Can Physical Therapy Treatment be Used for Vertigo?

woman having vertigo

Vertigo can drive you nuts, especially if you don’t know what’s causing it.  The nauseating sense of dizziness or that you’re moving when you’re not can come at any time.

There are several key causes for vertigo, including inner ear infections, issues in the cervical (upper) spine and strokes or heart attacks.   But one of the most common causes is BPPV (Benign Paroxysmal Positional Vertigo) and that’s something a physical therapist can help you with.

Physical therapy is, in fact, the most commonly used therapeutic tool used to treat BPPV.

What Is BPPV?

BPPV is caused by tiny calcium carbonate crystals (otoconia) coming loose, so it’s often referred to as “loose crystals”.  And for something so small, those loose crystals can cause a lot of trouble.

So where do they come from?  They come from an organ found in the inner ear, called the utricle.  When the otoconia become dislodged, the make their way to the balance canals of the ear, where they accumulate.

This accumulation represents a structural change to your body’s means of balancing itself, which is a serious matter.  So those little crystals throw your entire system out of whack.

By causing turbulence in the balance canal, your brain gets the message that you’re moving, which is what causes the dizziness and nausea people experience with BPPV.

People over the age of 60 are those most susceptible to developing BPPV.


A physical therapist will submit you to a Dix-Hallpike test.  Because the turbulence in the fluid of ear canals tricks the brain into thinking you’re moving, your eyes change position when this occurs.  By monitoring your eye movements while administering the test, your physical therapist will be able to determine if BPPV is the type of vertigo you’re experiencing.

When eye movements are involuntary (created by those false signals your brain’s picking up), they’re known as nystagmus.  The direction the eyes turn to can alert the therapist to the location of the crystals causing the problem.

The Epley Maneuver

While there are several methods used in physical therapy to treat BPPV, Epley is by far the most successful.  It’s effective in 90-95% of BPPV cases.

Applying expert manipulation of the head, the physical therapist uses gravity to return the errant crystals causing your vertigo to the utricle, where they belong.

It’s amazing that something so simple can alleviate the nausea and dizziness of vertigo, but that’s the way it works.

And while this works for BPPV, your vertigo may be caused by something more serious.  If you’re experiencing vertigo, it’s therefore of paramount importance that you immediately consult your primary caregiver to rule out an infection of the inner ear, or other conditions which may cause vertigo.

Back & Body Medical

At Back & Body Medical, we’re a team of medical practitioners who are changing the way people approach pain.  At our award-winning clinic in the heart of Manhattan, we provide multi-disciplinarian care, drawing on the disciplines of chiropractic, physical therapy, sports medicine and acupuncture.

Contact us to be tested for BPPV.

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