NYC Physical Therapy and Fitness Training Studio - Custom PT



“Hello, hello (hola)
I’m at a place called Vertigo (¿dónde está?)
It’s everything I wish I didn’t know
Except you give me something
I can feel, feel”

“Whoa,” I thought as I sat up in bed, “I must’ve sat up too quickly, the room is spinning!”

As I made my way to work and throughout the day, something wasn’t right.

During the night prior, I had somehow ended up on my stomach, with my face turned to the left. Because my neck and back are consistently problematic and tight, this strained the right side of my neck. In my sleep, I rapidly picked up my head and turned it to the right. I felt a sharp sudden pain in my neck and head and fell back asleep.

It wasn’t until the next morning when I went to bend over during SLT that my world started to spin again. What the heck? I knew. I had vertigo.

There are various causes of vertigo, including infection and much more serious problems, namely blood vessel occlusions and brain masses. Luckily, most vertigo we experience is known as “Benign Paroxysmal Positional Vertigo” or BPPV. According to the Mayo clinic, BPPV is one of the most common causes of vertigo — the sudden sensation that you’re spinning or that the inside of your head is spinning. BPPV causes brief episodes of mild to intense dizziness. It is usually triggered by specific changes in your head’s position.

Scientifically defined: “According to a widely accepted theory BPPV is usually caused by otoconia that are dislodged from the otolith macula beds and are trapped in a semicircular canal. Gravity causes them to move after changes of the head position in the plane of the affected canal. The resulting inappropriate endolymph flow deflects the cupula and thus modulates the activity of the vestibular afferents of the affected canal, causing attacks of positional vertigo and nystagmus.”1

To summarize: There are little crystal-like formations inside the three loops of your inner ear. They can get dislodged and jostled during sudden movement. And until they return to their regular position, your nervous system reads them as motion. To diagnose it, you can see the person’s eyes beat to one side. Crazy, right?

What’s even crazier is that physical therapists can treat this! BPPV was first identified by Hallpike and Dix in the 1950s. In the 1980’s Dr. John Epley described a maneuver to reposition these crystals. Today, this is known as the modified Epley maneuver, or simply the Epley Maneuver. I knew how to do this on others, but had never tried it on my own. No time like the present!

The one caveat to an Epley Maneuver: patients can sometimes vomit! I prepared my trash can and got to work.

Here are the instructions I followed from John’s Hopkins University.

It worked, a little.… Then I texted Cat to see if she would help me in the office. Of course!

Cat is experienced in doing the Epley Maneuver and treating vertigo! She has helped clients overcome this and sure enough, helped me!

While I skipped the vomiting (thank goodness), I basically got instant relief from vertigo!

If you are suffering with dizziness, come on in! We can diagnose BPPV and which side it’s on, and help you move your crystals back in the right direction, alleviating vertigo!


1. Journal of Vestibular Research 25 (2015) 105–117 105 DOI 10.3233/VES-150553

IOS Press. Benign paroxysmal positional vertigo: Diagnostic criteria

Consensus document of the Committee for the Classification of Vestibular Disorders of the Bárány Society. Brevern et al

2. Mayo Clinic


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