Vertigo / BPPV
Vertigo is the feeling that you or the room is spinning. The most common cause is BPPV, where tiny crystals in the inner ear drift out of place, and a physical therapist can often find it and move the crystals back with the Epley maneuver. We treat vertigo with physical therapy in Chubbuck, Idaho, for patients from Chubbuck and Pocatello.
Vertigo or just dizzy?
The words get used loosely, but the difference guides treatment.
Vertigo
A false sense of motion: rocking, tilting or spinning while you are perfectly still. It can last seconds, hours or days.
General dizziness
Lightheaded, woozy or about to faint, with no sense of spinning. That can come from blood pressure, medicines or other causes, and your doctor should look at it. Ongoing unsteadiness is covered on vestibular rehabilitation.
Ear crystals, in plain language
Each inner ear holds tiny calcium crystals that help you sense gravity. In BPPV (benign paroxysmal positional vertigo) a few of them slip into one of the semicircular canals, which are the loops that sense turning. Each time your head moves, the crystals shift and your brain gets a false signal, so you feel a short, strong spin.
The word positional matters. BPPV comes with head position. Head injuries, inner ear illness and long stretches in bed can all bring it on, and sometimes there is no clear reason.
What sets BPPV off
Dizzy when I lie down
Lying back onto the pillow can start the spin within a few seconds.
Dizzy when I roll over in bed
Turning to one side at night is a classic trigger, and many people wake up spinning.
Looking up or bending over
Reaching to a high shelf, tipping your head back at the hair salon or bending to tie a shoe can do it.
Quick head turns
A fast look over your shoulder when driving or sudden turns while walking.
How we find it and fix it
Here is the usual path, from your first test to staying clear of it.
We ask about your spells
How long they last, which positions bring them on, and whether anything besides the spin goes along with them.
We test with the Dix-Hallpike or the roll test
We move your head and body into set positions while watching your eyes. Eye movements that are typical of BPPV tell us which ear and which canal is involved. The test can bring on the spin for a moment, and we guide you through it.
We move the crystals with the Epley maneuver
The canalith repositioning procedure, or Epley maneuver, is a series of slow head and body positions that guides the crystals out of the canal. Your therapist rechecks afterward and may repeat it.
We teach what to do next
Cawthorne head exercises, a series of head and eye movements, are used for vertigo that lingers. We also show you how to manage a flare-up at home, and a home program may follow.
How many visits does BPPV take?
Many people with BPPV feel a big change after one to three visits, because repositioning goes straight at the cause. That is why it is worth being checked early, instead of waiting for it to pass on its own. BPPV can come back, and if it does, we can treat it again and show you what to do.
Visits typically last 30 to 60 minutes. We accept most insurance plans and verify your benefits before you arrive. Auto injury liens, Medpay and workers compensation are accepted, and there is a self-pay option. Call the office to confirm your plan.
When it is not BPPV
If your spinning lasts for hours, if it does not depend on head position, or if the Epley maneuver does not change anything, something else may be going on, such as an inner ear illness or a problem that begins in the brain. In that case, we move to a full evaluation and a program of vestibular rehabilitation, and we talk with your doctor about what else to check.
Vertigo after a hit to the head is also common. The Concussion page explains how we treat it. Some medicines, including blood pressure drugs, can also cause vertigo, so bring your list.
Go to the ER right away if vertigo comes with
- Slurred speech or trouble speaking
- A drooping face
- Weakness or numbness in an arm or leg
- Double vision
- A sudden, severe headache
These can be signs of a stroke. Call 911. Idaho allows direct access to physical therapy, so you do not need a referral from a doctor to begin. Some insurance plans, and Medicare typically, may still require one. If you are unsure, call us and we will check your plan.
Vertigo questions
What is the best vertigo treatment?
It depends on the cause. For BPPV, repositioning with the Epley maneuver treats the cause directly, and other types of vertigo respond to exercises that retrain the brain.
My room is spinning. Why?
A room spinning feeling is vertigo. Inner ear crystals are the most common cause, and a positional test can tell.
Why am I dizzy when I lie down?
Lying down moves the crystals in the inner ear if BPPV is the cause. A positional test confirms it, and treatment can start the same day.
Can I do the Epley maneuver at home?
It works best after the right ear and canal are identified. Doing it on the wrong side can make things worse, so have it checked first. Your therapist can show you what to do at home for next time.
Is there vertigo physical therapy in Pocatello?
Our clinic is in Chubbuck, Idaho, a short drive from Pocatello, and we treat vertigo with physical therapy for patients from both towns.
Related care
Vertigo and BPPV treatment in Chubbuck, Idaho
Call or request an appointment at our Chubbuck clinic. We see patients from Chubbuck, Pocatello and the surrounding area.
We see patients at our Chubbuck clinic from Chubbuck and Pocatello, Idaho.