Physical Therapy and Vestibular Rehabilitation
“I feel like the room is spinning around me, what is happening and is there anything I can do?”
What you are experiencing is vertigo. It may be a specific type of vertigo known as benign paroxysmal positional vertigo (BPPV).
Let us break down what these words mean:
Benign: not life threatening
Paroxysmal: comes on suddenly for a brief amount of time
Positional: triggered by certain head positions
Vertigo: sensation of a spinning room
Let’s take a closer look at what is going on in BPPV
Our inner ear has three fluid filled semicircular canals that are depicted in Figure 1. These canals play a role in maintaining our sense of balance during movement. There are little crystals, smaller than a grain of sand, that are located in a structure just below the canals. Normally the crystals are attached to a jelly substance within this structure. However, sometimes with trauma or older age, the crystals will detach and will end up free-floating in the fluid-filled canals. These free-floating crystal results in incorrect signals being sent to the brain resulting in a false sensation of the room spinning (vertigo). In order to get rid of this sensation, the canals need to be cleared of these crystals.
In 85% of the cases it is the posterior semicircular canal that is affected. One of the treatments to clear that canal is the Epley’s maneuver (shown in Figure 2). During this maneuver the practitioner will place your head into different positions resulting in the crystals moving through the canal and eventually out. After the treatment, you will most likely still feel off and somewhat unbalanced. This is very typical because the brain needs a couple days to calibrate the reset signals coming from the inner ear and adjust to a new normal. Usually one to two treatments are sufficient to rid the canal of the crystals.
There is a chance of reoccurrence and unfortunately, there is a higher probability of developing BPPV if you have already had one incident or have been in a significant trauma where the head was jerked around suddenly.
If you think you may have BPPV, know that there are very effective treatments out there that will help you return to the things you love most!