Stopping the spins

Cliff Vancura/Durango Herald

By Dale Rodebaugh Herald staff writer

If the world around you seems to be spinning, it could all be in your head – literally.

It’s called vertigo, say two Durango physical therapists, who have a fix.

The loss of balance or spatial orientation – vertigo – can be disconcerting, frightening or immobilizing, depending on severity, but it can be treated successfully 90 percent of the time with physical therapy, two physical therapists say.

They’re Stephanie Roberts at Peak Physical Therapy and Jessica McGinley Voegeli at Rivergate Physical Therapy.

Dizziness involves light-headedness.

Vertigo, a subset of dizziness, gives the sensation that the surroundings – or the observer – is spinning. It’s most common form is called benign paroxysmal positional vertigo (BPPV). It can be triggered by bending over or looking up or from head trauma.

BPPV is two to three times more common in women than in men and is most commonly found in people 50 to 70 years old, McGinley Voegeli and Roberts said in separate interviews.

The American Physical Therapy Association says BPPV is found in 2 percent to 3 percent of the general population. Many states require a physician’s referral to be treated for BPPV by physical therapy, but Colorado is a direct access state, meaning a patient can consult a physical therapist directly.

Vertigo also can be treated with medication prescribed through a physician.

BPPV occurs when the microsized calcium crystals in the inner ear that maintain balance and spatial relationship become dislodged from the utricle and enter the adjoining semicircular canals of the ear.

No precise cause of BPPV is known, McGinley Voegeli said. It could be a virus or bacteria, infection, concussion or other head trauma, a tumor, alcohol use or an insidious onset. The problem can come on and go away by itself, she said.

Physical therapists diagnose BPPV by lowering the patient to a supine position on an examination table with the head cocked at an angle. Uncontrollable rotation of the eyes confirms BPPV in either or both ears.

Treatment is through a series of movements developed by an Oregon physician, Dr. John Epley, and first described in 1980. The patient is put through a series of positions on the examination table. The goal is to get the dislodged calcium crystals back in place.

Roberts said the Epley maneuver is successful 80 percent of the time. She likes patients to wear a soft cervical collar for 48 hours to avoid any abrupt head movements and to sleep at a 45 degree angle. If the BPPV is in only one ear, the patient shouldn’t sleep on the affected side.

Sometimes, a second or third visit is necessary, Roberts said.

As a followup, she has a patient do balance and eye exercises and return in three to five days.

BPPV is not part of the aging process and is not inevitable, Roberts said.

“If you have double vision or have difficulty speaking, suffer a change in the level of consciousness or find yourself weak in the arms or legs, call a doctor,” Roberts said.

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