Treating Benign Paroxysmal Positional Vertigo
Epley Maneuver For Treating BPPV
For people that have vertigo, specifically BPPV which stands for Benign Paroxysmal Positional Vertigo, life can be a pain. This type of vertigo is not due to a tumor or anything medically concerning. it’s usually due to deficits in inner ear balance, along with misplacement of the calcium carbonate crystals inside of the ear. The simple fix is a technique We’ve been utilizing for over 15 years.
This easy, but very effective technique is called the Epley, or Epley’s Maneuver. Usually, a patient will come complaining of having vertigo, due to BPPV. In some cases, we’ve found that people suffering from BPPV have been sent home by their doctor, or urgent care physician without any form of treatment. Often, people are told to go home and try it themselves.
While one can eventually learn to do this maneuver themselves, it is made much easier when performed with the help of a doctor, physical therapist, or chiropractor. It also makes a great difference to have someone present that knows what BPPV and vertigo even are. During treatment what we do is, we watch the eyes and figure out which one is presenting nystagmus or involuntary eye movement caused by confusion between the brain, nerves and eyes. This “confusion” is due to the aforementioned crystals in the ear becoming lodged in a fluid in the ear canals.
As the maneuver is performed, were constantly checking the patient’s eyes. In most cases, when a patient is brought in to position for the Epley’s Maneuver they get really dizzy and may want to vomit. Having someone there that knows what they’re doing will assure them they are not going to get hurt. After 20 or 30 seconds of a rapidly turn the head the opposite direction wait 20 or 30 seconds again looking for the nystagmus again. Then we turn the body to align with the head and rest there for 20 seconds. At the end, we have the patient sit up and rest there, again for 20 seconds.
Usually, this procedure is done two or three times until the nystagmus goes away. Since we are a chiropractic, and physical therapy based practice, an examination of the upper cervical spine specifically C1 C2 is performed. In most cases when people have BPPV, they also exhibit some neck and upper back problems. The maneuver is performed two to three times and usually results in about a 90% reduction in a patient’s symptomatology. Once the inner ear crystals are aligned properly the vertigo subsides completely. But this is not a permanent solution, and the symptoms can recur, and some patients may not respond to Epley’s. The good news is that BPPV can almost always be treated mechanically, and can be kept at bay quite easily.
If you’re unsure about your diagnosis, you should be aware that there are other things that could cause vertigo, and that’s why it’s important to see your doctor. If you have been diagnosed with Benign Paroxysmal Positional Vertigo, and want help treating your symptoms, give us a call at 212 645 8151.