Physical therapy student Kristy Hoskins watches as Dr. Drew Nesbitt performs a vertigo checkup on Nancy Mitrotz.
Physical therapist Drew Nesbitt of Hartz Physical Therapy in Lititz talks to client Nancy Mitrotz about her vertigo problems.
Drew Nesbitt of Hartz Physical Therapy works on patient Nancy Mitrotz to alleviate the symptoms of her vertigo problems. Through maneuvering the head at different angles, physical therapists can help move crystals in the ear canal that can contribute to vertigo, reducing or getting rid of the symptoms.
When Nick Foster was hit with a bout of vertigo, it was incapacitating.
Although many of the bouts with the topsy-turvy condition came on when 61-year-old Foster of Harrisburg went from sitting to standing, he found himself almost afraid to move for fear it would hit him.
"I woke up one Sunday with it and spent a lot of the time sitting because I didn't want to feel that way," Foster said.
Vertigo can affect 10 percent of Americans at some point in their lives, according to physical therapist Drew Nesbitt of Hartz Physical Therapy Group in Lancaster and Lititz.
Different from lightheadedness, vertigo sufferers have the sensation that the room they're in, or they themselves, are moving or spinning. There are different kinds of vertigo; the most common is benign paroxysmal positional vertigo (BPPV). It's characterized by a sensation of motion initiated by sudden head movements or moving the head in a certain direction. This type of vertigo is not serious and can be treated, according to Nesbitt.
It is not known what causes vertigo. Some experts say head trauma, head colds or staying in a reclined position for too long. What is known is that crystals form in a person's ear and get lodged in one of the three rings within the ear canal, causing the imbalance. About 60 to 70 percent of those who experience vertigo suffer from the crystals in the ear, Nesbitt said.
"The person unknowingly will put himself in a position that creates the vertigo, and his room will be turned upside down," Nesbitt said.
Vertigo can last from several seconds to several minutes and make the sufferer feel almost like he or she is on a roller coaster, according to Nesbitt. Some sufferers may experience nausea from the imbalance.
One way of treating vertigo is to treat the dizziness with medicines such as meclizine, a type of antihistamine, according Anita Roma, physical therapist with Drevna Physical Therapy. However, according to Nesbitt and Roma, that just treats the dizzy feeling and not the actual problem that is creating the vertigo.
"Usually the patient has tried all kinds of things to help with the problem," Nesbitt said. Some of his patients, he said, have tried medicines, sea sickness bands and other home remedies.
"There are physical positions that can be done to help alleviate the vertigo symptoms almost immediately," Roma said.
Foster was able to see Nesbitt within a few days of his first bout with vertigo and received almost instant relief.
"It took a couple of sessions, but I felt better right after the last one and haven't had a problem since," Foster said.
These positions, collectively known as the Epley Maneuver and created by Oregon opthamologist Dr. John Epley, moves the crystals to a location in the ear that does not affect balance. There are other maneuvers that can also be done to help alleviate vertigo, but the Epley maneuver is one of the more commonly practiced.
"Once the positions are learned they can be done at home when the vertigo episodes happen," Nesbitt said.
However, Roma recommends that a professional perform the maneuvers.
"I know the angles that are required and have things that I look for when treating someone," Roma said.
The Epley maneuver does not work on every patient, Nesbitt warned, but he has treated at least 100 patients who got relief.
"I would say I have about a 90 percent success rate," Nesbitt said.
In assessing a patient, the patient is put in a state of vertigo to see where the ear canal is being affected. This is done by engaging the patient in certain positions and watching how the eyes react.
"The eyes are connected to a person's balance, and we can tell when the vertigo is in effect by watching the eyes' reaction," Nesbitt said. "It does make the person nervous because he doesn't want to feel the vertigo symptoms, but it is necessary to diagnose the vertigo."
Screening the patients properly to diagnose vertigo is important as there are other medical conditions that have the same symptoms, such as inner ear infections.
"I ask a lot of specific questions during the screening," Roma said. "Do they have difficulty when they sit down, stand up, roll over in bed or bend down?"
If it is determined that the person has vertigo, the maneuvers are done on the patient and then he or she is reassessed several weeks later.
"This is something that people should not have to suffer from," Roma said. "Nobody wants to walk around being scared of feeling dizzy or nauseous."
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