Dr. Jaclyn Banker: The Dizzy Doctor

Ever feel like your head is in a dizzying whirl? It can be sudden and scary.

“Oh my God, my room is spinning, what’s happening to me?” Perhaps you or someone you know experienced an episode of severe dizziness. Sensing a room that’s spinning can impair one’s ability to turn in bed, stand up from a lying or sitting position, bend forward, and even walk. Jaclyn Banker, PT, DPT, OCS, FAAOMPT ( Fellow of the American Academy of Orthopedic Manual Physical Therapists.), is a specialist in treating this condition. She helps resolve dizziness in her patients and instructs them on how they can manage it at home. Known as a “dizzy doctor,” she says, “Seeking a physical therapist trained to treat this problem can help you quickly alleviate dizziness and return to normal activities.”

Physical therapists (PTs) are known in the healthcare world as experts in the field of movement dysfunction. They analyze different movement patterns of each individual and develop a plan to promote the ability to move, reduce pain, restore function, and prevent disability. PTs can teach people how to prevent or manage their condition to achieve long-term health benefits. They can also help develop fitness and wellness programs for healthier and more active lifestyles. Some people have had the experience of going to physical therapy at some point in their life for the typical back pain, neck pain, post-operative, or other type of injury. However, many do not know that a physical therapist can also treat dizziness.

Ear Rocks

Have you ever awakened and experienced a room-spinning dizziness, also known as vertigo? If you drank alcohol the night before this might just be a hangover. If not, this is most likely a very common condition and easily treated by a physical therapist that is trained in vestibular rehabilitation. This condition is called Benign Paroxysmal Positional Vertigo (BPPV) which is a problem presenting itself in the tubular mechanics of the inner ear. It occurs when calcium carbonate crystals, also known as canaliths or ear rocks, that belong in a certain portion of the ear are dislodged and travel into one of the three fluid-filled semicircular ear canals. When the affected canal amasses enough crystals, normal fluid movement that senses head motion can be impaired. This causes the inner ear to send wrong information to the brain causing a short-lasting vertigo-like sensation when changing positions. Most symptoms occur when repositioning in or getting out of bed, moving your head back, quick head movements, and with activities such as going to the dentist and hairdresser.

BPPV is common and seen in many age groups and having associations with trauma, migraines, inner ear infection, diabetes, or reduced blood flow. According to a Mayo Clinic study, there are an estimated incidence of 107 per 100,000 a year. Diagnosis is simply made by testing the head in different positions and reproducing the vertigo along with a visible nystagmus (eye movement). The direction of the nystagmus indicates where the crystals are displaced. Although medication is typically given, it is purely a bandage and will not fix this issue.

Stopping the Spin Cycle

Treatment is performed with a maneuver, most commonly, the Epley maneuver. However, there are other maneuvers depending on the type of BPPV one has and therefore should always be treated by a medical professional. PTs will adjust a maneuver based on the patient’s limitation in movement or position. The Canadian Medical Association Journal reports that in 90% of cases, patients get better within 1-3 treatment sessions. Unfortunately, BPPV has a high recurrence rate of 50% within 5 years, mostly related to trauma, according to a report by the American Academy of Neurology. However, if the symptoms do return contact a local trained physical therapist for a quick treatment. In most states, and depending on one’s insurance, a doctor’s referral is not needed to see a physical therapist.

Although BPPV may be common, its effect can vary widely depending on the type a person suffers from. Effects can range from mild to devastating affecting daily function, personal safety, and an increased risk of falling. Banker advises, “Make sure that if you, your friends, or family members ever mention dizziness or vertigo, keep your vestibular certified physical therapist in mind so the condition can be treated effectively, and their dizzying sense of the world can be stopped!”

Specialists in Treatment

To treat BPPV, physical therapists and clinicians undergo rigorous training in the practical management of the condition. This includes instruction in the affected anatomy and physiology, pathophysiology, examination methods, and various maneuvers for canalith repositioning. They are also taught guidelines for post-treatment and instructing patients in home care.

Those affected by BPPV often go to their family doctor who may not be aware of highly effective treatments that are available. Their patients are often told to live with the condition and that it may subside on its own over time. Banker says, “Choosing to see a PT who is trained specifically to manage BPPV will ensure receiving the best treatment and outcome.”

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