Vertigo / BPPV
If the room spins when you roll over in bed or look up, the cause is often benign paroxysmal positional vertigo (BPPV), tiny ear crystals that have moved out of place. Vertigo physical therapy can find the problem with a simple positional test and treat it with a repositioning maneuver, and Joint Effort Physical Therapy treats vertigo in Hot Springs, Arkansas.
Is it vertigo or ordinary dizziness?
Dizziness is a broad word. It can mean lightheadedness, feeling woozy or faint, or briefly seeing tunnel vision after standing up too fast. Lack of sleep, overexertion or a head cold can all cause it.
Vertigo is more specific: a spinning or rocking sensation, as if the world is moving around you even when you sit still. Patients often call it room spinning. It usually points to the inner ear, which is part of your vestibular system. If your trouble is more general unsteadiness, see our page on vestibular rehab for dizziness and balance.
What BPPV is and what sets it off
Inside the inner ear are tiny calcium crystals. When they break loose and drift into the wrong canal, head movements send false signals to the brain.
Rolling over in bed
Many people say they get dizzy when I roll over in bed, often only on one side.
Lying down or sitting up
Feeling dizzy when I lie down is a classic complaint, and so is a spin on sitting up quickly.
Looking up or bending over
Reaching for a high shelf, tipping the head back at the hair salon or bending to tie a shoe can all do it.
How BPPV is found and treated
The visit is short on tests and heavy on watching your eyes.
We ask about your symptoms
What triggers the spinning, how long each spell lasts, and any hearing change, headache or recent head injury.
We check with a positional test
Our physical therapist moves your head and body into set positions, such as the Dix-Hallpike test, and watches your eyes for the telltale movements that show which ear and canal are involved.
We reposition the crystals
The Epley maneuver is a series of slow head and body movements that guide the crystals out of the canal where they cause trouble. Our physical therapist matches the maneuver to the affected ear and canal.
We give you home guidance
You learn what to expect afterward and what to do if symptoms come back, and we recheck as needed.
Why BPPV often settles in a few visits
BPPV is a mechanical problem, not damage to the nerve. Because the crystals are in the wrong place, moving them back often stops the spinning, and for many people that takes only a few visits. Others need more repositioning, and some have lingering unsteadiness afterward that a vestibular rehabilitation plan can address.
Joint Effort Physical Therapy also treats other causes of vertigo, including vestibular neuritis, Meniere’s disease, migraine-related vertigo and vertigo after a stroke. Vertigo after a blow to the head may be tied to a concussion; see concussion rehab.
When it is not BPPV
If the positional test does not show BPPV, or you have constant dizziness, trouble with walking, or hearing changes, our physical therapist works up another cause. Treatment may then shift to exercises that retrain the inner ear and brain, covered on our vestibular rehab page. Cawthorne head exercises, for example, aim to lower the nerves’ sensitivity to movement.
Go to the ER if vertigo comes with
Vertigo is usually not dangerous, but these signs can mean a stroke or another emergency:
- Slurred speech or trouble speaking
- Drooping on one side of the face
- Weakness in an arm or leg
- Double vision
- A sudden, severe headache
Call 911 or go to the nearest emergency room right away. Do not drive yourself.
Questions about vertigo treatment
Can I be treated if I have never had a positional test?
Yes. The positional test is part of your first evaluation, and it is how we learn whether ear crystals are the cause.
Will I feel dizzy during the maneuver?
You may, because the point is to bring on the movement that shows the problem. Our physical therapist guides you slowly and you stay in control.
Related care
Vertigo and BPPV care in Hot Springs, Arkansas
Joint Effort Physical Therapy treats Vertigo and BPPV at our Hot Springs clinic, 1880 Airport Rd., Suite C. If rolling over in bed has become a gamble, call us.
Not sure whether your plan needs a referral? Call us. As a courtesy, we verify your health benefits before you arrive.
Meet the people who treat you on our team page.