While dizziness remains one of the most commonly diagnosed issues by physicians in North America for aging populations, it is not a normal part of aging. Commonly referred to as "dizziness," issues with balance, vertigo, or spinning can actually arise from issues in the inner ear (vestibular apparatus), proprioception (your body's spatial awareness) or the visual system.
Why is this important? Dizziness or a lack of balance, can lead to a variety of other issues that drastically affect quality of life. It can affect your ability to go to work, it can cause falls, or even basic functional activities such as walking or getting out of bed.
What is Benign Positional Paroxysmal Vertigo (BPPV)?
BPPV is the most common cause of vertigo in the aging population. BPPV is characterized by the onset of dizziness or spinning with rapid positional changes such as: extending and rotating the head, or getting up and down. The main differentiating feature of BPPV from other forms of dysfunctional balance or dizziness, is the commonly reported feeling that the room or environment is spinning around them.
The main differentiating feature of BPPV from other forms of dysfunctional balance or dizziness, is the commonly reported feeling that the room or environment is spinning around them.
BPPV is caused by a dysfunction in the structures of the inner ear. Within the inner ear, there are canals pertaining to each axis of movement containing a fluid called endolymph. Within each canal, there is an end structure called the cupula. During head movement, the endolymph flows freely over hair cells (stereocilia) in the cupula which then measures the amount of movement to helps to determine where we are in space. In BPPV, otoliths (sand-like particles) from the vestibule in the inner ear become detached and become displaced in the semicircular canals or adhered to the cupula.
The otoliths become free floating within the semicircular canals, which creates a delayed onset of vertigo in response to head movement.
The otoliths become adhered to the end-structure cupula, which creates an immediate onset of vertigo in response to head movement.
What is Vestibular Rehabilitation?
During Vestibular Rehabilitation, the cause of dizziness/vertigo is determined by assessing: eye movements, balance, posture, aggravating movements or visual system influences. Information such as: medical conditions, medications and prior history are take into account for their involvement in exacerbating the condition.
What kind of treatment can I expect during Vestibular Rehabilitation?
During Vestibular Rehabilitation, a customized treatment plan consisting of manual techniques within the clinic, at-home exercises or home-care principles will be developed to help your particular condition. During assessment of your dizziness/vertigo, symptoms may be exacerbated but your treating therapist will guide you through the process.
If you are suffering from vertigo, spinning or dizziness and you are unsure of the cause. Don't wait to get assessed. You will be surprised that such delicate structures of the inner ear can have such a profound effect on your quality of life.
Brendon Ip is a Registered Physiotherapist in great standing with the College of Physical Therapists of British Columbia. He is Canadian-educated and has been trained to assess and treat Vestibular conditions. Book an assessment at your convenience!