Ever have problems with balance doing simple things?  Getting out of bed?  Hanging washing on the line?  Doing up your shoelaces?  Or, do you feel like the room is spinning around?  Feel unsteady, giddy or even nauseous are signs that you are experiencing vertigo.

What is vertigo?

Vertigo is a condition in which one feels a sensation of whirling or tilting that causes a loss of balance.  One of the many causes of vertigo is a condition known as BPPV.  In fact this condition accounts for approximately 20% of the world’s dizziness, and up to 50% of all dizziness in older people.

What is BPPV?

BPPV or Benign Paroxysmal Positional Vertigo is one of the most common causes of vertigo.  This condition impacts the inner ear, known as the vestibular organ and affects ones balance.  This organ is comprised of three semi-circular canals filled with fluid.  Movement of the head and neck influences the flow of this fluid and gives the brain feedback related to the body’s position in space.  BPPV occurs when microscopic crystals, which normally sit within the ear, are dislodged and eventuate into the canals.  This alters the message sent to the brain and results in vertigo.

In about half of all cases of BPPV, the cause is idiopathic, meaning that the cause is of no known cause.  The other half may have experienced a head trauma, migraine, or for older patients, degeneration of the vestibular organ.

How do I know if I am suffering from BPPV?

 Signs and symptoms of BPPV vary and depend on which of the semi-circular canals are affected.  If you are experiencing symptoms with one or more of the following it is quite possible that you have BPPV.

• Rolling over in bed
• Looking upwards
• Getting out of bed
• Bending over
• Associated nausea
• Dizziness that last for 30-60 seconds before subsiding
• The dizziness has been present for only a short time

I think I have BPPV.  What now?

First of all, don’t stress.  Approximately one third of people over the age of 70 have experienced BPPV at least once in their life.  It is a benign condition, non life threatening and effectively treated.  After consulting your local physiotherapist you will undergo a test called the Hallpike Manoeuvre to confirm diagnosis, prior to treatment.

BPPV can be described as being self-limiting, meaning that it is not intrinsically life threatening, and in most cases subsides within two months.  Therefore you can potentially go without treatment.  However, as this condition can be quite debilitating and potentially last longer than two months, it is better to treat the problem actively and be done with it.

What does the treatment involve?

 Treatment techniques are quick and easy and almost always immediately effective.  Your physiotherapist will guide you through a manoeuvre designed to guide the dislodged crystals back out of the semi-circular canal, and back where they belong.  You will also be taught specific exercises to do at home to prevent recurrence.  Occasionally a repeat treatment is required.  There is strong research to suggest that treatment offered by physiotherapists is efficient and effective.

• Other conditions that may cause vertigo.
• Vestibular neuronitis/labyrinthitis
• Menieres disease
• Acoustic neuroma
• Oto-toxicity
• Vestibular migraine

If you are suffering from one of the above conditions you should consult your General Practitioner before commencing vestibular rehabilitation.