I learned about this very distressing problem on my first day home from the hospital. Whenever I tried to lie down, I’d immediately feel like either the room was spinning or that I was. It was literally impossible for me to sleep in my bed. Luckily, I had a reclining love seat, and in an ever-so-slightly reclined position, this became my new sleeping location. Periodically, I’d give my bed another go, but this condition persisted and left me unable to use my own bed.
A couple of months into my recovery, I decided to go see my chiropractor to start addressing some of the pains in my neck and my back remaining from the motorcycle crash. As I started to lie down on the chiropractic table, I complained of the vertigo – and my chiropractor told me this was called benign paroxysmal positional vertigo (BPPV)(1).
Before I talk about how my chiropractor corrected this issue, let me give you a little background on just what BPPV actually is.
Benign Paroxysmal Positional Vertigo
Otoconia is the term describing small bio-crystals of calcium inside our inner ears. The purpose of otoconia is to couple mechanical forces with sensory hair cells to allow us to sense linear acceleration and gravity for the purpose of maintaining bodily balance. These also relay positional changes of the head such as when we tilt, turn or experience linear acceleration(2).
When these crystals become displaced, they may relocate into the semi-circular canals of the ear and stimulate sensory cells so that we feel a sense of acceleration or movement when there is none. This can be triggered by a simple change in the position or orientation of our head. This all sounds reasonable, but it’s so very uncomfortable when it happens. If this hasn’t happened to you, perhaps think back to a time when you were young, and your friends spun you in circles until you collapsed to the floor from dizziness. Remember how it felt as though the whole world continued to spin around you? This is how BPPV feels… and it can come about from something as simple as lying down, bending over, or turning your head.
How TBI Causes BPPV
A TBI is caused by an impact or trauma to the head, and the forces involved can dislodge the crystals in your inner ear. In 2018, a study of 179 mTBI (mild traumatic brain injury) survivors showed a 47.4% occurrence of BPPV(3). BPPV can cause brief attacks of vertigo that can be intense enough to cause nausea or even vomiting. It’s normally preceded by a change in head position, such as lying down or even just turning your head to look in a new direction(4).
In the general population, BPPV incidence is very infrequent – but as shown in the study referenced above, around half of all TBI survivors experience this disturbing condition. But there is some very good news to go along with this. In TBI survivors, the BPPV will be present in both ears, making it easier to treat. According to the Complete Concussion Management web site, BPPV that isn’t due to head trauma can often be present only in a single ear and a little more challenging to treat(5).
How is BPPV Treated?
My chiropractor corrected my BPPV in a single treatment, for which I was both amazed and incredibly grateful, using something called Epley’s Maneuver. This treatment is safe, quick, painless, non-invasive, and inexpensive – it’s all the things we all want in our medical care. How Epley’s Maneuver works is to combine gravity with specific head positions to get the loose crystals out of the wrong place and back where they belong.
For mine, my chiropractor first turned my head 45° to the left and helped me to lie back on the treatment table with the head support positioned to allow my head to be extended back about 20 to 30 degrees. After maybe 60 seconds, he turned my head 90° to the right. Again, we waited about 60 seconds, then he had me roll to my right side and then sit up. We then repeated this for the other ear. He told me I should stay upright for the next 30 minutes or so to let things settle, and by the time I got home, I was again able to lie down in my bed without the world spinning in crazy circles.
Now, by reading this you’re probably thinking, “Hey, I could do that without having to pay anyone…” and you are correct. That said, it’s considered best to have a medical professional show you how to perform the Epley maneuver for the first time to ensure you’re doing it correctly. To learn more, the www.HealthLine.com website is but one of the many resources out there that offers a tutorial on doing the Epley maneuver.
Does this Always Work?
More than 90% of the cases of BPPV are resolved with a single Epley maneuver. According to one study, 92% recovered within a week after the first treatment, with 72% recovering immediately after treatment; the remainder reported recovery after their second or third treatment(6). Given how distressful it is when the world starts spinning around, and how simple and effective the Epley maneuver is, if you’re experiencing vertigo then my strong recommendation is for you to talk to a trusted medical professional to see if this is the right treatment for you.
References
- Renata Palmeri, Anil Kumar, (2020), Benign Paroxysmal Positional Vertigo
- Yunxia Wang Lundberg, Yinfang Xu, Kevin D. Thiessen, and Kenneth L. Kramer, (2016), Mechanisms of Otoconia and Otolith Development
- Magdalena Józefowicz-Korczyńska, Anna Pajor, Wojciech Skóra, (2018), Benign Paroxysmal Positional Vertigo in Patients after Mild Traumatic Brain Injury
- G. R. Haripriya, Preethy Mary, Mathew Dominic, Rashmi Goyal, and Ambily Sahadevan, (2018), Incidence and Treatment Outcomes of Post Traumatic BPPV in Traumatic Brain Injury Patients
- Complete Concussion Management: Treating BPPV in Concussion Patients https://completeconcussions.com/2017/05/11/vertigo-concussion/
- Sushil Gaur, Sanjeev Kumar Awasthi, Sunil Kumar Singh Bhadouriya, Rohit Saxena, Vivek Kumar Pathak, and Mamta Bisht, (2015), Efficacy of Epley’s Maneuver in Treating BPPV Patients: A Prospective Observational Study
Be the first to comment