BPPV and the Role of Vestibular Physiotherapy
Vestibular disorders are conditions that affect the vestibular system, which is responsible for maintaining balance, spatial orientation, and coordination of eye movements. Benign Paroxysmal Positional Vertigo, better known as BPPV, is one of the most common vestibular conditions estimated to affect roughly 50% people at some point in their life. While it is typically more common in adults over 50, it can affect anyone at any time. The condition is considered ‘benign’ as it is non-life threatening and ‘paroxysmal’ because the symptoms usually occur suddenly and are episodic.
BPPV occurs when the harmony of our inner ear is disrupted, leading to bouts of vertigo, a false sense of spinning. The cause? Tiny calcium crystals called canaliths, which have become misplaced and float inside the inner ear's fluid-filled semi-circular canals. This movement of crystals is usually triggered by specific head movements such as rolling over in bed, moving from lying down to sitting up, looking up or down or leaning back.
When these crystals go astray, they disturb the fluid's natural flow, sending conflicting signals to the brain about the head's position and movement. The result? A disconcerting sensation of spinning (vertigo) or dizziness, sometimes accompanied by nausea, unsteadiness, and difficulty with balance. These symptoms can be very distressing as they come on suddenly and can be mistaken for a serious illness. The good news is BPPV is very treatable.
Diagnosing BPPV involves a thorough examination of symptoms and a clear understanding of the patient’s history. Repositioning manoeuvres such as Epley will most likely be used to relocate displaced crystals, alleviating the disruption in the affected canals. The Epley manoeuvre involves turning the head in a series of movements that are specifically designed to use gravity to dislodge the crystals from the semi-circular canals and return them to where they belong, alleviating the symptoms of vertigo.
How can vestibular physiotherapy help?:
If you are suffering from BPPV, it can be effectively treated by Vestibular Physiotherapy, a specialised form of physiotherapy that specifically addresses disorders within the vestibular system. A vestibular physiotherapist can diagnose BPPV and provide the following treatment:
Canalith Repositioning Manoeuvres: Such as the Epley manoeuvre outlined above, or the Semont manoeuvre, to help to reposition displaced crystals within the inner ear's semi-circular canals and send them back to where they belong, alleviating the symptoms of BPPV.
Habituation Exercises: The physio will subject your vestibular system to movements that provoke symptoms. While this may sound like a bad idea, gradually exposing you to these movements in a controlled manner means that your vestibular system should adapt and become less sensitive over time.
Gaze Stabilisation Exercises: The physio will develop a program of exercises for you to improve your ability to fixate on objects while moving your head, which can help reduce dizziness and improve balance.
Balance Training: an individual exercise plan will likely also include exercises to improve your balance and proprioception, which can be affected if you are suffering from BPPV. These exercises may involve standing on unstable surfaces or performing specific movements to challenge balance control.
Education and Lifestyle Changes: perhaps most importantly, the physio will equip you with knowledge of BPPV, its triggers and symptoms, and then help you to develop strategies to manage the symptoms in daily life.
Progression and Follow-Up: your physio will agree on a series of follow-up appointments with you to assess your progress, adjust the treatment plan as needed, and provide ongoing support.
Overall, vestibular physiotherapy plays a crucial role in managing BPPV by targeting the underlying cause of vestibular dysfunction to help regain balance, reduce dizziness, and improve a person's quality of life.
If you are experiencing BPPV, you must consult with a healthcare professional or work closely with a qualified vestibular physiotherapist to receive personalised treatment plan and receive proper guidance and support throughout your rehabilitation journey.
Get in touch to find out more! Contact us on info@balancededinburgh.co.uk or call 0131 315 3105.