An Easy Fix for Vertigo

Joe Bayer said it best when he described lying down for bed as being on a “merry-go-round.”

“You’re sitting perfectly still, but everything around you looks as if it is spinning out of control,” Joe says.

Joe was suffering from BPPV, otherwise known as benign paroxysmal positional vertigo, a vestibular disorder that is the most common cause of vertigo. With this condition, one feels a false sense of spinning. is usually occurs when someone moves their head, such as when they look up, tilt their head, lie down, or roll over in bed. Someone with BPPV may also experience symptoms like vomiting, loss of balance, and nausea. though not life-threatening, BPPV can be frightening due to its paroxysmal, or sudden, onset.

An Inner Ear Issue

In the inner ear, complex mechanisms of canals, nerves, crystals, tiny hair cells and uids serve as part of the body’s balance system.

BPPV occurs when those crystals become dislodged and nd their way into one or more of the three semicircular canals in the ear — this interferes with the normal uid movement that these canals use to sense head motion, which then results in confusing signals to the brain. e dislodging of the crystals can sometimes be associated with a head injury, migraine, inner ear infection or disease, diabetes, or osteoporosis. However, Boone erapy Physical erapist Rachel Beanland says the vast majority of the cases she sees happen for no apparent reason.

“Most times patients simply lie down for bed or stand up from lying down and notice the room is spinning,” Rachel says.

Diagnosing and Treating BPPV

In 2020, Joe came to Boone Therapy after the spinning sensation became unbearable at night.

“Joe had nystagmus, which confirmed he had BPPV,” Rachel says. Nystagmus is a rapid, involuntary movement of the eyes. A medical professional can watch for nystagmus with tests like the Dix-Hallpike, which involves holding the patient’s head and having them lie back on a table quickly, with their head tilted to one side and slightly lower than the shoulders. The Dix-Hallpike allows gravity to move the dislodged crystals and trigger vertigo.

If the condition is con rmed, a physical therapist can reposition the crystals or otoconia in the inner ear with a simple procedure known as the Epley maneuver, or canalith repositioning.

“The maneuver moves the crystals out of the canals so they stop causing symptoms,” Rachel says. e Epley maneuver is a series of rapid changes in the position of the head. It’s similar to the Dix-Hallpike test — the Epley maneuver follows the final position of the Dix-Hallpike test – but involves an additional rolling of the body to one side while the patient’s head is held in position. e maneuver is repeated three to four times.

If a patient doesn’t get full relief from the Epley maneuver, Rachel says other maneuvers can work depending on the canal the crystal is in.

Rachel Beanland, PT performs the Epley maneuver on Lisa Bowman.

Joe Bayer and Rachel Beanland, PT.

Rachel adds that the majority of patients, including Joe, are better in one session. Others may require one or two follow-up sessions.

The Role of Boone Therapy

Joe Bayer and Lisa Bowman have both benefited from Boone Therapy. Lisa was referred to Boone Therapy after experiencing pain from a work injury 17 years ago. Rachel began working with Lisa earlier this year.

“I noticed Lisa had a nystagmus while she was performing an exercise during one of our sessions,” Rachel says.

Rachel Beanland, PT working with Lisa Bowman.

“Rachel cured me in less than five minutes,” Lisa recalls. “It’s crazy to think that something I had been living with for 17 years was fixed within five minutes.”

Once confirming Lisa was suffering from BPPV, Rachel performed the Epley maneuver.

“Rachel cured me in less than five minutes,” Lisa recalls. “It’s crazy to think that something I had been living with for 17 years was fixed within five minutes.”

Lisa also appreciates the educational component of Boone Therapy, saying Rachel helps her to know what is expected of her during each movement. Rachel says she has enjoyed getting to know Lisa and Joe through the years. Part of building relationships with her patients is also establishing trust. “The treatment for BPPV isn’t always pleasant because I am stimulating the symptoms of vertigo by putting the head into positions that move the dislodged crystals,” Rachel says. “Building relationships and trust with my patients helps them understand my knowledge and why I am asking them to do what they need to do.”

By Kaitlyn Bailey