Vertigo: Causes, Symptoms and Treatments

Caitlin Hard
Caitlin Hard Executive Assistant at AHS

Vertigo is a condition that affects millions of people. It is characterized by the sensation that you or your surroundings are spinning. One of the most common forms of vertigo is Benign Paroxysmal Positional Vertigo (BPPV), which originates in the inner ear and impacts the vestibular system that maintains balance for the body. 

Though vertigo and BPPV are not life threatening or progressive, they can occur suddenly and cause short periods of dizziness that are triggered by changes in head position, especially when looking up, bending over, lying down, or turning over and sitting up in bed. With vertigo, movement causes a layer of calcium carbonate material present in the inner ear to break off and move into the ear canal, which stimulates the nerve endings and causes episodes of mild to intense dizziness.

Risk Factors and Causes of Vertigo

  • Trauma to the head, especially a head injury that results in an injury to the inner ear
  • Inner ear infections or disorders such as Meniere’s Disease
  • Surgery that removes or injures the inner ear or its nerves
  • Migraines
  • Women are more likely to develop vertigo, and it may be hereditary
  • Age (occurs most often in individuals 50 years or older, but can occur at any age)

Symptoms of Vertigo and BPPV:

  • Dizziness and the sense that your surroundings are spinning or moving
  • Lightheadedness, loss of balance, or unsteadiness
  • Abnormal eye movements
  • Nausea
  • vomiting

BPPV occurs less than 15 seconds following a change in head position. Sensations of dizziness are brief, but intense, and last bout 15-45 seconds. The symptoms of vertigo may last for up to 2 minutes if the calcium crystals become stuck to part of the inner ear. These episodes can occur frequently for weeks and months at a time, and may even disappear for some time and recur. 

Some may experience additional symptoms with vertigo such as fever, severe headaches, double vision, trouble speaking, and weakness in the arms and legs which would require emergency care, as it could be a sign of a more serious problem. If vertigo or BPPV is left untreated, it can increase the risk of falling, which could lead to other injuries. Fortunately, there are several ways a physical therapist with experience treating neurological problems can treat this condition.


PT Treatments for Vertigo:

  1. Canalith Repositioning: your PT will guide you through a series of 2-4 head and neck maneuvers with each position change to be held for 30 seconds – 2 minutes. The goal of this treatment is to move the crystals from the ear canal back to the inner ear to reduce the sensation of vertigo.
  2. Awareness of symptoms and coping strategies: if certain activities or chores trigger dizziness, your PT can show you different ways of performing these activities to reduce vertigo. If you experience dizziness, sitting down immediately and using good lighting at night are recommended.
  3. Exercises: your PT will provide you with exercises to improve balance, the ability to focus your eyes and vision, and to help the brain correct differences in the inner ears.
  4. Surgery: in rare cases in which BPPV cannot be managed by treatment maneuvers, a surgical procedure called “Posterior Canal Plugging” may be considered.

How can Vertigo be prevented?

There are no known ways to prevent BPPV or Vertigo, and symptoms may recur even after successful therapy, especially if new crystals break off and get into the ear canal due to a head injury.

Once you experience Vertigo, you will be able to recognize the symptoms and take the necessary precautions to keep yourself safe until you can get help.

Your PT will apply the maneuvers needed to return the crystals to their correct position, and will teach you how to do exercises that can reduce or eliminate the symptoms of vertigo. This condition can be managed with the proper PT and home treatments.


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