hard to predict, and sometimes there is never a recurrence.
Regardless, the fact that there is a simple, effective treatment for this debilitating condition is great news. There is also a home exercise (Semont exercise) that can be prescribed to help give immediate relief for recurring episodes of BPPV. Awareness of a BPPV treatment technique among physicians and rehab specialists is not as widespread as you would expect, and many people continue to suffer. If you suspect that you or anyone you know may have positional vertigo, consult your physician or physiotherapist. If you are diagnosed with BPPV, make sure the Epley maneuver is performed!
I am curious as to whether any of our readers have experienced positional vertigo. We would love to hear your story!
If you have any clinical questions regarding vertigo diagnosis and treatment, please send them to firstname.lastname@example.org