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 "I just have to tell you how much I appreciate your help in straightening out my Vertigo.  I was in sad shape when I came in and by three visits I was better! You're a miracle worker!"


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Dizziness or veritgo can be caused by many things including:  medications, abnormal blood pressure, and inner ear infections. The most coommon cause of dizziness, however, is benign paroxysmal positional vertigo also known as BPPV.  BPPV is a common disorder, and it can be very debilitating, confining sufferers to their homes in many cases.  Unfortunately, many people suffer from BPPV either due to mis-diagnosis or improper treatment.  Dizziness caused by BPPV typically occurs with changes in head positions, it usually lasts between 15-60 seconds, and it can be very severe, resulting in falls.  Most people suffering with BPPV can't recall any specific cause of their dizziness. Others, however, report mild head trauma, an ear infection, or having cold symptoms days prior to the onset of their symptoms.  Also, BPPV does occur more frequently with age as most sufferers are between the ages of 60 and 80 years old; though younger adults do experience BPPV.  

What causes BPPV?

The inner ear is a very complex structure that allows us to feel velocity changes (For example, a passenger in a jet can feel when the plane slightly slows down or speeds up although they have no visual point of reference).  Each inner ear contains 3 semicircular ducts or canals oriented at right angles to one another (See image below). 


These canals are hollow, fluid-filled tubes.  These tubes are attached to a structure call the utricle that have many finger-like structures (called hair cells or cillia) projecting from the inner walls.  The tips of these hair cells contain flattened crystals whose function is similar to that of a sail on a sail boat.  The base of the hair cells is attached to tiny nerves that go to the brain.

 With head movement or body movement, the fluid in the canals normally moves in the direction opposite the head movement.  Similar to how the sails of a sail boat catch the wind in order to move the boat, the crystals attached to the hair cells catch the fluid of the canal when it moves bending the hair cells in the direction of fluid movement.  This bending stimulates the nerves attached to the hair cells, and it sends sensory information to the brain.  The brain processes this information from the semicircular canals to let us know in what direction we are moving.   

In patients suffering from BPPV, these small crystals have somehow become detached from the hair cells and are floating freely inside the semi-circular canals.  As a result, certain head positions or movements will disperse these free-floating crystals causing them to randomly stimulate the hair cells.  Because the brain can't interpret this unusual sensory input, the result is the patient's complaints of dizziness.  In addition, rapid eye movements (called nystagmus) may be observed during the episodes of dizziness.  The dizziness may last anywhere from a few seconds to a minute, and there may be associated nausea and vomiting.

Though BPPV can be very debilitating, the good news is that it is a condition that can be treated very quickly and effectively.  At ELEVATE, our physical therapists are experts in treating dizziness caused by BPPV. Approximately 50% of all our patients have symptom resolution within 3 visits, while 95% are symptom free by week four.  It's been our observation that the longer the symptoms have been going on, the longer it takes to treat; so don't wait!  

BPPV can be very debilitating, and it can cause frequent falls resulting in fractures or more serious injuries.  If you or someone you know is suffering from the debilitating and, many times, dangerous effects of BPPV, call our office today.  We can get you "back into life!"




Within a given year, 90% of men and 95% of women have at least one headache, and recent studies show that more than 45 million americans suffer from chronic recurring headaches. Additionally, more than 20% of all young people in the United States experience chronic headaches. 

Headaches have many different causes. They are generally classified as either a primary headache or a secondary headache.  A primary headache is caused by dysfunction or overactivity of pain-sensitive features in your head. A primary headache is not a symptom of an underlying disease such as cancer.

A secondary headache is a symptom of a disease that can activate the pain-sensitive nerves of the head. Any number of conditions — varying greatly in severity — may cause secondary headaches. 

Tension headaches are a type of primary headache and are by far the most common type of headache.  It is estimated that about 30%-80% of the adult U.S. population suffers from occasional tension headaches; and, approximately 3% suffer from chronic daily tension headaches. Women are twice as likely to suffer from tension-type headaches as men, and most people with episodic tension headaches have them no more than once or twice a month, but the headaches can occur more frequently.  Chronic tension headaches tend to be more common in females, and many people with chronic tension headaches usually have had the headaches for more than 60-90 days.   
A tension headache is named not only for the role that stress may play in triggering the pain, but also for the contraction of the neck, face, and scalp muscles brought on by stressful events. Tension headaches are a severe (but temporary) form of a muscle-contraction headache. The pain can range from mild to moderate, and it feels like pressure is being applied to the base of the head or neck.

What Causes Tension Headaches?

There is no single cause for tension headaches. This type of headache is not an inherited trait that runs in families. In some people, tension headaches are caused by tightened muscles in the back of the neck and scalp. This muscle tension may be caused by:

  • Degenerative disc disease
  • Herniated disc
  • Inadequate rest
  • Poor posture
  • Emotional or mental stress, including depression
  • Anxiety
  • Fatigue
  • Overexertion

Tension headaches tend to occur at increased frequency when there is also an underlying neck problem such as:  history of neck strains, disc herniation, or degenerative disc disease.  Over time, these neck problems can result in stiffness of the joints that make up the cervical spine and weakness in the muscles that support the neck.  These range of motion and strength impairments can put the neck muscles at a disadvantage in supporting the head and neck.  The average head weighs up to 12 pounds.  Needless to say, weakened neck muscles can become unable to efficiently hold up the head during normal activities.  With the fatigue of these muscles, muscle tension increases and neck pain occurs.  The pain typically begins at the base of the skull where the large muscles (upper trapezius muscles) attach.  The head pain will increase in intensity and radiate around the head as this process progresses-producing a tension headache.  Usually, these tension headaches begin mid-day and worsen throughout the afternoon and evening if rest from activity doesn't occur. 

 At ELEVATE, our therapists have extensive experience in treating these types of tension headaches.  We will assist you in normalizing the postural, range of motion, and strength impairments required to provide long-term headache relief and prevention.  In addition, we utilize the most effective and revolutionary treatments available to provide quick, lasting pain relief to help you manage your headaches and return to a normal, active lifestyle.  Don't let the debilitating effects of tension headaches keep you down.  Call our office today at (828) 877-2110!