M.V. FIT TIPS: BPPV Vertigo-You Really Do Have Rocks In Your Head

By DOUG GILES, DPT

If you think you have rocks in your head, you might be right! Every year, millions of people in the United States develop vertigo, a spinning sensation in one’s head that can be very disturbing. Like an on-going carousel ride in your head.

Benign paroxysmal positional vertigo (BPPV) is one of the most common types of vertigo. It is surprisingly common, effecting nearly 10% of older adults. BPPV is an inner ear problem that causes short periods of dizziness when your head is moved in certain positions. It occurs most commonly when lying down, turning over in bed, or looking up. This dizzy sensation is called vertigo.

Our bodies primary system for balance is called our vestibular system. Although only about the size of a dime, without an intact vestibular system, we would fall flat on our faces. We literally couldn’t stand up straight without it.

The vestibular system is very complex structure housed within our inner ear. It is made up by a series of semicircular canals, named by their anatomical location. Inside the canals are tiny calcium crystals, sometimes called “ear rocks”. BPPV occurs when these tiny rocks break off and move to another part of the canal, usually the posterior canal. (Hopefully these terms don’t make your head spin!)

When you move your head a certain way, the crystals or rocks move inside the canal and stimulate the nerve endings, causing you to become dizzy. The crystals may become loose due to trauma to the head, infection, conditions such as Menieres disease or aging, but in many cases there is no obvious cause.

No medication has been found to be effective with BPPV. Fortunately, most people recover from BPPV with a simple but very specific head and neck maneuver performed by a physical therapist trained in vestibular disorders. The maneuver is designed to move the crystals from the semicircular canal, back into the appropriate area in the inner ear.

I recently had a patient come to see me for another condition but during her evaluation we discovered she became dizzy when she moved her head in certain directions. I learned from her that this dizziness had been going on for several years but she had rationalized living with it, thinking it was “just part of getting older”. “A quick exam confirmed BPPV and within two treatments her symptoms were completely resolved. She could hardly believe it was so easy, and is grateful to not have that dizzy feeling any longer.

In my experience, this maneuver is as close to a miracle cure that we have in physical therapy. Usually, within one to two visits we can completely rid a person of BPPV and the misery of the vertigo.

Although our treatment for this condition is usually a slam-dunk, it can sometimes reoccur. If it does reoccur it usually can be treated again with similar successful results. There are many other causes of balance and dizzy problems and often requires a team approach between physical therapy, audiology, and medical doctors to adequately diagnosis and treat. If you think you have rocks in your head, you may be right. If you are dizzy, it is worth you time to get it checked out by a medical professional trained in vestibular and balance problems.