A case of the spins

by Jill Grider, PT, DPT, Certified Orthopedic Clinical Specialist

Have you ever felt a sensation of uncontrollable spinning despite not being in motion? You may remember this experience from playing as a kid when you would spin in circles super fast and then abruptly stop. Or maybe you’ve felt this spinning after drinking a little too much alcohol. This sensation of uncontrollable spinning is referred to as vertigo. Many people experience vertigo as a result of dysfunction with their vestibular system which is comprised of different parts of the brain and the inner ear. The most common vestibular disorder causing vertigo is Benign Paroxysmal Positional Vertigo aka BPPV.

BPPV is a prevalent disorder in which a person experiences acute bouts of vertigo when they move their head in certain directions. Benign Paroxysmal Positional Vertigo is a mouthful but it makes sense when you break it down.

Benign: not malignant

Paroxysmal: comes on suddenly

Positional: occurs immediately following a change in positions

Vertigo: is accompanied by a sensation of spinning

The vertigo symptoms last anywhere from a few seconds to a couple minutes. The vertigo is often accompanied by complaints of nausea, vomiting, and imbalance. Common movements that trigger the vertigo are rolling over in bed, rinsing hair in the shower, and bending over. 

So what causes this involuntary sensation of spinning in BPPV? You may have heard of having crystals in your inner ear. These crystals are called otoconia. In BPPV, these crystals are knocked loose in the inner ear. Most often these crystals spontaneously dislodge for no known reason but sometimes it occurs after a head trauma or inner ear infection. These loose crystals move with gravity when you move your head in certain directions. The loose crystals stimulate hair cells in your inner ear when you move one direction which confuses the brain into thinking you’re moving another direction. In response, the brain triggers an involuntary oscillatory movement of the eyes which makes it seems like the room is spinning. The loose crystals eventually settle and stop moving which then allows the spinning to cease. This is a simplified version of the process but this is the general gist of how BPPV works.

BPPV and its accompanying symptoms can have a significantly negative impact on a person’s quality of life. Increased fatigue, difficulty concentrating, depression, and social isolation are often reported alongside vestibular disorders. The great news is that a trained physical therapist (PT) can easily treat your BPPV. The PT accurately diagnoses which part of your inner ear the crystals are loose. From there, the PT places you in a series of very specific positions that utilize gravity to put the crystals back where they belong. This doesn’t merely mask your symptoms but it actually fixes the problem. BPPV is a very treatable disorder so don’t hesitate to seek help if you think you may have it. We want to get you back to living the life you love without a fear of the spins! In the meantime, vestibular.org is a wonderful resource to help answer any questions.

Schedule a consult with Staszak Physical Therapy & Wellness Center today at 541-505-8180.