physiotherapy treatment for BPPV vertigo

Vertigo, Vestibular Rehabilitation Therapy

Vestibular Rehabilitation Therapy (VRT) is an exercise-based program for reducing the symptoms of disequilibrium and dizziness associated with vestibular problems like vertigo. ReLiva Physiotherapy provides vestibular rehabilitation with a neuro-otological approach for managing such symptoms at its clinics in Navi Mumbai and Thane.

VRT is an alternative treatment involving specific exercises that can eliminate or significantly reduce symptoms of vertigo by promoting central nervous system compensation for inner-ear deficits. The program is designed to achieve these goals:

  • 1. Decrease dizziness and visual symptoms.
  • 2. Increase balance and walking functions.
  • 3. Increase general activity levels.

Typically the VRT would include:

1. Canalith repositioning maneuver/ Epley maneuver:

Designed for inner ear condition known as Benign Paroxysmal Positioning Vertigo (BPPV). This condition occurs when crystals in inner ear gets dislodged and float in the ear canal. Canalith repositioning maneuvers are very effective in case of BPPV and may require only couple of sessions.

2. Vestibular retraining:

This program would typically include exercises for improving coordination of eye and head movements, balance retraining and desensitization of the vestibular system. This part of the therapy would typically require 8 – 12 sessions. In some cases where significant balance and walking training is required it may require many more sessions.

3. Self Exercise Program:

We educate our clients on the exercises they need to continue to manage their symptoms by themselves at home and continued improvement in fitness and endurance. Person entering a vestibular rehabilitation program needs to undergo a detailed assessment prior to starting the program because not all dizziness is caused by vestibular deficits.

Many times, vertigo is felt due to cervical spondylosis for which a different treatment program is prescribed

What is Vertigo ?

Vertigo is a more like a symptom, rather than a condition itself. It is the sensation that you, or the environment around you, is moving or spinning.

Typically you would feel a loss of balance (which can make it difficult to stand or walk), nauseous and dizzy. Basically the feelings of unsteadiness; wooziness (swimming feeling in head); lightheadedness; feelings of passing out; and sensations of moving, spinning, floating, swaying, tilting, or whirling. These sensations can occur when standing still, lying down or when changing positions.

Feeling of vertigo at times can develop suddenly and may last for a few seconds, or it may last longer. Severe vertigo can lead to constant symptoms which could make normal life very difficult.

What causes Vertigo ?

Vertigo is commonly caused by a problem with the way balance works in the inner ear, although it can also be caused by problems in certain parts of the brain.

Vertigo, dizziness and imbalance are the frequent symptoms in patients who suffer trauma to the head, neck or craniovertebral junction and can result in peripheral or central vestibular dysfunction.

Once trauma, infection, injury or other underlying causes are ruled out, doctors typically zero in on a diagnosis of either Meniere’s disease or Benign Paroxysmal Positional Vertigo (BPPV). These two otherwise benign conditions are the leading causes of vertigo, with a fifth of all cases attributed to BPPV.

Both Meniere’s and BPPV result from disorders of the inner ear, which contains the body’s balance mechanism. Their causes are not known (they are not caused by injury or infection), but the disturbances affect the sense of equilibrium

What is the recovery Vertigo patient can expect with Vestibular Rehabilitation ?

As per Cleveland Clinic, in most cases, if patients continue to perform the exercises they have learned, balance and dizziness problems decrease significantly or completely disappear.  Read More

Vestibular Disorder Association, USA, says that vestibular rehabilitation can be effective in improving symptoms related to many vestibular (inner ear/balance) disorders.  Read More

Expected vestibular rehabilitation outcomes include:

  • Decreased fall risk
  • Decreased dizziness symptoms
  • Improved balance
  • Improved ability to stabilize vision/gaze
  • Increased body strength
  • Return to prior level of movement/function
  • Increase in confidence in ability to maintain balance
  • Improved neck motion, reduced symptoms

How Common is Vertigo ?

As per Medscape, the overall incidence of dizziness, vertigo, and imbalance is 5-10%, and it reaches 40% in patients older than 40 years. The incidence of falling is 25% in subjects older than 65 years. A report reviewing presentation to US emergency departments (EDs) from 1995 through 2004 indicated that vertigo and dizziness accounted for 2.5% of presentations. The estimated number of 2011 US ED visits for dizziness or vertigo was 3.9 million.

pain relief exercises in office

Stretching Exercises in Office: Neck, Back pain

Quick tips for pain relief!

Be Active at workplace. Do these simple stretching exercises while standing anywhere in office to avoid that pain – either in the back or neck! This poster from ReLiva is intended to support individuals and organisations in the promotion of physical activity in the workplace and to reduce sedentary behaviour.

Taking the time to stretch throughout the day anywhere – in office or at home, can have numerous health benefits. Stretching can improve flexibility and is an important activity to warm up or cool down after exercise. Stretching can also be a fun and healthy break from your computer screen during the work day. This along with correct posture while sitting at your desk, also helps you to keep all those pain in the back and neck away.

This newly developed Standing Stretch Sheet is perfect to do before a lunchtime walk, and for those who have standing roles. The 5 Minute Office Stretch Sheet while sitting at your work desk also provides you with 6 simple and effective stretches that you can complete whilst sitting at your work station.

We recommend you repeat each stretch twice, and hold each time for 20 seconds.

Print a copy and pin it up next to your workstation to remind you and your colleagues – Have you stretched today?

ReLiva stretching Exercises for back, neck pain in office, standing

home remedy for neck pain

Neck Pain: Managing at Home

Neck pain or a stiff neck is a common problem and usually nothing to worry about, except that it may be far more troubling.Neck Pain : Healing at Home

Neck pain or a stiff neck are extremely common and can affect your life in so many different ways.  Whether it is sharp neck pain, dull muscular aches, headache, or an inability to fully move your head, a sore neck, it can be very frustrating yet it’s simple to fix in the majority of cases.

The pain and stiffness usually gets better after a few days or weeks, and is rarely a sign of a more serious problem.

Neck pain can occur anywhere in your neck, from the bottom of your head to the top of your shoulders. It can spread to your upper back or arms. It may limit how much you can move your head and neck.

What Causes Neck Pain / Stiffness?

Neck pain can be caused by any of these:

1. An activity that harms/strains the neck.

You can get a painful or stiff neck if you sleep in an awkward position, use a computer for a prolonged period of time, or strain a muscle because of bad posture like slouching, continuously looking at an elevated screen etc. Anxiety and stress can also sometimes cause tension in your neck muscles, which can lead to pain in your neck.

2. An injury.

Neck pain can also be caused by an injury. A fall from a ladder or whiplash from a car accident can cause neck pain.

3. A medical condition.

Some less common medical problems like an infection in the neck, narrowing of the spinal canal  in the neck (Cervical Spinal Stenosis), Rheumatoid Arthritis can also lead to neck pain.

In such cases the symptoms are far more acute. You may feel a knot, stiffness, or severe pain in your neck. The pain may spread to your shoulders, upper back, or arms. You may get a headache. You may not be able to move or turn your head and neck easily. Sometimes you might have pain that shoots down your arm, ­­numbness, tingling, or weakness in your arm. If you have such severe symptoms, you need immediate medical attention.

Whatever it may be, it is important to make an accurate diagnosis of the cause of your neck pain so that appropriate treatment can be directed at the cause. In most cases caused by the first reason – neck strain, you can normally manage your symptoms at home by following the advice below.

Managing Neck Pain at Home

For most of neck pain cases caused by strain/ posture, the advice is generally the same: carry on with your normal daily activities, keep active, and ease your neck to relieve the symptoms. You can also take these steps to manage your pain:

  • Try holding a hot water bottle or heat pack to your neck – this can help reduce the pain and any muscle spasms, although some people find cold packs offer better relief
  • Sleep on a low, firm pillow at night – using too many pillows may force your neck to bend unnaturally
  • Check your posture – bad posture can aggravate the pain, and it may have caused it in the first place
  • Avoid driving if you find it difficult to turn your head – this may prevent you being able to view traffic
  • If your neck is stiff or twisted, try some neck exercises – gently tense your neck muscles as you tilt your head up and down and from side to side, and as you carefully twist your neck from left to right; these exercises will help strengthen your neck muscles and improve your range of movement
  • If the pain or stiffness does not improve after a few days, or if you are worried your neck pain could have a more serious cause, you should see a doctor or Physiotherapist without further delay.

You can write to for more information and to receive document on neck exercises.

What Increases Your Risk?

Certain conditions can increase or decrease the chances of you getting a neck pain. Some of these are controllable and can be worked upon, while there are few others that remain beyond control.

Uncontrollable Risk factors for Neck Pain:

  • Age. People who are middle-aged or older are more likely to have breakdown (degeneration) of discs or joints, as well as bone spurs in the vertebrae of the neck (cervical spondylosis).
  • Recent injury or history of injury. A common injury to the neck is whiplash caused by a car accident.
  • Conditions that affect the bones and soft tissues of the neck and back, such as rheumatoid arthritis, a narrowing of the spinal canal (cervical spinal stenosis), or a severely curved spine (scoliosis).
  • A history of headaches.

Controllable Risk factors for Neck Pain:

  • Awkward positions that put stress on the neck, or poor posture at home or at work.
  • Stress or depression, or boredom at or unhappiness with work.
  • Heavy physical work.
  • Smoking or drug abuse.
  • Poor physical condition and lack of exercise

The human body is incredibly talented and will adjust itself so that other joints or muscles move further or work harder than they should to self-manage the pain. While this is usually okay on the short term, it’s devastating in the long term for neck pain. Unfortunately the result is often chronic neck pain, neck stiffness, headaches, wry neck or even tension type migraine.

Luckily, there is a very quick, extremely safe and long-term solution. And it’s waiting for you at ReLivaTM Physiotherapy & Rehab

Physiotherapy and Neck Pain

When you visit a physical therapist, you’ll first have a complete evaluation to assess the extent of movement, strength, reflexes and other potential sources of pain in the neck.

We understand that neck pain is not solely about joints and not solely about neck muscles. There is a whole gambit of information that your physiotherapist will analyse and correct if needed to resolve your individual problem. New research has shown that a combination of neck joint and muscle treatment performed by your physiotherapist and some specific strengthening exercises are an effective way to eliminate your neck pain, stiffness and headaches.

During treatment, your physiotherapist will work on relieving pain, strengthening your neck muscles and also help you improve your posture and range of motion. To help you learn proper postures, the physiotherapist might have you stand in front of a mirror while exercising so that you can see your mistakes and correct them.

The good news is that you can also reduce your chances of neck pain returning significantly if you do the right thing quickly. Please contact us for more specific advice on your neck pain.

SELF HELP ADVICE-  You may find the following advice helpful in preventing neck pain:

Do’ s :

  1. Make sure you have good posture when sitting and standing
  2. Take regular breaks from your desk, driving or any activity where your neck is held in the same position for a long period of time
  3. If you often feel stressed, tryrelaxation techniquesto help ease any tension in your neck
  4. Do turn to one side while getting up from supine/sleeping position.
  5. Use hot pack for your neck.
  6. Use towel roll under the neck during supine lying.
  7. Use pillow of normal thickness in side lying position.
  8. Use a seat belt when in a car.
  9. Make sure your mattress is relatively firm – a soft mattress could mean your neck is bent while you sleep
  10. You should retract your shoulders (move shoulders backward) atleast once every hour.

Don’t s :

  1. Avoid sleeping on your front, and make sure your head is in line with your body (not tilted to the side) if you sleep on your side
  2. Don’t bend your neck for a prolonged period of time.
  3. Avoid sitting for prolonged period of time in stressful posture.
  4. Do not lift heavy weights on head or back.
  5. Do not drive for long hours; take breaks.
  6. Avoid habit of holding the telephone on one shoulder and leaning at it for a long time.
  7. Do not take many pillows  (usually only one) to keep your head level with your body, while sleeping.
  8. In order to turn around, do not twist your neck or the body; instead turn around by moving your feet first.

“This article is purely for general information. Please contact your healthcare expert for specialised medical care. Please go through our Disclaimer and Privacy policy.

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