Vertigo, Dizziness and Benign paroxysmal positional vertigo (BPPV)

Whats the Difference?

Dizziness and vertigo have similar symptoms but with some specific differences. Dizziness is a general term used to describe sensations such as light headedness, giddiness, disorientation and unsteadiness. Vertigo is easier to describe and involves a sensation that the room or the environment is spinning. Vertigo is highly characteristic of an inner ear (vestibular) complaint, whereas there are a number different causes for sensations of dizziness. These include inner ear (vestibular) disorders, reduced blood flow to the brain (vascular), neck (cervicogenic) issues, psychological problems and mild traumatic brain injury (concussion).

Research has determined that inner ear (vestibular) disorders are the cause for dizziness and vertigo in at least 50 per cent of cases but remain poorly diagnosed. For this reason, dizziness and vertigo are often associated with significant feelings of frustration, anxiety and depression and can affect a range of everyday activities. If your symptoms of dizziness and vertigo are triggered or made worse by moving quickly, then it is highly likely that they are caused by a problem in the inner ear (vestibular) system and require further investigation.

Can Physiotherapy Help?

Vestibular physiotherapy can be a very good option for treating symptoms of dizziness and vertigo, especially if these symptoms are triggered or made worse by movement. In many cases, dizziness that is worse with movement is caused by a disorder involving the inner ear (vestibular) system. Research has shown that vestibular physiotherapy is highly effective in treating vestibular disorders, such as benign paroxysmal positional vertigo (BPPV), viral infection of the inner ear (vestibular neuritis) and vestibular migraine (a form of migraine that causes vertigo and dizziness with or without symptoms of headache).

Your physiotherapist with specific skills in vestibular rehabilitation would conduct a comprehensive assessment of your dizziness and vertigo, and, in many cases, would be able to establish the cause for your symptoms. If unable to establish a cause for your symptoms, your physiotherapist would refer you to a medical specialist who would be able to order more extensive testing.

Vestibular physiotherapy involves:

• Habituation exercises: these exercises involve specific movements that are designed to gently stimulate the symptoms of dizziness in order to desensitise the vestibular system to those movements. They are designed to reduce symptoms of dizziness.

• Eye—head coordination exercises: these exercises are designed to improve focus and reduce symptoms of dizziness.

• Balance and gait exercises: these exercises involve challenging the vestibular balance system in order to strengthen it. They are designed to improve balance and confidence when walking.

• Re-positioning techniques: these techniques are used for a specific inner ear (vestibular) condition known as benign paroxysmal positional vertigo (BPPV). This condition results in significant symptoms of vertigo when changing position, such as when lying down or rolling over in bed. Techniques such as the Epley manoeuvre can successfully treat BPPV but should be performed by your physiotherapist with specific skills in vestibular rehabilitation.

Symptoms can include:

• Muscular pain

• Neck joint pain and stiffness

• Headaches

• Pain in the shoulder or between the shoulder blades

• Reduced neck range of motion

• Pins and needles, burning or numbness in the arm and/or hand

• Dizziness

• Ringing in the ears

• Blurred vision

• Nausea

• Irritability, sleep disturbances, fatigue

• Difficulty concentrating or remembering

Benign paroxysmal positional vertigo (BPPV)

Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo — the sudden sensation that you're spinning or that the inside of your head is spinning.

BPPV causes brief episodes of mild to intense dizziness. It is usually triggered by specific changes in your head's position. This might occur when you tip your head up or down, when you lie down, or when you turn over or sit up in bed.

Although BPPV can be bothersome, it's rarely serious except when it increases the chance of falls. You can receive effective treatment for BPPV during your physiotherapy treatment at Thrive.