Vertigo: Understanding the Spinning Sensation

What is Vertigo?

It’s the sensation that either you or your surroundings are spinning. This feeling can range from mild to severe, making it challenging to maintain balance and carry out daily activities.

What causes Vertigo?

Vertigo is a symptom of dysfunction in the vestibular system, located within the inner ear. The ear is composed of a complex structure of bone, cartilage, and a network of tubes called semicircular canals. These canals contain fluid that shifts with movement, and sensors in the inner ear respond to these changes, helping regulate our sense of balance.

What are the Types of Vertigo?

There are two main types of vertigo: peripheral and central. Peripheral vertigo is more common and occurs when there is an issue with the inner ear or the vestibular nerve. Central vertigo, though less common, results from conditions affecting the brain, such as infections, strokes, or traumatic brain injuries.

The most common form of peripheral vertigo is Benign Paroxysmal Positional Vertigo (BPPV), accounting for over half of patients with vestibular system dysfunction. BPPV is caused by the displacement of small calcium carbonate crystals, called canaliths, within the inner ear. A skilled physical therapist can often treat BPPV effectively in just a few sessions, depending on the severity of the dysfunction.

How do you treat BPPV?

Before treating BPPV, a thorough exam is performed, including specialized tests like the Dix-Hallpike Maneuver. This quick, noninvasive test is the gold standard for diagnosing BPPV. Once confirmed, several treatment options, known as canalith repositioning procedures, are available. One of the most common is the Epley Maneuver, which involves a series of head movements designed to guide the displaced calcium crystals (canaliths) back to their proper position.

Additional treatments for vertigo may include habituation exercises, which use specific head movements to desensitize the vestibular system; eye-head coordination exercises to improve focus and reduce dizziness; and balance and gait training to challenge the vestibular system and minimize fall risk.

Here are some tips that can help alleviate your symptoms of vertigo:

• Rest in a quiet, dark room to help ease the spinning sensation.

• Move your head slowly and carefully during daily activities.

• Sit down immediately if you feel dizzy to prevent falls.

• Keep lights on if you need to get up at night for better visibility.

• Use a cane or walker if you're at risk of falling for added stability.

• Elevate your head with two or more pillows when sleeping.

• Rise slowly from bed—sit at the edge for a minute before standing.

• Practice relaxation techniques to manage stress, as anxiety can worsen vertigo.

If you or a loved one are experiencing vertigo, contact our office at 973-910-1441 to schedule an evaluation.

About the Author

Frank Failla, DPT, is doctor of physical therapy at Total Acupuncture and Physical Therapy in Cedar Grove, New Jersey. Dr. Failla takes pride in providing one-on-one physical therapy in a private setting, creating a relaxing and nurturing environment. Throughout his fifteen years of advanced orthopedic practice, Dr. Failla has taken extensive continuing education courses in manual therapy, myofascial release, and osteopathic techniques. He has trained with the McKenzie Institute in mechanical diagnosis and treatment of the spine; the Barral Institute in neural manipulation for an integrative approach to pain and dysfunction; and the Institute of Physical Art in functional and visceral mobilization. He is a certified provider of Active Release Technique. Dr. Failla enjoys helping patients who have struggled to find pain relief using conventional medical disciplines. He believes patients can often avoid surgical procedures through proper care and lifestyle modifications.

References:
Hughes CA, Proctor L. Benign paroxysmal positional vertigo. Laryngoscope. 1997May;107(5):607-13. doi: 10.1097/00005537-199705000-00010. PMID: 914916