By Nicole Friederich, DPT, ATC Clinic Manager at ApexNetwork Physical Therapy – Belleville West
Dizziness is a common symptom that affects more than 90 million Americans, most commonly in those above the age of 75. There are a variety of terms used to describe dizziness such as spinning, lightheadedness, vertigo, disequilibrium, and many more. The key for successful treatment is determining the true cause of symptoms.
More than one-third of Americans over the age of 40 have experienced some sort of vestibular dysfunction. The vestibular system includes parts of the inner ear and brain that process sensory information involved with controlling balance and eye movements and is an important component to maintaining balance in addition to vision and proprioception or muscle activation.
Symptoms of vestibular dysfunction may include balance problems such as vertigo, dizziness, or imbalance, difficulty concentrating, vision disturbances, and hearing changes. The most common diagnoses for vestibular disorders include benign paroxysmal positional vertigo (BPPV), labyrinthitis or vestibular neuritis, and Meniere’s Disease. It is important to note that not all dizziness is due to a vestibular problem as other conditions such as blood pressure, medications, circulation issues, or infection could be the possible cause.
Diagnoses of vestibular dysfunctions can be tricky and often incorporates taking a thorough health/medical history and several types of testing including hearing, balance, and vision assessments. Your physical therapist can assist in diagnosis and treatment of vestibular conditions specifically, and most-commonly, BPPV or what is commonly considered “vertigo”.
Benign paroxysmal positional vertigo (BPPV) is most common in women in their 40s and 50s. Patients typically complain of dizziness or spinning with changes in head position such as when rolling over or getting out of bed and symptoms are often side-specific. Vertigo symptoms typically occur suddenly and last less than 1 minute however light-headedness may be more constant.
BPPV is caused by particles (canaliths) in the inner ear that are misplaced and can be corrected with positional maneuvers. For treatment, your doctor, or physical therapist, will take a thorough health history and if BPPV is the suspected diagnosis, a Hallpike-Dix Maneuver will be performed where the head is placed in a position to reproduce symptoms and determine which ear is at fault. Once the side at fault is determined, an Epley maneuver will likely be performed to reposition the canaliths using gravity and resolve symptoms. Oftentimes, treatment is successful on first attempt and patients will have spontaneous resolution of their symptoms. For those with more persistent symptoms, treatment may have to be performed multiple times but overall, there is a 91% success rate. In addition, your physical therapist can educate you in several exercises incorporating balance, vision, and head movements to retrain the vestibular system for future prevention.
If you have any questions or concerns in regards to balance, dizziness, or possible vestibular dysfunction please don’t hesitate to contact your physician or physical therapist. We can help you determine your next step for treatment and provide you with the relief you desire.
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