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Benign Paroxysmal Positional Vertigo

What is BPPV and it's common symptoms?

Benign paroxysmal positional vertigo (BPPV) is an inner ear problem that causes short periods of vertigo when your head is moved in certain positions. It occurs most commonly when lying down, turning over in bed, and looking up. Even though you are still, you may feel like you are moving, or that the room is moving around you. You may also experience nausea, vomiting, sweating, and abnormal eye movements. If the vertigo is accompanied by double vision, difficulty speak-ing, a change in alertness, arm/leg weakness, or an inability to walk, you should immediately go to the emergency room. 

What causes BPPV?

BPPV occurs when small crystals of calcium carbonate, commonly referred to as rocks, in our inner ear break loose and fall into another area within the balance canals. The crystals may break loose for many reasons following an inner ear infection, fever, concussion, or whiplash injury. BPPV can also occur along with other diagnoses of the inner ear such as Meniere’s disease, migraines; or, it has been suggested that it is part of the “normal” aging process. 

How can physical therapy help with BPPV symptoms?

Most people (about 85%) recover from specific neck maneuvers, performed by their physician or physical therapist, which are designed to move the crystals back into place. Research shows that the repositioning maneuver works on the first ef-fort, 80-90% of the time. After the treatment is complete, you may feel nauseous, dizzy, or have more trouble balancing than before. This can last for several hours. Avoid dangerous activity and follow the instructions given to you by the physician or physical therapist. 

What should I do after my BPPV treatment session?

For several hours, you should not turn your head quickly or tilt your head far up (as if looking to the sky) or far back, such as when lying on your back, looking down at your shoes, or picking something up from the floor). You can sleep that night in whatever position you choose. Starting the next day, you should continue your normal activity and move your head as normally as possible. 

Can the dizziness come back? 

Since we do not know the exact cause of BPPV, it is also not possible to know how to prevent it. Unfortunately, medication has not been proven effective but ra-ther can cause more harm than benefit. If your BPPV does return, you should con-tact your physical therapist. The crystals may be in a different place, so your treat-ment may be different than before. You should never try to put the crystals back on your own unless instructed by your healthcare provider. Remember, BPPV is treatable and the maneuvers can greatly reduce your vertigo and other symptoms associated with BPPV. 

How soon can I expect to see improvements?

Each patient is unique, so this time frame can vary greatly. Research shows that depending on the severity of your condition, it takes from 2 weeks to a few months of treatment to resolve a vestibular condition. We most often request a frequency of 2-3 times a week for 12 total visits. That is why our office staff will ask you to schedule all 12 of your sessions before starting therapy. If you need more than 12 sessions, your therapist will discuss this with you after you have completed 12 visits and you will decide together whether continuing with therapy would benefit you or not. If so, your therapist will reevaluate you and send a progress note to your physician requesting an extension.

What are the credentials of my physical therapist?

All licensed physical therapists have had to apply and be selected to attend Physical Therapy school. It is a very competitive process and only those will the highest grades and best potential are selected. Doctors of physical therapy have invested a minimum of 7 years into their undergraduate and graduate training at universities. Once they graduate, they have to sit for a State Board Exam and pass to receive their license to practice. In order to keep their license active, they must dedicate a certain number of hours to continuing education each year.

At Anchor Physical Therapy we also require that therapists attend multiple post-graduate continuing education courses every year to stay up to date with latest research and continuously enhance their treatment skills in order to achieve the best possible treatment outcomes for our patients.

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