By Michael Vig, PT, Therapy Services
If you feel dizzy or woozy when laying down or rolling over in bed, when you get your hair washed at the salon, or when you’re doing a downward-facing dog pose in yoga – you may have Benign Paroxysmal Positional Vertigo (BPPV). The symptoms of BPPV include dizziness, lightheadedness, imbalance, and nausea (upset stomach). Basically, it feels like you’re spinning or the inside of your head is spinning. Activities that bring on symptoms will vary, but symptoms almost always begin with a change in position of the head with respect to gravity. Getting out of bed or rolling over in bed are very common “problem” motions.
Because people with BPPV often feel dizzy and unsteady when they tip their heads back to look up, it is sometimes called “top shelf vertigo”. It is one of the most common causes of dizziness and affects the older population more frequently, and females more than males. It is estimated that over 50% of these cases are of unknown origin, but aging and head trauma appear to contribute to the onset of BPPV. Many patients wake up with the condition, noticing vertigo while trying to sit up suddenly. BPPV will commonly cause involuntary eye movements. This is triggered by inner ear stimulation and is caused when the particles (crystals) get displaced in the canals of the inner ear.
People who have BPPV do not usually feel dizzy all the time, the lightheadedness is triggered by head movements. These symptoms may be mild to severe, including nausea and vomiting. Usually, vertigo will last less than 60 seconds and subsides when movement is halted. It is during this time that your eyes may twitch (nystagmus) and most patients close their eyes to decrease their sense of being unsteady.
BPPV is rarely serious, except when it increases your chance of falling. If your vertigo interferes with your normal daily activities or causes nausea and vomiting, you may need treatment.
Most people recover with simple but very specific and effective head and neck maneuvers. Physical Therapists are specifically trained to treat BPPV and will also teach you exercises that can reduce or eliminate the symptoms. The physical therapist will apply the appropriate maneuver to return the crystals to their correct position in the inner ear. A patient is usually treated between 1-3 sessions, with most patients feeling significantly better and their symptoms ended in one session.
Within 3 years of having BPPV about 50% of people may have a recurrence, especially if the BPPV resulted from head trauma. Although your BPPV might return, you will be able to recognize the symptoms and keep yourself safe until you can get help.
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