“I get dizzy if I even turn around too fast!”
“When my head moves the wrong way my whole world starts to spin.”
“Even though I am strong, I often feel lightheaded and am afraid to go out without my walker in case I fall.”
If any of these statements sound familiar, then Physique Physiotherapy can help! Physique Health director, Rebecca Bell has completed extensive education in the areas of dizziness, vertigo and falls prevention. Our clinic helps many elderly Mount Tamborine residents, as well as younger persons who suffer from inner ear dysfunction or other dizziness issues.
Vertigo is a feeling that you or your surroundings are moving when there is no actual movement. You may feel as though you are spinning, whirling, falling, or tilting. When you have severe vertigo, you may feel very nauseated or vomit. You may also have trouble walking or standing and you may lose your balance and fall. Overall, these symptoms are often the result of damage to, or a disruption of your “vestibular system”. This system is a small apparatus situated in your inner ear, located just next to your hearing apparatus. If working correctly we should be able to function without dizziness and move our head around at an extremely fast rate without any adverse reactions at all. Just like any other system, as we age, or if an injury or infection occurs, then the Vestibular System can cease to work correctly and needs a bit of help to get back on track.
BPPV stands for Benign Paroxysmal Positional Vertigo. It is a very common condition, particularly in people who are elderly or have suffered head trauma. It accounts for around 50% of people over the age of 65 who complain of dizziness. Located in each inner ear are 3 semicircular canals, filled with fluid, which detect the movements of your head. From them messages are sent to the brain, which makes compensatory eye movements so that your vision remains stable during head movements. These canals also play a part in helping you balance. Without this system you would be very unsteady and your vision would be blurred whenever you move your head, even in walking, and you would feel very dizzy and sick.
In part of this system there are little calcium carbonate crystals which are stuck in a thick jelly-like substance. These crystals can detach from the jelly substance (through a blow to the head, or just spontaneously) and fall into any of the canals. Whilst in the canals the crystals change the way the fluid moves in the canal and therefore give false information to your brain about the movement of your head.
This can cause symptoms of dizziness and vertigo when your head is in certain positions. Typically people with BPPV note that their symptoms are provoked by rolling over in bed, lying down, standing up, bending over or looking up. The symptoms usually last for less than one minute. Often problems with imbalance, particularly whilst walking, are associated with this condition. Other conditions, such as neck pain, headaches and tinnitus (ringing in your ears) may be associated with BPPV.
This condition is diagnosed by specific questioning by our physiotherapists and a test called the Hallpike-Dix which involves moving you from a sitting position to lying down with your head over the edge of the bed, or pillow. Your Physiotherapist can treat this condition by moving your head through a number of different positions. The aim is to move the crystals back out of the canal where they will be reabsorbed by your body. This treatment is very effective. Many people have complete resolution of symptoms in one treatment. However, the problem can recur in up to 30% of people, so once the correct diagnosis and treatment is resolved, you will usually be given a home program sothat you can manage yourself if the dizziness returns any time in the future. You may need to perform some balance exercises to treat any remaining balance problems once the BPPV has been resolved, or if your neck has been involved then some follow up treatment or exercises to manage this component is important.
After completion of your treatment sessions by your Physiotherapist it is important to follow the directions provided. This usually involves not putting your head down or lying down for a specified period of time. It is not unusual for people to feel an exacerbation of their dizziness on the day they have been treated.
- Headache and/or neck pain
- Nausea and vomiting.
- Ringing or other sounds in the ears (tinnitus)
- Difficulty hearing
- Staggering gait and loss of coordination (ataxia)
- Unusual eye movements, such as flitting of the eyes (nystagmus)
- Finding it difficult to see clearly when moving, for example, reading a sign while walking or driving.
There are many other causes of dizziness, and Physique will carefully ask a series of questions and perform a number of simple tests in the clinic to determine the most likely diagnosis. Often, if your condition is complex, and is accompanied by a number of different symptoms, then we will work with your GP and other medical specialists to determine the best management plan for you.
Some of these other causes include:
- variations in blood pressure (low or high),
- Meniere’s Disease,
- Anxiety disorders (these can also accompany true physical vestibular conditions),
- Labyrinthitis or Vestibular Neuritis,
- Cervicogenenic Dizziness
- Perilymph Fistula
Our aim is to offer a thorough examination to determine a provisional diagnosis and commence a treatment plan. As each person with dizziness and vertigo is an individual with a unique set of symptoms, we work to a plan that is right for you and to achieve your goals. We hope that treatment will resolve your dizziness, but if this is not 100% possible, then our aim will be to empower you with an understanding of your condition and a way to manage your symptoms, or self-treat when necessary.