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Vertigo: What is it and can PT help?



*Photo from Treble Health

What is Vertigo?


Aside from being the title of Alfred Hitchcock’s classic film, Vertigo is a sensation that feels like dizziness or being off balance; if you’re experiencing classic vertigo you may feel like you are spinning or falling, or being pulled toward one side. This is because many causes of vertigo stem within the inner ear (and the vestibular system), which your body relies upon for proprioception (the sense of where your body is in space and how it is positioned). Some causes of vertigo are:


  • BPPV, or Benign Paroxysmal Positional Vertigo. Small calcium particles (known as canaliths) in your inner ear are dislodged from their normal locations and collect in a manner which disrupts the signals sent to your brain about head and body movements. BPPV can occur for no particular reason, but may be associated with age.


  • Meniere's disease, an inner ear disorder believed to be caused by fluid buildup and changing pressure in the ear. It can cause episodes of vertigo along with tinnitus (ringing ears) and in serious cases, hearing loss.

  • Ear infections which cause inflammation of the inner ear can affect the nerves of the inner ear and lead to episodes of vertigo


Diagnosis of the cause of your vertigo may start with answering questions such as whether you experience it during specific activities or at certain times of day. The types of vertigo described above are considered Peripheral Vertigo. If the cause of your vertigo stems from your brain it is called Central Vertigo and may be caused by conditions like multiple sclerosis, tumors, or stroke. Central vertigo is often accompanied by additional symptoms such as double vision or facial paralysis, depending on the exact cause. 


How is Vertigo treated?


Sometimes vertigo symptoms can resolve or improve on their own, although this is often due simply to the adaptability of the brain which can learn to “filter out” bad signals it receives from the inner ear and rely more upon other senses for proprioception.


Treatments for vertigo which persists vary depending on the identified root cause. Medication may be used to help reduce feelings of nausea or dizziness. In cases of fluid buildup in the ear, diuretics may be used to reduce the amount of excess fluid. For cases related to canaliths, canalith repositioning maneuvers may be used to help them move away from areas of the inner ear which are sensitive. For more serious conditions such as tumors or problems with the blood vessels in the brain, surgical correction may be required. 


How can PT help?


If you are dealing with peripheral vertigo such as BPPV, your PT may guide you through the Epley Maneuver or other maneuvers which will reposition canaliths in your ear. It’s not uncommon for your vertigo symptoms to intensify during these maneuvers but they will lessen afterward. Your PT will also help you identify activities which bring about bouts of vertigo and help you to find ways to do them which don’t trigger your symptoms. Your PT can also help you with advice for rearranging your home to help reduce how often you need to move in ways that will trigger your vertigo and reduce your risk of falling when you are experiencing dizziness and trouble with your balance. 


Outlook


For some people, vertigo is short-lived and only accompanies a specific illness or issue and resolves when the underlying cause is treated. For others, conditions like BPPV can be recurrent, but with the proper treatment and prevention, it can be mitigated enough to not severely impact daily life. 

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