People who have vertigo experience episodes of dizziness or headache when they move their head. It makes it difficult to perform normal daily duties and they often develop disabling headaches. They also can experience nausea or vomiting especially when they wake up in the morning.
Benign positional vertigo is a condition marked by vertigo and dizziness and associated symptoms due to disorders of vestibular system. The primary pathology is hypersensitivity of the balancing system of the brain that gives wrong messages to the brain. Semicircular canals are very sensitive to the movement of inner hair cells (the input from organ of Corti is responsible for the maintenance of your head posture and body balance), but in the presence of calcium crystals that may occur due to aging, tumor, trauma or infection related conditions, the sensory system receives wrong information and you will experience dizziness, vertigo and headache with mild and abrupt head motion.
Although, doctors and healthcare providers suggest medications and pharmacological interventions, nothing really works for benign positional vertigo. But in majority of cases, physical therapy exercises have proved fairly helpful in treating and managing the cases of vertigo due to inorganic causes.
The aim of physical therapy exercises is to prepare and train your body to learn to differentiate different types of head motion. When the vertigo is caused by the movement of calcium crystals or bony fragments in the inner ear, physical therapy exercises help in relocating and readjusting the fragment to limit the duration and frequency of episodes. Physical therapy exercises are perhaps the most preferred mode of therapy in benign positional vertigo (when there is no organic cause of vertigo and other associated symptoms).
Epley or Sermont Maneuvers are performed in the doctor's office or in a physiotherapy clinic because the aim of therapy is to re-lodge or relocate the crystals in inner ear ossicles. During Epley and Sermon maneuvers, your therapist tilts your head at different angles while properly supporting your head in his arms. The overall therapy procedure takes no longer than 10 to 15 minutes. The calculated movements of the head help in shifting the crystals back into the canals.
The Brandt-Daroff exercise is normally performed in the home setting and it is very important to seek the advice of a healthcare provider before performing these maneuvers. Brandt Daroff exercise deals with performing step wise motion that may help in stimulation and habituation of inner ear cells to repeated head motion. Brandt Daroff exercises deal with maintaining a sitting posture and then tilting your body on the right side of the body to support the head on the side of bed. Sudden movement or tilting of the head will produce characteristic headache, vertigo and dizziness that may last for 30 seconds or more. Once you begin to feel stable, sit straight and stay in this position for another 30 seconds or until your symptoms subside. The next step is to drop your body gently but steadily onto the left side of the body and holding this position for good 30 seconds or until your symptoms subside. This finishes one complete round and you may have to repeat the steps based on the recommendations of your doctor or healthcare provider.
Other physical therapy maneuvers include movement of the hand in anterior-posterior plane 10 times, maintain a healthy lifestyle and diet habits and the movement of eye muscles in all directions.
Always seek the advice of your doctor before performing these exercises and to determine the number of times you have to perform these maneuvers. With the Brandt Daroff technique, always lie on a 45 degree angle when lying on the side of your body. If the Brandt Daroff technique does not produce any symptoms, you can stop the exercise after discussing with your physician. Generally these maneuvers are safe, effective and hazard-free and help in correction or at least management of benign positional vertigo. Perform all physical therapy exercises in a sitting posture to avoid the risk of falling or hurting yourself due to vertigo and dizziness.
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