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If you’ve ever experienced sudden bouts of dizziness, as if the room is spinning uncontrollably, you know how frightening and disorienting it can be. This sensation, known as vertigo, is often caused by Benign Paroxysmal Positional Vertigo (BPPV), the most common vestibular disorder. If you’ve been diagnosed with BPPV or suspect you may have it, understanding how vestibular rehabilitation can help you regain control is crucial. Your vertigo or dizziness should disappear if you are perfectly still. If your symptoms are constant it may be related to an infection and you should see your medical doctor as soon as possible.

What is BPPV and Why Does It Happen?

BPPV is a mechanical issue within your inner ear that leads to episodes of vertigo. Inside your ear, there are tiny crystals of calcium carbonate called otoconia, which normally sit in a gel-like substance within the utricle. Sometimes, these crystals become dislodged and migrate into one of the semicircular canals, where they interfere with the normal fluid movement that your inner ear uses to detect head motion. This disruption sends false signals to your brain, causing the sensation that you’re spinning even when you’re perfectly still.

This type of vertigo usually lasts less than a minute, but it can be intensely uncomfortable and disorienting. Between episodes, you might feel completely fine, or you might experience lingering feelings of imbalance.

How Vestibular Rehabilitation Can Help You

Vestibular rehabilitation is a specialized form of therapy designed to alleviate symptoms related to vestibular disorders like BPPV. The primary goal is to help your brain and body compensate for the false signals being sent by your inner ear, reducing or eliminating symptoms of vertigo.

In the case of BPPV, vestibular rehabilitation often involves specific maneuvers that guide the dislodged crystals back to their proper position. These Canalith Repositioning Maneuvers, such as the Epley maneuver, are highly effective in treating BPPV when performed by a trained professional. Your therapist will move your head through a sequence of positions, using gravity to move the crystals out of the semicircular canal and back into the utricle where they belong.

The Importance of a Professional Diagnosis and Treatment

While BPPV can be effectively treated, it’s crucial to get a proper diagnosis before beginning treatment. Not all vertigo is caused by BPPV, and different variants of BPPV require different treatment approaches. A vestibular rehabilitation therapist is trained to distinguish between these variants and can determine the specific cause of your symptoms through detailed assessments.

Tests like the Dix-Hallpike maneuver allow your therapist to observe the characteristic eye movements, or nystagmus, that occur when the dislodged crystals move. These eye movements help pinpoint which ear and which canal are affected, ensuring that the correct treatment is applied to relieve your symptoms effectively.

What to Expect After Your Treatment

Most people experience significant relief after just one to three treatments. However, it’s not uncommon to feel a bit unsteady or sensitive to motion for a few days afterward. Your vestibular rehabilitation therapist will provide you with exercises to help stabilize your balance and reduce any residual symptoms.

Follow-up care is essential, as BPPV can sometimes recur. If it does, your therapist can quickly address it and guide you through the appropriate maneuvers. In some cases, your therapist may even teach you how to perform these maneuvers on your own at home, though many patients prefer to return to the clinic for professional assistance.

The Role of Vestibular Rehabilitation in Your Long-Term Management

Vestibular rehabilitation isn’t just about treating the immediate symptoms of BPPV—it’s also about empowering you to manage your condition in the long term. By improving your balance, enhancing your body’s ability to compensate for vestibular dysfunction, and teaching you techniques to manage or prevent recurrences, vestibular rehabilitation helps you regain confidence and control over your life.

At PhysioActive, our team of vestibular rehabilitation specialists is dedicated to helping you overcome the challenges of BPPV. We understand how disruptive vertigo can be, and we’re here to provide the expert care and support you need to regain your balance and peace of mind. Don’t let BPPV keep you off balance—reach out to us today to learn more about how vestibular rehabilitation can help you get back to feeling steady and secure.

Cold Feet, Many Culprits

If your toes are always cold, one reason could be poor blood flow — a circulatory problem sometimes linked to smoking, high blood pressure, or heart disease. The nerve damage of uncontrolled diabetes can also make your feet feel cold to you. Other possible causes include hypothyroidism and anemia. A doctor can look for any underlying problems — or let you know that you simply have cold feet.

Foot Pain

When your feet ache after a long day, you might just curse your shoes. After all, eight out of 10 women say their shoes hurt. But pain that’s not due to sky-high heels may come from a stress fracture, a small crack in a bone. One possible cause is exercise that was too intense, particularly high-impact sports like basketball and distance running. The weakened bones of osteoporosis increase your risk.

Heel Pain

The most common cause of heel pain is plantar fasciitis, inflammation where this long ligament attaches to the heel bone. The pain may be sharpest when you first wake up and put pressure on the foot. Arthritis, excessive exercise, and poorly fitting shoes also can cause heel pain, as can tendonitis. Less common causes include a bone spur on the bottom of the heel, a bone infection, a tumor, or a fracture. There are many available treatments including shockwave, exercise and manual therapy. If you have it in both feet make sure your therapist checks your back and pelvis.

Foot Spasms

A sudden, sharp pain in the foot is the hallmark of a muscle spasm or cramp, which can last from a few seconds to many minutes. Overwork and muscle fatigue are common causes. Other causes include poor circulation, dehydration, or imbalances in potassium, magnesium, calcium, or vitamin D levels in the body. Low back or pelvic issues can affect nerve (electrical) and blood / lympth (the plumbing) can affect the supply to the feet adn cause spasms. Changing hormone levels of pregnancy or thyroid disorders may also play a role. If spasms are frequent or severe, see a doctor or therapist. Strengthening exercises can help with muscle fatigue.

Clubbed Toes

In clubbing, the shape of the toes (and often the fingers) changes. The nails are more rounded on top and curve downward. Lung disease is the most common underlying cause, but it also can be caused by heart disease, liver and digestive disorders, or certain infections. Sometimes, clubbing runs in families without any underlying disease. As our exercise and movement specialists how we can help.

Yellow Toenails

Your toenails tell a lot about your overall health. A fungal infection often causes thickened yellow toenails. Thick, yellow nails also can be a sign of an underlying disease, including lymphedema (swelling related to the lymphatic system), lung problems, or rheumatoid arthritis. Consult our chiropodist if you have any concerns.

White Nails

Injury to the nail or illness anywhere in the body can cause white areas in the nails. If part or all of a nail separates from the nail bed (shown here), it can appear white — and may be due to an injury, nail infection, or psoriasis. If the nail is intact and most of it is white, it can sometimes be a sign of a more serious condition including liver disease, congestive heart failure, or diabetes. Talk with your health care team about any concerns.

Pitting of the Nails

Pitting, or punctured-looking depressions in the surface of the nail, is caused by a disruption in the growth of the nail at the nail plate. It affects as many as half of people with psoriasis.

Burning Feet

A burning sensation in the feet is common among diabetics with peripheral nerve damage (neuropathy). It can also be caused by a vitamin B imbalance, athlete’s foot, chronic kidney disease, poor circulation in the legs and feet (peripheral arterial disease), or hypothyroidism.

Pain in the Big Toe

Gout is a notorious cause of sudden pain in the big toe joint, along with redness and swelling (seen here). Osteoarthritis is another culprit that causes pain and swelling. If the joint is rigid, it may be hallux rigidus, a complication of arthritis where a bone spur develops. Finally, turf toe is an ailment of athletes, particularly those who play on hard surfaces. It’s caused by an injury to the ligaments surrounding the joint. Our TCM and osteopath can help with treatment of the liver, lymphatics and ANS regulation to allow you stay pain free.

Itchy Feet

Itchy, scaly skin may be athlete’s foot, a fungal infection that’s common in men between the ages of 20 and 40. A reaction to chemicals or skin care products — called contact dermatitis — can cause itching, too, along with redness and dry patches. If the skin on your itchy feet is thick and pimple-like, it may be psoriasis, an over-reaction of the immune system. Medicated creams can relieve the symptoms.