DizzinessGroschan & Associates PT in Greater Baltimore

Vertigo, in particular "benign paroxysmal positional vertigo (BPPV)", is a common disorder in which the patient complains of spinning and dizziness with rapid changes in head positions.

BPPV is typically idiopathic (of unknown cause) in nature. Other reported causes are head trauma, vestibular neuritis (inflamed vestibulo-cochlear nerve), vertebrobasilar ischemia (inadequate blood flow to the brain), and inner ear infection.

It is hypothesized that small particles, (called otoconia) in the semi-circular canals, over-stimulate the sense organs (hair cells and cupula). This results in patient complaints of dizziness and the observation of nystagmus in the direction of head rotation. The dizziness may last anywhere from a few seconds to a minute and there may be associated nausea.

Brandt-Daroff and canalith repositioning movements (Epley Maneuver) are the most common therapeutic interventions. The goal of these treatments is to move the small particles within the semicircular canal to the utricle where they no longer are able to stimulate the sense organs within the canal.

Hi-quality research studies show significant numbers of patients that experience a resolution of symptoms and negative diagnostic tests for BPPV after treatment intervention as compared to the control groups.

While BPPV is a common diagnosis for those suffering from dizziness, there are other causes of vertigo (both central and peripheral). It is important to consult your doctor and physical therapist regarding proper diagnosis and treatment of vertigo.

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Frequently Asked Questions

A physical therapy visit lasts about 40-60 minutes. The actual contents of the visit vary based on your diagnosis/need, but typically what happens is:
1. You check in with the receptionist, make any appointments necessary, and we discuss your health insurance benefits with you.
2. You will be taken back to a room. You can change into other clothing if necessary.
3. The therapist will guide you in the treatment session as they deem appropriate after having a conversation about your current situation.
4. We can initiate other techniques to include manual work, taping, cupping, and dry needling as needed.
5. The therapist makes recommendations based on your progress. These can include altering the frequency of visits, making additions/alterations to your home exercise plan, or things to do before your next visit.
You will be with your therapist one on one for approximately 30 minutes. The only exception to this will be your first visit, which can take about 20 minutes longer due to the physical therapy evaluation your physical therapist will provide. We also recommend showing up about 20 minutes early to your first visit. This way, you can complete the paperwork before your visit time and streamline the process.
If we are asking you to do something that is hurting too much, let us know! Physical therapy should not be severely painful. It is not common to be so sore that patients are in pain or it affects their daily life. If this ever happens during or after an appointment, let us know and we will adapt your program.
During your initial evaluation, your therapist will take the time to get to know you and what is important to you. They will ask about the limitations you have and talk about your goals.

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