Jennifer Rivera earned her doctorate in physical therapy and has worked with a wide variety of patients from children to the elderly throughout her career. She explains why you might be suffering from symptoms of vertigo and what you can do to solve it.
Do you ever feel dizzy? Does it happen to you when you’re in a certain position? If so, you may have benign paroxysmal positional vertigo (BPPV). The name may be a mouthful, but it’s actually the most common disorder affecting the vestibular system – the system that controls balance and movement. In order to understand what BPPV is and if you might be affected by it, we must first understand the anatomy and function of the inner ear.
The inner ear can be separated into two different organs— the cochlea and the three fluid-filled semicircular canals. The cochlea is the body’s microphone that helps convert sound pressure impulses from the outer ear into electrical pulses for the brain through the auditory nerve. These signals basically tell our brain what we are hearing. The semicircular canals are more important in understanding BPPV, as they are the body’s balance organ that sense angular acceleration as we move front to back, side to side, and up and down. The canals contain small hair cells that are able to detect movement of the fluid in your ears that is caused by your head and body moving in different directions.
Connected to the end of the semicircular canals is the utricle, and connected to that is the saccule. These two organs provide information about head position when it is not moving. The utricle and saccule also have sensory hair cells, but attached to the ends of these hair cells are microscopic calcifications of calcium carbonate called otoconia. If you’ve ever heard someone say you have rocks in your head, this might have been what they were referring to. These calcifications are gravity-sensitive, so when you move your head they bend the hair cells and provide information to your brain about where your head is positioned.
So what does all this have to do with getting dizzy? Well, as we get older the otoconia or “rocks in our head” start to change. They can become fragmented or the links between each otoconia can weaken. Because of this, they can start to break free from the hair cell they were once attached to and migrate into one of the semicircular canals; most commonly the posterior canal. The canal now becomes gravity sensitive, which is not its normal function. This gives the individual an immediate false sense of motion, known as vertigo.
This dizziness does not happen all the time, and the intense feeling of vertigo usually only lasts for 5 to 45 seconds. The patients that I treat for BPPV generally report symptom provocation with certain head positions. The most common complaints are rolling in bed, lying down, getting up from lying down, reaching for an object that is overhead, washing their hair, or lying back in a dental chair.
There are several predisposing factors that can cause the migration of the otoconia. These include head trauma, falling, inner ear disease, osteopenia or osteoporosis, or prolonged head positioning. People that go undiagnosed tend to reduce and or change their normal daily activities to avoid becoming dizzy, and they may have a higher risk of falling.
BPPV can be easily and quickly treated by a physical therapist in only one or two visits if properly diagnosed. Our Scottsdale physical therapy clinic offers a free rapid evaluation that will direct you to the right course of treatment, or refer you to an MD if you have a sudden onset of dizziness or imbalance. BPPV is just one of many vestibular disorders, so talking to healthcare professionals about symptoms is extremely important.
Schedule a free consultation at Foothills today if you have questions or concerns about vertigo, or any other issues we could help with. To learn more about physical therapy and what Foothills can do for you, follow our blog!