Vestibular Rehabilitation (Vertigo)

Vertigo is one of the most common health problems in adults. According to the National Institutes of Health (NIH), about 40% of people in the United States experience feeling dizzy at least once during their lifetime. Prevalence is slightly higher in women and increases with age.

Dizziness or vertigo, a false sense of rotation, is a symptom, not a disease, and can occur for a variety of reasons. The most common cause of dizziness that a physical therapist sees and treats is Benign Paroxysmal Positional Vertigo (BPPV – see below), but other causes of dizziness or vertigo could include migraines, medication side effects, etc.  These causes may or may not be appropriate for physical therapy treatment. Your physician will help you determine if we can be of assistance.

If you are having any of these symptoms and follow up with your physician, you may be referred to physical therapy for the treatment of your dizziness. At CVMC Rehabilitation Services, a physical therapist will complete an evaluation and take a history and treat your symptoms accordingly.  

Benign Paroxysmal Positional Vertigo (BPPV)

Symptoms of BPPV, the most common form of vertigo, are decreased balance, vertigo and nausea. These symptoms typically occur when moving in bed, reaching for objects on the floor or in a cupboard, when washing your hair or putting in eye drops.    

BPPV is caused by the displacement of crystals (otoconia) in your ear.  This can happen with age, head trauma or can be the result of being in one position for a long time (always sleeping on the same side for example).  The otoconia are part of your vestibular system (i.e. structures of the inner ear, the vestibular nerve, brainstem, and cerebellum), which tells your body where you are in space to help maintain your equilibrium.  If the otoconia become dislodged, you will feel a sudden sense of rotation with certain body postures.

Treatment

Treatment of BPPV involves reproducing your symptoms by moving you through a series of positions called the Modified Epley Maneuver. Your therapist will have you lie on a treatment table and will have you roll in a specific sequence from your back to your side and then to a seated position. This will be repeated until you are able to sit up without any symptoms. The purpose of this is to relocate the otoconia so your vertigo is resolved.

Once your treatment is complete, your therapist will give you instructions for the next 24 hours to maintain the placement of the otoconia. A follow up visit may be indicated if your symptoms do not go away completely over the next 24 hours. You will be educated in means to help prevent a reoccurrence of your symptoms.

OUR VERTIGO SPECIALISTS

Michelle Alberghini, PT
Gordon Gatewood, PT
Andy Patterson, PT
Robert Patterson, PT
Rebecca Reed, PT
Lorelei Wyman, PT