Vestibular Therapy and BPPV Treatment
By: Stacey VanSchnydel
Vestibular Therapy is the assessment and treatment of vertigo and other inner ear pathologies.
Clients often attend a physiotherapy assessment with reports of dizziness which is a broad term used to describe an assortment of sensations. An initial assessment is required to determine the origin of your dizziness. Sensations of dizziness can be caused by the cardiovascular system (stroke, arrhythmias, etc), a neurological dysfunction like multiple sclerosis, visual disorders (glaucoma, macular degeneration) or vestibular (inner ear) system disorders. It is this vestibular category that a physiotherapist can assess and treat through vestibular therapy.
Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of dizziness, often affecting individuals as they age. It is characterized by sudden, intense episodes of vertigo triggered by changes in head position. Understanding the anatomy behind BPPV, its origin, and the role physiotherapy can play in treatment is key to managing this condition effectively.
houses the structures responsible for balance, including the semicircular canals, which detect rotational movements, and the otolith organs, which detect linear movements and gravitational forces. Inside the semicircular canals are tiny crystals called otoconia. Under normal circumstances, these otoconia (crystals) are located within the otolith organs, but in BPPV, they become dislodged and migrate into the semicircular canals, typically the posterior canal. When these crystals move, they disrupt the normal fluid motion within the canal, sending false signals to the brain that cause vertigo.
BPPV is often caused by age-related degeneration of the inner ear, but it can also be triggered by head trauma, prolonged bed rest, or even viral infections affecting the vestibular system. The condition tends to be "benign" because it is not life-threatening, but the episodes of vertigo can be distressing and significantly impair daily activities.
The hallmark symptom of BPPV is vertigo that occurs with specific head movements, such as rolling over in bed, tilting the head back to look up, or bending over. These vertigo episodes are brief, typically lasting less than a minute, but they can leave a person feeling disoriented, unsteady, or nauseous. It’s important to note that BPPV symptoms often resolve on their own, but they may recur, causing ongoing discomfort for some individuals.
Physiotherapists play a crucial role in the management of BPPV, particularly through techniques designed to reposition the displaced otoconia and alleviate symptoms. The most common treatment method is the Epley’s Maneuver. This technique involves a series of head movements that guide the dislodged otoconia back to their original location within the ear. It’s highly effective in treating posterior canal BPPV and typically requires only a few sessions for relief. In cases where the BPPV affects a different canal, or if the symptoms persist after initial treatment, additional maneuvers tailored to the specific type of BPPV may be used.
BPPV is a treatable condition, and physiotherapy offers effective, evidence-based interventions to alleviate symptoms and restore balance. If you experience dizziness or vertigo, consulting a physiotherapist who specializes in vestibular rehabilitation is an important first step toward recovery. With the right treatment, most individuals experience significant improvements and can return to normal activities with confidence and stability.
For more information on vestibular therapy or if you think you have a vestibular system disorder and would like an assessment please contact us at 705-788-1480 or check us out on our website at www.proactiverehab.com.