One of the questions I frequently ask my patients at their first visit is if they have any difficulty with everyday tasks. As a physical therapist, my job is to help people return to completing these tasks without pain. Although most people can name these easily, I frequently will have someone tell me they don’t have any difficulty. This recently happened to me when I was seeing a patient whose main complaint was “I feel like my feet aren’t getting the signals from my brain.” This was an odd comment but immediately made me start thinking the patient’s problem wasn’t just coming from their musculoskeletal system. During the evaluation of the patient, I found that the patient suffered from vertigo, or medically named as Benign Paroxysmal Positional Vertigo (BPPV).
This patient was just like you and me in the fact that when we have a problem we become resilient and always find a way to complete our tasks without aggravating it. After asking the patient mentioned above about tasks, specifically, the patient divulged to me that they had avoided rolling over in bed for approximately two years. Decreased ability in rolling over, along with fast head movements, looking up or under objects, and tilting the head are the most common movements that people with BPPV avoid secondary to these positions provoking their dizziness.
BPPV is a specific type of vertigo that is brought on by a change of head position with respect to gravity. One of the control centers of our balance is our vestibular system, which monitors changes in head motion and position in space. It does this by three semicircular canals within your ear that contain structures that detect motion such as your head moving to the right. The problem comes from another structure also within the inner ear. These are calcium crystals that can get dislodged and over time migrate into one of the semicircular canals causing BPPV. This creates a mismatched signal from the vestibular system to the brain causing one to have symptoms such as vertigo, loss of balance and nausea.
BPPV can be treated effectively by repositioning maneuvers that assist the dislodged calcium crystals back to their original position. Most people are surprised that a physical therapist and not just an ENT can choose which maneuver is right for you. These maneuvers are safe and have been found to have a high rate of complete resolution of symptoms after only one to three times through the maneuver. This is great news since a patient can quickly get an appointment for physical therapy and that people can quickly usually return to normal without having to have many scheduled appointments.
If you feel like this might be you speak to your primary care physician about setting up an appointment with a physical therapist that has taken advanced courses in vestibular disorders such as myself. Also, remember that there are many reasons why one can have a symptom of dizziness and speaking with your primary care will help you determine if your dizziness could be coming from your medication or a vestibular condition such as BPPV.
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For more information about BPPV, vestibular disorders, or to speak with someone about how to schedule an outpatient physical therapy appointment, contact our office at Eastern New Mexico Medical Center at 575-627-4053.