Vertigo

Diagnosis and Treatment of BPPV for Physical Therapy

I provided a lecture on BPPV for the Pennsylvania Physical Therapy Association Southeastern District Meeting on March 9, 2016 and had a request to post it online.  Keep in mind that this was a one hour lecture for topic that is often taught in a full day.  Unfortunately the videos won’t work, however some of the BPPV videos on it along with many other excellent videos can be found on Dr. Timothy C. Hain’s website http://www.dizziness-and-balance.com/sitedvd.htm.  Click here to download the lecture– Diagnosis and Treatment of BPPV for Physical Therapy водкаsingaporebackpagebinary options 2013услуги поддержки сайтовхарьковские музыкальныесайтTM binary options robotvsemsmartчерная губная помада

Epley Maneuver (modified) Video

The modified Epley maneuver (or canalith repositioning procedure) is the best treatment for the most common form of Benign Paroxysmal Positional Vertigo (BPPV).  For a detailed explanation of what BPPV is, how it causes vertigo, and why this treatment works, click here.

There are many videos on the internet on how to perform this treatment.  Many are done very well, however there are some that are inaccurate.  The technique shown in this video is taken directly from the evidenced based clinical practice guidelines put out by the American Academy of Neurology and the American Academy of Otolaryngology- Head and Neck Surgery and updated based on recent research.

Keep in mind there are many causes of vertigo and over a dozen different presentations of BPPV, many requiring different types of positional maneuvers for successful treatment.  Be sure to get properly evaluated by a healthcare provider with training in this area to make sure that this is the right treatment for the cause of your vertigo.  Since diagnosing and treating BPPV is one of our specialties we can do this for you at NPBTC.  If you or someone you know has vertigo or other forms of dizziness, call us to make an appointment.

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What Is the Treatment for Vertigo?

If you experience vertigo you may have heard about many different treatments and wondered if they work or not.   Here are a couple of tips to guide you in the answer:

The most important step in the treatment of vertigo is to find out the cause.  Keep in mind that vertigo is not a diagnosis*, just like pain is not a diagnosis.  Vertigo is a symptom defined as the illusion of movement when you are still.  Vertigo, like other forms of dizziness, can be caused by many different problems, some serious, while others are very benign.  Here are just some of the causes of vertigo:

  • Benign Paroxysmal Positional Vertigo (BPPV)
  • Vestibular Neuritis
  • Labyrhinthitis
  • Migraines
  • Stroke/Transient Ischemic Attack (TIA)
  • Meniere’s Disease
  • Panic Attacks
  • Multiple Sclerosis
  • Concussion/Traumatic Brain Injury (TBI)
  • Vestibular Paroxismia
  • Sick Sinus Syndrome of the Heart
  • Depression or Anxiety
  • Vestibular Epilepsy
  • Medication Side Effects

When vertigo is caused by a stroke, heart problems, or other problems associated with lack of blood flow to the brain you need to go to the emergency department.

For less emergent causes of vertigo you will want to see someone with an interest and special training in this area such as a neurologist, physical therapist (often referred to as vestibular therapist), or ENT.

For some causes such as medication side effects or non-emergent heart problems you will want to see your primary physician or cardiologist.

Once you have the correct diagnosis for the cause of your vertigo, then the right treatment can be given for successful management of it.   Treatments that have been found to rid people of vertigo include:

  • Positional Maneuvers (Eply’s Maneuver is one example)
  • Head/Eye Movement Exercises
  • Habituation Exercises
  • Balance Exercises
  • Psychotherapy
  • Medication
  • Surgery

Again, which of these treatments is right for you will depend on the cause of your vertigo.  If are doing a great treatment for the wrong diagnosis, you probably won’t get much better.  What worked for your Aunt Betty’s vertigo may not work for yours.  No matter what, no one can tell you what the best treatment is for your vertigo without a complete examination.

A final note: In general, being active and moving around is helpful in improving the symptoms for most causes of vertigo, even if the activity is as  simple as taking short walks within the tolerance of your symptoms.  Staying in bed and in the dark for an extended period can prolong your recovery or even make your symptoms worse.  How much and what type of activity that will give you the most benefit can only be determined after a complete examination by a qualified healthcare professional.

If your have the symptom of vertigo or another form of dizziness and want to get an examination to find out how you can get relief, call us at 215-591-0700 to schedule an appointment.

*While vertigo is not a diagnosis, insurance companies recognize it as one.  Therefore you may get a prescription for testing or to see a specialist that will list vertigo as a diagnosis just to make sure insurance pays for it.  Insurance also recognizes “pain in limb” as a diagnosis even then almost anything can cause pain in one of your limbs.

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