"“This morning I woke up terrified because when I rolled over in bed, the world started spinning
Julie Cai
November 15, 2022
"“This morning I woke up terrified because when I rolled over in bed, the world started spinning around me. What’s wrong with me?”
You are experiencing what is known as vertigo - which is a type of dizziness that is often described as feeling that you are spinning, or that the world is spinning around you, particularly if you change position. There are multiple causes of vertigo, although the most common we come across in our Marrickville clinic is BPPV - otherwise known as Benign Positional Paroxysmal Vertigo. This disorder is caused by problems in the inner ear, particularly the ear crystals residing in the vestibular system which gives you your sense of balance. In this post we will discuss the symptoms, causes, treatment and how Physio or Chiro can help.
BPPV is caused by calcium carbonate crystals (otoliths) in the semicircular canals of the inner ear. The crystals are actually debris that have migrated from another part of the inner ear. They can incorrectly move into either of the three semicircular canals which monitor certain directions of balance.
When you turn your head into the direction monitored by one of the semicircular canals, the crystals move which cause a momentary disturbance in the fluid movement within the canal resulting in vertigo. As the movement stops and the crystals settle, the vertigo dissipates within 30-60 seconds. This can also be accompanied with a longer period of queasiness of discomfort.
People suffering from BPPV often report:
BPPV can also be made worse by:
BPPV can be largely diagnosed by the Dix-Hallpike or supine roll test, which involves positioning the individual backwards, turning the head and observing eye movements called nystagmus. The specific semicircular canal that is affected is determined by the type of eye movement caused (upward/downward/rotary). This then informs the particular maneuver required to treat the affected ear canal accordingly.
Treatment for true BPPV is often highly effective, and generally requires only a few sessions to be completely resolved. The treatment involves different positioning sequences to move the particles out of the semicircular canals to another area where they do no harm, and can then be normally absorbed and excreted.
The positioning sequence required will depend on the semicircular canal affected. The posterior semicircular canal is the most commonly affected which requires the Epley Maneuver. The lateral canal requires the Lempert (BBQ) Maneuver, while the superior or anterior canals require the Deep Head Hanging Maneuver. Every positional change can cause momentary vertigo, however significant improvement is often experienced immediately after. Therefore it is important to consult an experienced health professional who can help determine which maneuver you require and ensure you are performing it correctly. These can then be done as home exercises.
There is also a newer exercise called the Half Somersault that causes less severe vertigo, but sometimes takes more repetitions. This can also be done at home.
It is important to note that there are also different types of vertigo which may be misdiagnosed. Watch this space for further posts on different types of Vertigo, particularly vestibular neuritis, labyrinthitis, Meniere’s disease, vestibular migraine, benign recurrent vertigo and others.
Our Physio and Chiro at our Marrickville clinic located in Sydney’s Inner West are experienced in assessing and treating BPPV. If you have any further questions about how we can help your vertigo, head over to our Contact Us page, or book in now to make an appointment.
Podiatry is a branch of medicine that deals with diagnosing and treating disorders of the feet and lower limbs. A podiatrist (also known as a chiropodist) is a healthcare professional who specialises in this field. Podiatry is a relatively new branch of medicine, only emerging as a distinct profession in the early 20th century. However, the field has grown rapidly in recent years, owing to increasing awareness of the importance of foot health. Today, podiatrists play an important role in keeping people mobile and active. They often treat conditions such as bunions, heel pain, ingrown toenails and Achilles tendonitis. In addition, they can provide advice on footwear and foot care for people with diabetes or other medical conditions that put them at risk of foot problems.
Dry needling is a type of therapy that involves inserting thin needles into the skin and muscles. The needles are usually made of stainless steel and are very thin, so they cause minimal pain when inserted. However, some people report feeling a brief, sharp pain when the needle enters the skin. There are several theories as to why dry needling causes this pain. One theory is that the needles stimulate nerve endings in the skin and muscles, which triggers a pain response. Another theory is that dry needling causes a release of chemicals called cytokines, which can increase pain sensitivity. It’s important to note that while dry needling may cause some discomfort, it is generally not considered painful. Many people find relief from their chronic pain after undergoing dry needling therapy.
A syndesmosis injury is a serious condition that can occur when the bones in the ankle joint are not properly aligned. This can happen when the foot is planted awkwardly, or the ankle is twisted. If not treated properly, a syndesmosis injury can lead to long-term problems. There are two main types of syndesmosis injuries: anterolateral and posterior. Anterolateral injuries are more common when the foot is planted awkwardly on an uneven surface. Posterior injuries are less common and occur when the ankle is twisted. If you think you have a syndesmosis injury, it is important to see a doctor right away. Treatment will vary depending on the severity of the injury but may include rest, ice, elevation, and immobilization. Surgery may also be necessary in some cases.
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