Vertigo Treatment

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Vertigo is one of the least talked about medical experiences and yet 35% of people over the age of 40 will experience symptoms of vertigo, as will 80% of people over 65. Although there may be many causes of vertigo, Benign Paroxysmal Positional Vertigo (BPPV) is one of the main types. We’ll discuss that a bit later.

When you experience vertigo, it can put you in danger if it happens at the wrong time. You could fall and hurt yourself at a moment when falling could be very hazardous. Any other time, it still disorients you and takes away your ability to interact with your environment. It is usually accompanied with the inability to participate in daily tasks, extreme nausea, and the inability to focus. 

In this guide, you will get a complete picture of what vertigo is, how it affects your life, and symptoms that can result from conditions related to vertigo. There’s also good news. You can do something to correct the underlying causes of vertigo. You don’t have to live with it forever. We’ll look at those solutions as well.

The Ultimate Guide to Vertigo Treatment

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The Ultimate Guide to Vertigo Treatment

What Is Vertigo?

what is vertigo

Vertigo arises from problems in the vestibular system, which includes your inner ear and all its structures, as well as two parts of the brain – the brainstem and the cerebellum – and finally, the vestibular nerve.

The vestibular system’s purpose is quite amazing, and not something you would think about being necessary. But it’s vital to functioning in our day to day lives. The vestibular system helps your brain keep objects in focus while your body is moving. This allows simple acts like bending over quickly, turning, and diving into a pool to be undertaken without losing clarity of what you’re seeing.

The vestibular system controls your balance and posture, as well as motor coordination tasks such as reaching out to pick something up while walking.

Its central feature is fluid in the inner ear area called endolymph and little sensors called otolith end organs which contain little crystals circulating in the area. The movement of this fluid causes the crystals to move in the ear which tells your brain how far and how fast your head is moving, and in which direction.

Vertigo is the feeling that you are in motion when in fact you are perfectly still. It is usually experienced as a spinning or whirling feeling, and sometimes includes other symptoms that we’ll discuss in a moment.

Vertigo is not the same as dizziness, lack of balance, or lightheadedness in most cases, though the vestibular system does relate to those symptoms as well.

You can experience vertigo lying in bed, on a boat, or in reaction to medication or alcohol. It usually happens without warning, and is often triggered by something as simple as rolling over in bed.

Vertigo can be treated with vestibular rehabilitation with the help of a physiotherapist who specializes in vestibular therapy. Various procedures can also treat other causes of dizziness and related issues. In this article we will explore all of your options.

What Are the Symptoms of Vertigo?

The primary symptom of vertigo is a spinning or whirling sensation that happens when your body is not in motion. At times, other symptoms can appear as well. These include:

• Nausea and vomiting
• Involuntary eye movement
• Weakness in your arm or leg
• Excessive sweating
• Sensitivity to light and sound
• Vision problems such as double vision, blurry vision, or bouncy vision
• Frequent falls
• Difficult walking in straight lines

The most common ages where you see these symptoms showing up are between 50 and 70, but if you’ve experienced any sort of head trauma, such as a concussion or a head injury in a car or bike accident, you might feel these symptoms at much younger ages too.

Check out this post from BeActive Physiotherapy and Wellness to learn more about Vertigo (Read the caption)

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Why Am I So Dizzy?

You can get dizzy for all sorts of reasons, many of them basic, such as lack of sleep, blood pressure issues, physical exertion well beyond your norm, standing up too fast, and illnesses like the cold or the flu.

Other causes of dizziness can be more serious, and result from a great variety of medical conditions that we don’t have room to explore here. If you’re experiencing frequent dizziness and you don’t think it’s caused by any of those basic reasons, you might want to see a doctor and discuss your symptoms.

What Are the Causes of Vertigo Symptoms?

Unlike run-of-the-mill dizziness, vertigo has very specific causes. As mentioned earlier, these can include head trauma from things like falls and contact sports, and bad reactions to certain medications.

Vertigo can also be caused by age, vestibular migraines, inflammation within the ear, stroke, neck joint dysfunction, acoustic neuroma, and Meniere’s disease.

Meniere’s happens when excess fluids build up within your inner ear structures, and often is experienced with a ringing sound. You might experience dizziness that can last for hours, as well as a temporary loss of hearing.

But the number one cause of vertigo, by far, is known as BPPV – benign paroxysmal positional vertigo.

BPPV is not life threatening (hence the ‘benign’), but as discussed earlier, if it happens at the wrong time, it can cause you a lot of trouble, especially if you start falling frequently. You’ll usually experience BPPV suddenly, and the dizzy, whirling room-spinning feeling won’t last very long. Usually, it is triggered by some sort of head movement, bending forward, or rolling over in bed. 

Check out this post from Pillars of Wellness to learn more about Vertigo and Vestibular Balance Disorder (Read the caption)

What Causes BPPV?

BPPV is caused by loose crystals in the inner ear fluid – the endolymph mentioned earlier. Usually, the particles, also called otoconia, are dislodged from their position.

Once loose, these particles enter the fluid and therefore when the endolymph moves (with head movements) the particles move around and take too long to settle. Therefore your body senses that there is still movement occurring when there is not. This is what causes the sensations associated with vertigo.

To put it in silly terms, it’s like your brain, eyes, and ears were all having a nice conversation at a party, but then suddenly they all got trapped in separate rooms. They’re still trying to talk to each other through the walls, but the signals are getting mixed up.

In reality, that dislodged object makes your brain think your body is moving even though it isn’t. And that’s why the feeling doesn’t last very long and is usually initiated by real movement.

This is also why BPPV can be treated. If we can get the crystals to settle where they are suppose to in the inner ear fluid, we can eliminate the vertigo it is causing.

What Is the Best Treatment for Vertigo?

Is there a cure for vertigo? In most cases, yes, but it’s better not to think of vertigo as a ‘disease.’ It’s a symptom of an underlying problem. If you fix the problem, you will fix the vertigo.

If you’re experiencing the symptoms you’ve been reading about and feel pretty confident you might have vertigo, consider going to see a physiotherapist who has been trained in vestibular rehabilitation. You might see the title ‘vestibular physiotherapist’ in their bios.

The first thing the specialist will do is perform an assessment. While BPPV is the most common cause of vertigo, as you saw earlier it is not the only cause. This assessment will help the therapist determine which condition may be causing your symptoms. The treatment you need depends on what is causing the vertigo, so the diagnosis is critical.

The physiotherapist will first try to rule out the less common causes of vertigo mentioned earlier, such as cardiovascular issues or an inner ear infection. Some clinicians use specialized visual goggles to further assess fine eye movements that may be abnormal and not easily detected. These abnormal eye movements are associated with BBPV.

During their assessment, the specialist will typically use what’s called the Dix Hallpike Maneuver. This is a very accurate test for BPPV. If the procedure reveals that BPPV is in fact causing your vertigo, they will likely perform the Epley Maneuver, also called a Canalith Repositioning Procedure. The idea is to re-settle the loose crystals in your inner ear fluid. It is an entirely drug-free and non-invasive procedure, and you will feel no pain.

The procedures just takes a few minutes to perform, but it has to be done very precisely and with the right timing. That is why a specially trained physiotherapist needs to help you with the procedure. 

Now if the Epley Maneuver doesn’t seem to help, your vertigo physiotherapist will probably try the Brandt-Daroff Treatment next. 

If the Dix Hallpike Maneuver doesn’t show that you have BPPV, your vertigo may be caused by something else. Another diagnostic test that is used it the head roll test. No, it’s not what you think… It is a gentle procedure to determine if your symptoms are coming from a different part of the inner ear. If that test comes out positive, you will likely receive what’s known as the barbecue treatment. Again… not what you think, though all this medieval-sounding language might be making you feel a bit apprehensive. Rest assured, it’s all simple and safe.

One of the most effective treatments of BPPV, courtesy of Aquatic Centre Physiotherapy

Will Vestibular Physiotherapy Help Me?

The good news is, it usually only takes a few treatments of the Epley Maneuver to successfully address the BPPV that is causing your vertigo symptoms by repositioning the canalith in your inner ear. Sometimes, just one treatment is all you need.

While there is a chance more crystals will dislodge and your vertigo will return, most patients never experience the return of their vertigo dizziness after completing the Epley Maneuver.

Your vertigo physiotherapist may also use other exercises, such as the Cawthorne head exercises to minimize the risk for future vertigo and decrease nerve sensitivity.

Check out this post to learn more about Vertigo courtesy of Dynamic Balance Physiotherapy & Sports Injuries Centre

Vertigo Home Remedies

Here are 3 vertigo remedies you can do at home.

1.) Epley’s Maneuver

When being assessed for vertigo by your physiotherapist, they will most likely complete a test called the Dix-Hallpike test. If this test brings on your vertigo symptoms, they will complete the Epley’s Maneuver. The Epley’s Maneuver works to clear the calcium carbonate particles out of the semicircular canals in your inner ear. The Epley’s Maneuver is very effective at treating vertigo, and in fact one performance of the maneuver can sometimes completely stop your symptoms. If you experience a reduction in symptoms, your physiotherapist will teach you how to complete the Epley’s Maneuver at home to allow for continued improvements. 

Here is how to complete an Epley’s Maneuver at home:

If your vertigo is more dominant on the right, then complete the following instructions. If your vertigo is more dominant on the left, then complete the following instructions in the opposite direction. 

First, lie down on your back on your bed and place a pillow behind your shoulders and neck. Then sit up from that position and turn your head to the right at a 45-degree angle. Your head position should be halfway between looking forward and being completely rotated to the right.

Then lie down quickly on the pillow with your head turned 45 degrees and the head back so that the head is slightly extended backwards over the pillow. Moving into this position may bring on your symptoms. Wait in this position until your symptoms completely subside. If symptoms do not come on with the position, then wait for 30 seconds.

Next, turn your head slowly 90 degrees to the left. Now your head position should be halfway between looking forward and being completely rotated to the left. Again wait until the symptoms of vertigo stops, or at least 30 seconds

Next, keeping your neck in the same position, roll your body over completely to the left. Wait for vertigo symptoms to subside, or at least 30 seconds.

And lastly, sit up slowly while keeping your head in the same position as previous looking over your shoulder.

Completing this maneuver helps dislodge those crystals in the inner ear, which can reduce your vertigo. 

Again it is important to consult with a doctor or physiotherapist before completing this self-treatment.

Check out this post from BeActive Physiotherapy and Wellness to learn more about Vertigo (Read the caption)

2.) BBQ Roll

If your physiotherapist completes the Head Roll Test and it elicits your vertigo symptoms then the BBQ Roll is probably the best option for you.

Here’s how to perform it. Complete the following instructions if you tested positive on the left. Complete the following instructions in the opposite direction if you tested positive for the right :

Lay down on your bed on your back in a comfortable position. You can place a pillow underneath your head if you want.

Roll your entire body to your left side. Pause until your vertigo symptoms subside, or for at least 30 seconds.

Keeping your head in contact with the pillow, next roll your body back to the neutral position so that you’re looking up at the ceiling. Again, wait until your vertigo symptoms decrease, or for at least 30 seconds.

Next, roll your entire body towards the right. Wait until vertigo symptoms stop, or for 30 seconds

Next, tuck you chin into your chest and turn over to lie in the prone position (on your stomach) supporting your upper body on your forearms. Wait until your vertigo symptoms stop, or for 30 seconds.

Now, roll onto your left side, keeping your head on the pillow. Then wait for another 30 seconds. After this, sit up at the side of the your bed.

You may need to complete a few rounds of the BBQ roll to completely reduce your vertigo symptoms.

3.) Foster Maneuver

Your physiotherapist may teach you to perform the Foster Maneuver if they suspect there is particle build-up in the back of the semicircular canals. 

Here’s how to perform:

First, kneel down with your body upright. Then look up toward the ceiling for 3-5 seconds. You may start to experience your symptoms at this point. 

Next, bend at your back and turn your head down so that your forehead touches the ground while tucking in your chin. Support yourself by keeping your hands on the ground. Hold this position until all your vertigo symptoms subside.

After, turn your head to the side of the ear that causes vertigo. Wait until your symptoms decrease or for 30 seconds..

Next, keeping your head turned toward your shoulder on the side you are working on, raise your head up so it’s now level with your back. Your hands should still be on the floor at this point. Wait until symptoms decrease or for 30 seconds.

Finally, still keeping your head turned, raise yourself up to the original kneeling position and again wait for symptoms to subside.

You may have to perform this a couple of times to get the relief you desire. Just make sure you rest for a few minutes before each round.

Now if you want a more customized plan to address your specific Vertigo causes, then Body Science Therapy can help. They specialize in treating Vertigo. To learn more visit: 

https://www.bodysciencetherapy.com

One of the most effective treatments of BPPV, courtesy of Aquatic Centre Physiotherapy

How To Stop Feeling Dizzy?

Many times dizziness will go away on it’s own. However, if it persists there are a few things you can do to stop feeling dizzy.

  • Perform positions changes slowly. If you feel dizzy after a position change, take a few deep breaths in through your nose. This will help deliver more oxygen to your brain.
  • Get enough rest because exhaustion can cause dizzy spells.
  • Drink plenty of water throughout the day.
  • Limit your intake of coffee and alcohol.

Inner ear issues like we discussed above can be treated successfully with a customized vestibular treatment plan developed by a Physiotherapist. This treatment plan consists of exercises to help your vestibular system integrate your neck and head position more efficiently, thereby reducing vertigo symptoms.

In the case of BPPV, certain maneuvers performed by your physiotherapist can help alleviate the symptoms as well.

Now if your dizziness doesn’t go away or keeps coming back then it may be a good idea to see a Physiotherapist to find the root cause of your symptoms. You can use the search box on this page to find a Physio near you and book an appointment.

The 3 Do’s and Don’ts After a Treatment for Vertigo

Once you’ve completed a successful treatment for vertigo and feel no more symptoms, the last thing you want is to undo your progress.

Here are three things to do after a vertigo treatment with a vestibular physiotherapist:

1. Sleep propped up

The next few nights, sleep with pillows underneath you so your head is elevated.

2. Follow your plan of care

Your vertigo physio should have given you a home care plan that includes some exercises and other suggestions. Follow it! That plan was designed to keep your vertigo from relapsing.

3. Go about your regular tasks

Don’t just lay around all day. Do your normal routines, tasks, and activities. That doesn’t mean go rock climbing or run marathons just yet, but you want your body to move around so your brain experiences normal head movements.

Next, to make sure your vertigo dizziness stays in the past, here are three things not to do:

1. Don’t lie down flat

For at least one day, don’t lie flat on your back or side. Use a recliner when sitting to keep your head elevated.

2. Don’t sleep on the affected side

Whichever ear was affected by vertigo, don’t sleep on that side. Sleep on the other side if you must or on your back. But again – keep your head propped up. So, on your back is best.

3. Don’t bend in any direction

For the next few days, don’t bend backward, forward, or to either side. No leaning over. So, when we say to go about your normal daily tasks, make sure to avoid those tasks require a lot of bending. This should only be done temporarily.

Top 5 Exercises to Help Treat Vertigo at Home

Before going in to see a vestibular physiotherapist, there may be a few exercises you can try at home. The only thing that makes these at home treatments for vertigo difficult is that, as mentioned earlier, the exercise has to fit the cause of vertigo you’re dealing with. Without a diagnosis, it’s kind of hard to know what that is.

However, these exercises are painless and have a very low risk of any side effects, so the worst that can happen is probably that it won’t make any difference. It is a good idea to have someone else in the room when you do these, just in case you experience vertigo and lose your balance.

Let’s look at five exercises for vertigo you can try at home.

1. Crystal Repositioning – Epley

This is very similar to the Epley Maneuver.

Begin by sitting on at the end of your bed with your head turned at 45 degrees to the dominant side of your symptoms.

You are going to lie back quickly on the surface, keeping your head turned the whole time. Wait until vertigo stops. Then, turn your head 90 degrees to the opposite direction and wait until it stops again.

Then, roll over a quarter turn to the side opposite of the side of symptoms, and wait until vertigo stops again. Lastly, sit up slowly, keeping your head turned. Your symptoms should decrease after this maneuver.

2. Brandt-Daroff Treatment

If the Epley Maneuver doesn’t seem to help your vertigo, the Brandt-Daroff procedure may help with suspected BPPV. Use this process to complete it:

Sit on the side of a bed, turn your head 45 degrees left, and lay quickly on your right side until the vertigo stops, and then an additional half minute.

Then, sit up quickly and stay there, following the same timing procedure.

Lastly, turn your head 45 degrees to the right and quickly lay on your left side. Again, wait until vertigo symptoms ceases, and then an extra half minute.

You want to repeat these steps 5 times, two times a day until you go two straight days with no vertigo dizziness or other symptoms.

3. Barbecue Roll

If the cause of your vertigo is something other than BPPV, which the head roll test (explained above) will confirm, this is probably your best exercise to try. Here’s how you can complete it:

Complete the following instructions if you have symptoms on the left side. Reverse the directions in you have symptoms stronger on the right side.

Start by lying on your back with a pillow under your head. Roll to your left side and wait for vertigo symptoms to cease. Then return to your back, and wait again for vertigo to stop.

Next turn your whole body to the right side and wait until the vertigo symptoms subside. Then roll onto your stomach, using your fists to hold up your chin and tip your head downward. Wait again for vertigo symptoms to cease.

Now roll back to your left side again. After the vertigo symptoms stops, sit up from this position.

4. Eye-Ear Reflex Exercise

Now, if the cause of your vertigo is related to something else entirely, you could be dealing with a breakdown in communication between your eyes and ears. Inflammation and ear infections are possible causes for this. If you have blurry vision when you turn your head or move it up and down, this next exercise might be a good one to try.

  • Sit in a chair facing a wall, and put a picture or a word on the wall that you can see clearly
  • Focus both your eyes on the picture, and keep them there throughout the entire exercise
  • Turn your head slowly left, never taking your gaze off the picture
  • Turn your head slowly to the right, again without shifting your gaze
  • Keep doing this, left and right, back and forth, for 30 seconds without stopping, never taking your eyes off the picture
  • If you feel dizzy when doing this, that’s a good sign. It means you are probably addressing the cause of your vertigo and are rebuilding the proper communication between your eyes and your ears.
  • Once you have evidence this exercise is working (eg. it is inducing some dizziness), do it for five minutes straight, two times per day. Allow symptoms to come on only slightly. This will help your brain re-establish the connection between your ears and your eyes.

5. Movement Re-creation

Now, if you had an illness like the flu and have felt dizzy or unbalanced ever since, your inner ear may have become inflamed.

Another way to correct these symptoms is to figure out which movement causes your vertigo, and have a physiotherapist help you recreate that movement in a symptom-free or low-symptom way. This is called a habituation exercise and it helps your brain re-process the movement and allow you to complete it without issue.

Be careful with this one though, as it can be easy to re-create your symptoms. Your physiotherapist will help you avoid this.

An episode will usually last only a few minutes and may not occur again. When it doesn’t go away or becomes recurrent, contacting a vestibular physiotherapist will help you get rid of vertigo.

Usually dizziness is not a sign of something serious if it only happens occasionally. However if you experience dizziness for prolonged periods or experience repeat episodes then you should see a doctor as soon as possible.

Frequently Asked Questions

With the right treatment, yes, it can go away permanently in most cases. But the most important thing is to get a proper diagnosis. For many diagnoses it is possible to recover from symptoms by doing specific physical exercises. If you have been diagnosed with “Meniere’s disease” this can lead to attacks of vertigo and may result in ringing in the ears and hearing loss. This may be caused by blood vessel constriction, a viral infection, or autoimmune reaction. In this case, you could benefit from other types of treatment such as medications, introducing a low salt diet, balance training, relaxation techniques, and surgery in severe cases.

First, lie still in a quiet, dark room when the spinning sensation is at its worst, and wait until it subsides. Then, take extra time to perform the movements that seem to trigger the vertigo symptoms. It may be something as simple as looking up, rolling over, or turning your head. Identifying the movements that cause your vertigo will help your physiotherapist determine the appropriate exercises for your recovery. Also, squat when picking something up; don’t bend over. Use a cane to walk, if it is necessary. If your symptoms persist after two days of trying these, please contact your healthcare provider.

In general, no. But it’s not that simple. Vertigo itself is not a condition, it is rather a symptom of an underlying problem. However, some of the problems that can cause vertigo may involve specific genetic factors and may run in families. If someone is experiencing repeat episodes of vertigo, even after treatment, then we may suspect a hereditary or genetic component.

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