Vertigo is one of the most common complaints in medicine affecting roughly 30% of the population. It is also one of the leading causes of lack of activity and fear of falling in the elderly population (Yongchao Li, 2015) (Uzdan Uz, 2019). Dizziness or vertigo can be characterized as an unpleasant disruption in spatial awareness and can be accompanied by symptoms such as lightheadedness, feeling yourself or the room is spinning, double vision, or even nausea and vomiting.
While anyone may experience vertigo or dizziness at any point in their life, it is particularly an issues in the elderly population. Vertigo is a potential risk factor for reduced mobility and high frequency of falls, which can be fatal (Uzdan Uz, 2019). One reason for such dizziness/vertigo is a condition called BPPV (benign paroxysmal positional vertigo). BPPV is an issue in the inner ear in which the semicircular canals contain otolith crystals that can accumulate and when dislodged trigger the feeling that you or the room is spinning. This can then be accompanied by nystagmus (fluttering of the eye), trigger nausea and even a vomit response. The feeling like the room is spinning can last up to 5-10sec, and a lingering feeling of unsteadiness can persist. Thankfully there is an easy home exercise patient’s can use to clear their inner ear canals and reduce their symptoms called an Epley Maneuver.
The Epley Maneuver is well established in treating BPPV, and involves a step by step motion of the head in space to clear the canal, namely the posterior canal where most of the crystals accumulate (Uzdan Uz, 2019). Step one is to sit up with your head turned to 45 degrees towards the side you experience symptoms (found by a qualified healthcare provider) (figure 1). Next, quickly lay back with your head hanging off the edge of a table or bed and stay there for up to a minute until symptoms pass (figure 2). Turn your head 45 degrees to the opposite side and wait for an additional minute until symptoms subside (figure 3). Then, roll your whole body to the same side your head is turned until you are looking down to the floor and wait until symptoms subside (figure 4). Then sit up and wait until you feel ok to stand. WARNING! Do not do this maneuver on your own until you have been evaluated by a qualified healthcare professional to rule out any other comorbidities or contributing conditions.
Other possible contributing conditions that could cause vertigo include cervical vertigo. This is a condition in which the dizziness is accompanied by neck pain, however there is much debate as to it’s existence. One study by Yongchao and Baogan (2015) report evidence both for and against it’s existence. As a physiotherapist who has treated many cases of vertigo and cervical pathologies, I can attest to it’s existence. Manual therapy has been found to be an effective treatment for this condition, as well as any vestibular rehab for any case of vertigo or dizziness (Verena Regauer, 2020).
For the best treatment options, reach out to your trusted physiotherapist or other healthcare professionals for an in depth assessment. We can help you find relief!
Uzdan Uz, D. U. (2019). Efficacy of Eply Maneuver on Quality of Life of Elderly Pateints with Subjective BPPV. The Journal of International Advanced Otologu, 15(3), 420-424.
Verena Regauer, E. S. (2020). Physical therapy interventions for older people with vertigo, dizziness and balance disorders addressing mobility and participation: a systematic review. BMC Geriatrics, 20, 494-506.
Yongchao Li, M. B. (2015). Pathogenesis, Diagnosis, and Treatment of Cervical Vertigo. Pain Physician, 18(2150-1149), E583-E595.