Stop the spinning. I want to get off this ride
Dizziness ranks second only to pain in patient complaints at physician visits.
Here’s a little secret about me: I love patients who are dizzy!
There are different types of dizziness and many ways that the symptom is described. Lightheadedness, haziness, foggy, cloudy, blurry, vertigo, spinning and on and on.
I once had a patient who described it as “squirrelly.”
When I say I love patients who are dizzy, it is because physical therapy can have a profound impact on this debilitating feeling that can really be a scare and limit the activity level of those suffering.
Most types of dizziness respond very well to conservative treatment and we will focus on my favorite here.
The best kind of dizziness for me is the worst kind of dizziness for the patient, at least in terms of the severity of the sensation.
True vertigo — defined as the false sense of movement — is caused by nystagmus, which is essentially a repeated twisting motion of the eye caused by overstimulated eye muscles.
My dizziness is caused by my eye muscles? In the type of dizziness that I will speak about here, benign paroxysmal positional vertigo or BPPV, the eye muscles are heavily involved.
Your eye muscles are connected to the inner ear. Why?
One of the jobs of the inner ear is to make sure your eyes can stay focused while your head moves.
Try this: Stare at your TV, or a book, or computer, and move your head side to side and up and down. You are still able to maintain your eyes focused on the object while your head is moving. That’s because the inner ear is telling your eye muscles how to react to the movement of your head so that the eyes can continue to see the target.
Let’s see if I can explain how this all works.
Picture a Hula-Hoop filled with fluid. If you turn the hula hoop, the fluid inside naturally moves. The inner ear is similar.
When not stricken with BPPV, when you move your head, fluid moves in the semicircular canals and sensory nerves are activated to manage the contraction or relaxation of the eye muscles.
In normal semicircular canals, the fluid is the only thing that should be moving.
In another section of the inner ear, there are “crystals” or otoconia, which serve a physiological purpose.
For one reason or another, such as illness or a bump on the head, some of those “crystals” get dislodged and move into the semicircular canal (Hula Hoop).
Now, when you move your head a certain way, the eye muscles get the stimulation that they should be getting from the fluid movement, but they also get a different stimulation from the “crystals” and pairs of eye muscles work together to move the eye in a way it wasn’t designed to move. The result is called nystagmus.
That eye movement is what causes the nauseating feeling that the world is spinning around you.
BPPV lasts less than a minute and is usually felt while getting up and down from bed, rolling in bed, bending over, or looking up to the ceiling.
If you’ve never experienced it, it’s the same feeling you got when you were a kid and you ran around a stop sign 10 or 20 times. It truly is frightening, especially if the reason is unknown, often to the point where you think there must be something life-threatening going on.
There are other causes of vertigo, but, BPPV is one of the most common and easily confirmed.
Here is the part I love.
BPPV can be cured in a high majority of cases in just about 10 minutes.
A therapist will take a complete history, perform a few tests to confirm the diagnosis, and implement a treatment known as an Epley Maneuver (or other maneuvers depending on the findings).
If this sounds like you or someone you know, let your doctor know about this article so you can get the help you need. The results are pretty amazing!
That is why I love patients who are dizzy. It’s very exciting to ease someone’s worries in such a short span of time.
Let’s get you off of that ride so you can get back to enjoying life.
Joel J. Digris is a Schuylkill County resident with a master’s degree in physical therapy. He is currently employed by Achieva Rehabilitation as an outpatient provider of physical therapy and serves residents in Carbon, Schuylkill and Luzerne counties. The Times News Media Group and affiliates do not endorse or recommend any medical products, processes, or services or provide medical advice. The views of the author do not necessarily state or reflect those of the Times News. The article content is not intended as a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician, or other qualified health provider with any questions you may have regarding a medical condition.