What is Vertigo?
Benign Paroxysmal Positional Vertigo (or BPPV) is the most common cause of vertigo, which is a false sensation of spinning.
Benign – it is not life-threatening
Paroxysmal – it comes in sudden, brief spells
Positional – it gets triggered by certain head positions or movements
Vertigo – a false sense of rotational movement
Most often, people feel like things around spinning around them while they are staying still. This spinning sensation is triggered with head movements. This false sense of movement can be quite scary, especially if you do not know what is happening. Typically, this movement is worse when turning to one side over the other.
What is actually happening?
BPPV is a mechanical problem in the inner ear. It occurs when some of the crystals (otoconia) that are normally embedded in part of the inner ear become dislodged and move into one or more of the 3 fluid-filled semicircular canals, where they are not supposed to be. These crystals then interfere with the normal movement of fluid through the semicircular canals which sense head motion. This causes the inner ear to send false signals to the brain which causes the sensation of spinning. Vertigo symptoms typically last less than one minute, however, they can last longer. Between the vertigo spells, some people feel symptom free while others feel a sense of imbalance or feeling off.
Assessment and Treatment
Vertigo can be assessed and treated by a Phyiotherapist trained in Vestibular therapy. We conduct a thorough vestibular assessment to determine if it is indeed vertigo or another vestibular dysfunction. Vertigo treatment requires a series of head and body movements done on a treatment table. Most people that experience Vertigo require 2-3 treatments.
It is also important to note that Vertigo can come on spontaneously or it can be caused from a virus or head injury. Vertigo can also re-occur. However, it can be treated and with vestibular therapy you will be provided with information and resources so you will be prepared if it does reoccur down the road.
If you are experiencing vertigo symptoms, such as feeling the room spinning with head movements, or other dizziness. Book in for a full vestibular assessment so we can get you back on track.
Lauren Romeril, PT.
Image credit: Biology. Authored by: OpenStax. Provided by: OpenStax College. Located at: http://email@example.com:1/Biology. License: CC BY: Attribution
I have frequently been told after getting a massage that I should “drink lots of water to help flush the toxins.” This statement is based on the belief that massage therapy will somehow draw toxins out of your cells and deposit them into your bloodstream. The people who promote this theory believe that by drinking more water, you would increase the filtration rate of your blood, thus flushing the toxins. This is not correct. Massage DOES NOT increase the amount of “toxins” in the blood stream, and drinking more water does not significantly increase the filtration rate of your blood.
Massage Therapy has many positive benefits for the body. It has been shown to decrease anxiety (1), to decrease the perception of pain (2), and to increase local circulation (3). I was unable to find any credible research that suggests massage has any effect on cellular metabolism. As part of cellular metabolism, waste products are created and eliminated from the cell. In order for a massage to increase the transportation of these waste products into the blood stream, a massage would have to increase the rate at which a cell functions. Massage being a passive, generally comfortable pressure on the skin is unlikely to alter the metabolic rate of your cells.
The actual “flushing” of metabolites from the bloodstream is accomplished by the kidneys and liver. It has been shown in many studies that increasing water intake does not increase the filtration rate of the kidneys (4). Both the kidneys and the liver are controlled by complex processes that involve various hormones, and increasing the amount of water consumed will not significantly affect their rate of filtration.
Although science has disproven the need to drink more water after a massage, water is good for you. If you are thirsty after a massage, drink water, just don’t expect it to flush your imaginary toxins away.
(1) Esther Mok, Chin Pang Woo, The effects of slow-stroke back massage on anxiety and shoulder pain in elderly stroke patients, Complementary Therapies in Nursing and Midwifery,
Volume 10, Issue 4, 2004, Pages 209-216,
(2) Lee, S.-H., Kim, J.-Y., Yeo, S., Kim, S.-H., & Lim, S. (2015). Meta-Analysis of Massage Therapy on Cancer Pain. Integrative Cancer Therapies, 297–304. https://doi.org/10.1177/1534735415572885
(3) Wiltshire, E. V., Poitras, V., Pak, M., Hong, T., Rayner, J., & Tschakovsky, M. E. (2009). Massage Impairs Post Exercise Muscle Blood Flow and "Lactic Acid" Removal. Medicine & Science in Sports & Exercise, 1. doi: 10.1249/mss.0b013e3181c9214f
(4) Anastasio P, Cirillo M, Spitali L, Frangiosa A, Pollastro RM, De Santo NG: Level of hydration and renal function in healthy humans. Kidney Int 60 : 748 –756, 2001
Have you ever experienced dizziness, a loss of balance or feelings of the room spinning? Have you had sensitivity to light and sound and had a headache? If so, you may have been experiencing a problem with your vestibular system.
The vestibular system is an integral part of our bodies ability to balance and orientate itself. Made up of various components in the inner ear, the vestibular system is a complex network or sensory receptors, tubuoles, and other components that send input to the brain with relation to balance, movement and body orientation.
Whenever there is dysregulation of the vestibular system, you may feel a plethora of uncomfortable symptoms. Some of the more common symptoms are:
- Vertigo ( feelings of the room spinning around you)
- Balance and spatial disorientation (imbalance, stumbling, difficulty walking straight, difficulty with coordination, head tilting to one side, the need to hold onto something when standing and walking)
- Trouble focusing on objects
- Sensitivity to light and moving or flickering lights
- Tinnitus (ringing, buzzing or other noises in the ear)
- Sensitivity to loud noises
- Motion sickness or sensitivity
- The sensation of your eyes lagging when you are looking around
Thankfully, there are many ways that we can help. Vestibular Rehabilitation is a form of physiotherapy that uses specialized exercises to treat vestibular dysfunction including habituation and gaze stabilization, among other things, to improve vestibular function, balance and decrease the feelings of dizziness.
During the initial appointment, your physiotherapist will conduct a thorough vestibular assessment including a health history, oculomotor screening and specific vestibular testing. Based upon the findings of this assessment, your physiotherapist will create and discuss a treatment plan to best relieve your symptoms. The ultimate goal of the treatment plan is to decrease and depending on the findings, to resolve your dizziness, as well as to provide you education on management and prevention when possible. After asking any questions that you may have, and after ensuring you feel secure in the proposed treatment, your physiotherapist will work with you to try and improve your current health state.
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