Vertigo – Head Spinning? Dizzy? BPPV?

The Vestibular or balance system is responsible for integrating sensory stimuli and movement of the body. Located in the inner ear, it allows your body to keep objects in visual focus when the body moves. Vertigo is a condition which creates a false sensation of movement resulting in feelings of spinning, tilting, rocking, swaying, dizziness or falling.

We asked Physiotherapist, Nevine Eskander, to provide some insight into the Vestibular System and how patients experiencing these symptoms can benefit from Physiotherapy:

What are the causes of Vertigo?

Benign Paroxysmal Positional Vertigo (BPPV) accounts for 25% of all cases of vertigo. Other causes can be:

  • Vestibular neuronitis
  • Stroke
  • Migraine
  • Meniere’s disease
  • Cervical dizziness and vertigo
  • Ear infection
  • Whiplash
  • Certain medication


What do the ears have to do with balance?

The inner ear is comprised of canals and nerves that feed the brain information regarding head velocity, movement, acceleration and how the head is moving with respect to gravity.

Can you tell us more about Benign Paroxysmal Positional Vertigo (BPPV)?

BPPV is the most common type of vertigo. It is a condition characterised by episodes of sudden and severe vertigo. It can come about simply as a result of changing body positions suddenly – for example moving from lying to sitting. It can be very debilitating and long lasting if not treated properly.

What are the causes of BPPV?

Debris called otoconia (which can be thought of as ‘ear rocks’) can collect in the ear canals. Sudden, severe movements such as whiplash or sudden head jolting can cause the otoconia in those who suffer with BPPV to become dislodged. When this happens, the otoconia can move into areas of the inner ear which control balance and cause disturbance.
Inner Ear

The exact cause of BPPV is unknown. However it is known that certain factors cause ‘ear rocks’ to migrate into the balance organs for various reasons. These factors can include:

·         Head or ear injury
·         Ear surgery or infection
·         Degeneration of inner ear structures
·         Minor strokes
·         Vestibular neuritis
·         Meniere’s disease

How can physiotherapy help?

Nevine will work with you to ascertain the frequency, duration and intensity of your dizziness and provoking positions to determine which canal of your inner ear is responsible for BPPV.

Specific tests such as the ‘Epley’s manoeuvre’ are carried out to confirm the problem area. Clients are given a specific individualised home exercise program based upon their individual assessment findings.

This, as well as balance retraining, vision exercises (ie. gaze stabilisation) and exercises for the neck and torso are also importantly needed for effective rehabilitation.

These treatment techniques can provide up to 90% symptom relief within 4-10 treatment sessions depending on the severity of the client’s symptoms.

If you are experiencing these symptoms and would like to discuss treatment options, contact Langwarrin Sports Medicine Centre to make an appointment with Nevine Eskander.