“Vertigo is a sense of spinning/movement within a still environment; a false sense of self motion (rotational or linear).” - Jeff Walters

Vertigo is NOT a Diagnosis

Have you ever experienced vertigo? It can be a scary experience and most people seek immediate medical attention when the symptoms are severe. If a stroke or other serious diagnoses are ruled out, most doctors diagnose you with "vertigo" and send you home on medication.

Vertigo is NOT a diagnosis, it is just a SYMPTOM of an underlying condition. If you had pain in your chest area, would a doctor diagnose you with chest pain? No, they would try to figure out if the pain was from a heart attack, pulled muscle, acid reflux, etc. The same should be said for vertigo and dizziness but most doctors don’t know how to evaluate and manage these symptoms.

Beware of the Doctor Who Tells You, "Just Look up a Video on YouTube"

I have heard from my doctor friends that vestibular training in medical school consisted of 1 lecture. In PT school, this unit is usually 1-2 weeks long and covers the basics. For those who have graduated and desire further training, it takes several weekend and week long courses to become an expert in this specialty.

An ER doctor may diagnose you with Benign Paroxysmal Positional Vertigo (BPPV) and have you look up the Epley Maneuver on YouTube because it is one of the most common causes of vertigo in people 40+. PLEASE DO NOT DO THIS. This diagnosis should be made with positional testing by a trained professional. I've often had patients referred to me for BPPV who have been doing the maneuver with no resolution of their symptoms because BPPV was not the cause of their vertigo. Let me explain more about the vestibular system and why BPPV happens.

The Vestibular System

In our vestibular system located deep in our inner ears, we have calcium crystals that are attached to a gelatinous mass that functions to tell our brain which direction we are moving. As we age, these crystals can detach and escape into one of 3 adjacent loops or canals. When the crystals move, they disrupt the fluid in the canal and sensors tell our brain our head is turning when it's not. Our eyes will move in the way it feels after we’ve spun around in circles very fast and suddenly stop. This is called nystagmus. This feeling can last a few seconds up to a minute. It is triggered by movements in relation to gravity like getting in or out of bed, rolling in bed, bending over, titling your head back in the shower, hair salon or dentist. 

The reason why you shouldn't watch a random YouTube video is because there are three canals in each ear and there are specific positional tests that must be performed to determine which canal is involved with the loose crystals. Once this is determined, there are several different maneuvers to reposition the crystals back “home,” called repositioning maneuvers. These tests and maneuvers should be performed by a trained specialist like a vestibular physical therapist or an Ear, Nose and Throat (ENT) doctor. 

The good news is that BPPV is benign and easy to treat but positional testing is necessary to make a proper diagnosis. If you feel you may have BPPV, or another cause of vertigo, dizziness or imbalance, reach out to Balance Solutions Rehab for a free discovery call.