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Is your head spinning? LifeForce can help!

By Daniel Jordan - LifeForce Physiotherapist

I’m so dizzy, my head is spinning. No, this isn’t just a line from one of the greatest songs of the 90s (perhaps even the best song ever, am I right?!), but also something I hear quite often as a physiotherapist. 

 

Vertigo is quite common, with an incidence of around 5-10%, and up to 40% for 40+ year olds. The rate of falls linked to vertigo in 65+ year olds is 25%, which can be very serious, so as you can see, it isn’t a condition to ignore. Up to 70% of the population will suffer from some kind of vertigo during their lifetime.

The most common type of vertigo is called Benign Paroxysmal Positional Vertigo. I’m going to just go ahead and call it BPPV, because typing it out the other way makes my head spin (not literally, though that would be kinda ironic)! BPPV accounts for approximately 75% of all vertigo cases.

 

CAUSE

Ok, there’s no easy way to say this, so I’m just going to come out with it; you have rocks in your head. No don’t be offended, we all have them. In our inner ears, we have a collection of tiny rocks, called otoliths or otoconia. They’re crystals made of calcium carbonate, and they play a big role in our perception of movement, and in being able to balance ourselves. I’m going to tell you how this all works, but a word of warning; this is going to get very weird, very quickly.

So. Inside our inner ear, lies the parts of the vestibular system called the saccule and utricle. Within these labyrinthine caverns are these otolith crystals. The otoliths sit on top of a plateau called the cupula, which is resting upon a bunch of tiny, tiny hair-like cells, called cilia. These cilia are attached to the macula, which is attached to nerves, which send signals to our brain. All of this exists within a gelatinous fluid. Gross.

Do you believe me? It’s true, all of it (bonus points for Han Solo reference, surely!)

When our head moves, the otoliths move with it, causing the viscous fluid in the canal to swirl about, which, in turn, causes the hair-like cilia to sway and move. This movement is sensed by the nerves below the macula, which causes a signal to be sent to the brain. As a result, we perceive movement. I’m sure that everyone has experienced the dizzy feeling after spinning around quickly in a circle? Imagine the fluid in the canals sloshing about after you’ve stopped moving, making your cilia bend and sway. Now you know why you get that temporary dizziness.

But what happens when the system goes a bit haywire? Chaos, that’s what. If one of the otoliths falls off of the cupula, and lands in the canal fluid, it causes a disturbance in the fluid, which in turn causes the cilia to sway and bend, sending an incorrect signal to the brain, stimulating a sensation of movement, when in reality, there isn’t any. This is BPPV, and can be pretty awful.
 

SYMPTOMS

Anyone who has suffered from vertigo can tell you that the symptoms are most definitely not nice. And, on a side note, if there was a girl who made your head spin, like a whirlpool that never ends, I’d recommend avoiding her, as this doesn’t sound like the basis for a healthy relationship!

Usual BPPV symptoms are as follows:

  • A feeling of movement or motion, even when remaining still. This is often, but not always, more noticeable with lying down, or turning the head towards one side, or the other, or both.
  • Loss of balance
  • Dizziness
  • Light headedness
  • Nausea
  • Vomiting

 

TREATMENT (Oh please tell me it's treatable!)

Thankfully, specific positioning techniques under the guidance of your physiotherapist can be very successful at treating this debilitating condition; studies have shown that these treatments are up to 98% effective in resolving symptoms of BPPV. Often, BPPV can be resolved with one or two treatments, although there is a recurrence rate of approximately 45% in the first 30 weeks following treatment. This means that a few extra sessions may be needed to effectively treat the problem long term. Still better than having to lean on walls to maintain your balance for months on end (this can happen, trust me)!

If you think you may have BPPV, call LifeForce health solutions at Golden Grove on 8289 2800, and tell our receptionist that you wish to see a physio for vertigo treatment. We’ll get you standing on solid ground once more!

 

REFERENCES

Beynon, G., Baguley, D. and da Cruz, M. (2000). Recurrence of symptoms following treatment of posterior semicircular canal benign postional paroxysmal vertigo with a particle repositioning manoeuvre, The Journal of Otolaryngology.

Helminski, J., Janssen, I., Kotaspouikis, D., Kovacs, K., Sheldon, P., McQueen, K. and Hain, T. (2005). Strategies to Prevent Recurrence of Benign Paroxysmal Positional Vertigo. Archives of Otolaryngology–Head & Neck Surgery, 131(4), p.344.

Samy, H. (2017). Dizziness, Vertigo, and Imbalance: Background, Etiology, Epidemiology. [online] Emedicine.medscape.com. Available at: http://emedicine.medscape.com/article/2149881-overview [Accessed 30 Mar. 2017].