November 2004
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Exercises keep vertigo from spinning out of control
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Some vertigo sufferers may be thrown off balance to learn just how easily their conditions can be cured.
A Baylor College of Medicine study on the most common form of vertigo illustrates that certain motions, not medications, can eliminate the vestibular problem's disorienting effects.
Helen Cohen, EdD, associate director of the Center for Balance Disorders at BCM in Houston, found that low-impact exercises successfully resolve problems caused by benign paroxysmal positional vertigo.
"Unlike other disorders that are caused by damage to the nerve - a tumor growing or some metabolic problem in the inner ear - this is a mechanical problem," said Cohen. "So the way to fix it is with a mechanical fix."
She proved her hypothesis in a five-year study, funded by the National Institutes of Health. That research compared repositioning exercises to a placebo treatment. The trial tested several commonly practiced head maneuvers, which were administered by the physician. Cohen hypothesized correctly that certain exercises - particularly those that tilted the patient's head in motions that relocated displaced calcium particles - were more effective than others, such as those designed simply to desensitize the patient from feeling vertigo.
While some conditions that cause vertigo can be treated with medication, this form of vertigo is not one of them. This kind of vertigo creates the illusion of motion caused by the abnormal reaction of the inner ear balance system to certain head movements. The disorder occurs when microscopic particles of calcium carbonite, used to sense the direction of gravity, become dislodged within the vestibular labyrinth of the inner ear and settle into the wrong compartments.
This displacement causes the patient to experience vertigo when a change occurs in either the elevation or angle of the head. Even though benign paroxysmal positional vertigo ranks as the most common form of vertigo (occurring in 64 people per 100,000), very little research has been conducted to better understand the disorder, likely because it is not life threatening, Cohen said.
"It's very unusual to have somebody with benign paroxysmal positional vertigo who is not treatable," Cohen said.
Under rare circumstances in which repositioning exercises do not work, physicians may recommend surgery as a last resort to relocate manually any displaced particles.
Vertigo creates the illusion of spinning or tilting when a person is not actually moving.
Cohen said anyone with symptoms of vertigo that last more than one week should see a physician. Furthermore, Cohen recommends that patients describe what they are experiencing rather than make vague generalizations.
"Do not go to your doctor and say, 'I'm dizzy,'" she said.
Vertigo can occur at any age but is most common around the age of 60.
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