Neck

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Neck pain is a very common symptom that affects nearly 2/3 of all individuals during their lifetime. Neck pain can range from mild to severe depending on the injury and source of pain. It can be acute in nature and resolve within a few days or weeks, but it can also linger and become chronic.

There can be many causes neck pain that can result from an abnormal movement, traumatic incident, poor posture, or can develop over time without cause.

Neck pain that persists is mainly a sign that treatment is needed. An orthopedic injury, disease, congenital malformation, or age-related changes may be responsible for more significant pain. A trained medical professional must determine the underlying cause of such neck pain. Examination, diagnosis, and treatment by a physical therapist will help to relieve your pain in the short-term and in the long-term will help to prevent recurrence.

How can Physical Therapy Help?

Once your neck pain has been examined or physical therapist may determine that you have an orthopedic injury. This means the source of your pain is coming from your muscles, joints, or nerves. You may have pain locally at your neck, but your neck can also refer pain into your shoulders, shoulder blades, arms, and hands. Symptoms can include pain, numbness, or tingling. These can all be treated by a physical therapist!

Once you have gone through a full physical therapy examination, your therapist will determine the exact treatment that is going to relieve your pain. Treatments in physical therapy include the following:

  • Massage and soft tissue mobilization
  • Modalities to relieve acute pain
  • Neck traction to relieve nerve pain
  • Joint mobilization
  • Strengthening and flexibility exercises
  • Functional exercises to help you return to your daily life or work activities

Your treatment will be determined by your symptoms and is specifically designed for YOU!

Possible Treatments

  • Aerobic/Endurance Exercise
  • Core Strengthening
  • Cryotherapy or Cold Therapy
  • Electrotherapeutic Modalities
  • Heat Pack
  • Isometric Exercise
  • Neck Active Range of Motion
  • Neck Joint Mobilization
  • Neck Passive Range of Motion
  • Neck Resistive Range of Motion
  • Neck Traction
  • Posture Training
  • Proprioception Exercises
  • Physical Agents
  • Stretching/Flexibility Exercise

Possible Treatment Goals

  • Decrease Risk of Reoccurrence
  • Improve Fitness
  • Improve Function
  • Optimize Joint Alignment
  • Improve Muscle Strength and Power
  • Decrease Nerve Compression
  • Increase Oxygen to Tissues
  • Improve Proprioception
  • Improve Range of Motion
  • Improve Relaxation
  • Self-care of Symptoms
  • Improve Tolerance for Prolonged Activities

Whiplash or Whiplash Associated Disorder (WAD) describes the sudden forward and backward movement of the head and neck, most commonly occurring during a motor vehicle accident. It can also occur during a variety of other activities such as recreational and competitive sports. Note that a whiplash could also occur with rapid side-to-side movement as well.

WADs are estimated to cost consumers and the insurance industry billions of dollars each year. With a WAD there can be soft tissue injury, bone fracture, and nerve damage. Because of the considerable number of structures (bone, spinal cord, brain, ligament, intervertebral disc, muscle, joint capsule, and tendon) involved, recover can take months or years. However, most cases of whiplash resolve themselves of severity in a few months or less.

A classification of whiplash was offered by the Quebec Task Force (a group that did extensive study on Whiplash) :

  • No complaints about the neck, no physical signs.
  • Neck complaints of pain, stiffness, or tenderness only No physical signs.
  • Neck complaint AND Musculoskeletal signs (decreased range of motion and point tenderness).
  • Neck complaint AND neurological signs (decreased or absent deep tendon reflexes, weakness, and sensory deficits).
  • Neck complaints AND fracture or dislocation.

X-rays and other diagnostics may be performed by your physician to rule out fractures.

How can physical therapy help with Whiplash Associated Disorders?

Physical therapy can be very helpful with the recovery of range of motion, strength, endurance, and the management of pain. Soft collars are of little benefit but rigid collars may be helpful in the acute stages of recovery. Early on, treatment will be gentle and focused on pain relief and gaining mobility. As you progress, treatment will focus more on strengthening and return to function and daily activities. Sometimes these injuries can be more challenging than other cases of neck pain and symptoms, so seeing a physical therapist to help you recover is even more important!

Possible Treatments

  • Aerobic/Endurance Exercise
  • Core Strengthening
  • Cryotherapy or Cold Therapy
  • Electrotherapeutic Modalities
  • Heat Pack
  • Isometric Exercise
  • Neck Active Range of Motion
  • Neck Joint Mobilization
  • Neck Passive Range of Motion
  • Neck Resistive Range of Motion
  • Neck Traction
  • Posture Training
  • Proprioception Exercises
  • Physical Agents
  • Stretching/Flexibility Exercise

Possible Treatment Goals

  • Improve Fitness
  • Improve Function
  • Improve Muscle Strength and Power
  • Increase Oxygen to Tissues
  • Improve Proprioception
  • Improve Range of Motion
  • Improve Relaxation
  • Self-care of Symptoms
  • Improve Safety
  • Improve Tolerance for Prolonged Activities

Additional Resources

Temporomandibular disorder (TMD), is a term that describes an entire group of disorders involving the temporomandibular joint or joints (TMJ).

The TMJs are the jaw joints. There is one on each side of your head just in front of your ear canals. Like many other joints in the body, they consist of:

  • muscles that control joint movement,
  • ligaments that hold the bones together,
  • cartilage that provides a smooth surface for the bones to move on,
  • a disc that helps with proper movement, of the bones,
  • elastic tissue that helps hold the disc in place.

One or more of the above tissues can cause symptoms. In fact, studies suggest that one third of the population at any one time experiences TMJ symptoms such as pain with chewing, yawning, or jaw opening. Women seem to have TMJ problems much more often than men and it is estimated that 3-6% of the population might benefit from treatment.

There are a variety of temporomandibular disorders. The muscles (myogenous), joint(s) (arthrogenous), or a combination of the two may cause pain.

Since physical therapists treat muscle and joint problems, they are ideally suited to address a TMD. Moreover, a majority of patients diagnosed with TMD, also have associated neck pain. Both respond well to treatment provided by a physical therapist. No other healthcare practitioner is better suited to address both the TMD and neck pain.

TMD may appear to be a complex condition and it shouldn’t be. This website and your physical therapist can help to insure the following:

  • You are properly educated,
  • that your treatment is conservative, cost-effective, and reversible,
  • goals are realistic,
  • your examination is brief and meant to identify your source(s) of pain.

When a physical therapist performs the examination, they will be able to classify you as having one or more of the following:

  • An inflammatory condition
  • Limited jaw range of motion
  • Excessive jaw range of motion
  • Arthrogenous Disc Displacement
  • Jaw muscle pain
  • Neck pain causing related headaches (sometimes mistaken as TMD)

Once the involved structures are identified, the therapist will be able to provide you with the appropriate treatment.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Electrotherapeutic Modalities
  • Heat Pack
  • Iontophoresis
  • Neck Traction
  • Posture Training
  • Proprioception Exercises
  • Physical Agents
  • Stretching/Flexibility Exercise

Possible Treatment Goals

  • Decrease Risk of Reoccurrence
  • Improve Function
  • Improve Muscle Strength and Power
  • Improve Proprioception
  • Improve Range of Motion
  • Improve Relaxation
  • Self-care of Symptoms
  • Improve Tolerance for Prolonged Activities

Additional Resources

Epley Maneuver is Helpful for Vertigo

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.

More on Vertigo at the Mayo Clinic

  • Neck pain is a very common symptom that affects nearly 2/3 of all individuals during their lifetime. Neck pain can range from mild to severe depending on the injury and source of pain. It can be acute in nature and resolve within a few days or weeks, but it can also linger and become chronic.

    There can be many causes neck pain that can result from an abnormal movement, traumatic incident, poor posture, or can develop over time without cause.

    Neck pain that persists is mainly a sign that treatment is needed. An orthopedic injury, disease, congenital malformation, or age-related changes may be responsible for more significant pain. A trained medical professional must determine the underlying cause of such neck pain. Examination, diagnosis, and treatment by a physical therapist will help to relieve your pain in the short-term and in the long-term will help to prevent recurrence.

    How can Physical Therapy Help?

    Once your neck pain has been examined or physical therapist may determine that you have an orthopedic injury. This means the source of your pain is coming from your muscles, joints, or nerves. You may have pain locally at your neck, but your neck can also refer pain into your shoulders, shoulder blades, arms, and hands. Symptoms can include pain, numbness, or tingling. These can all be treated by a physical therapist!

    Once you have gone through a full physical therapy examination, your therapist will determine the exact treatment that is going to relieve your pain. Treatments in physical therapy include the following:

    • Massage and soft tissue mobilization
    • Modalities to relieve acute pain
    • Neck traction to relieve nerve pain
    • Joint mobilization
    • Strengthening and flexibility exercises
    • Functional exercises to help you return to your daily life or work activities

    Your treatment will be determined by your symptoms and is specifically designed for YOU!

    Treatments

    Aerobic/Endurance Exercise

    Stationary cycling is usually prescribed for improving the strength and/or range of motion of the hips, knees, ankles as well as cardio-vascular endurance.

    Core Strengthening

    The trunk and its associated muscles make up the core. The extremities are the arms, forearms, hands, thighs, legs, ankles/feet. Strong core muscles provide a foundation for the extremities to attach to and work more efficiently. It is hypothesized that a weak core can cause excessive stress on the extremity muscles, tendons, ligaments and joints. Core strengthening is a multi-joint exercise, involving larger muscle groups such as the chest, back, abdominals, back, hip/thigh, and shoulder blade muscles. Core strengthening is often incorporated as part of a low back or neck rehabilitation program. Because recovery or enhancement of core strength provides a stable base for the extremities, it is also commonly part of an arm, forearm, thigh, leg or ankle program.

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Electrotherapeutic Modalities

    Possible Treatments

    • Neuromuscular Electrical Stimulation
    • Transcutaneous Electrical Nerve Stimulation (TENS)
    • Iontophoresis
    Heat Pack

    Heat is recommended to decrease chronic pain, relax muscles, and for pain relief. It should not be used with an acute or “new” injury.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Neck Active Range of Motion

    AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Neck Joint Mobilization

    Hands-on therapeutic procedures intended to increase soft tissue or neck joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.

    Neck Passive Range of Motion

    The movement of the neck, by the patient or therapist, through a range of motion without the use of the muscles that “actively” move the joint(s).

    Neck Resistive Range of Motion

    Exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

    Neck Traction

    A gentle longitudinal/axial pull on the neck, either manual or mechanical, intermittent or continuous for relief of neck pain, to decrease muscle spasm, and facilitate unloading of the spine.

    Posture Training

    Instruction in the correct biomechanical alignment of the body to reduce undue strain on muscles, joints, ligaments, discs, and other soft tissues. There is an ideal posture but most do not have it. Therapists educate patients about the importance of improving posture and body mechanics with daily activities. Stretching and strengthening exercises may be prescribed to facilitate postural improvement and to prevent further disability and future recurrences of problems.

    Proprioception Exercises

    Proprioception is the body’s ability to sense where it is in space. For example, close your eyes and touch your nose. How were you able to move your finger to your nose without seeing it? Proprioception exercises are used to help retrain your sensory system after the nerves have been damaged during a musculoskeletal injury. Your body uses its sensory system in the joints and muscles to know how they are moving. Balance and coordination both depend on your body’s proprioceptive skills.

    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound
    Stretching/Flexibility Exercise

    Exercise designed to lengthen a muscle(s) or soft tissue. Stretching exercises are usually prescribed to improve the flexibility of muscles that have tightened due to disuse or in compensation to pain, spasm or immobilization.

    Goals

    • Decrease Risk of Reoccurrence
    • Improve Fitness
    • Improve Function
    • Optimize Joint Alignment
    • Improve Muscle Strength and Power
    • Decrease Nerve Compression
    • Increase Oxygen to Tissues
    • Improve Proprioception
    • Improve Range of Motion
    • Improve Relaxation
    • Self-care of Symptoms
    • Improve Tolerance for Prolonged Activities

    Resources

  • Whiplash or Whiplash Associated Disorder (WAD) describes the sudden forward and backward movement of the head and neck, most commonly occurring during a motor vehicle accident. It can also occur during a variety of other activities such as recreational and competitive sports. Note that a whiplash could also occur with rapid side-to-side movement as well.

    WADs are estimated to cost consumers and the insurance industry billions of dollars each year. With a WAD there can be soft tissue injury, bone fracture, and nerve damage. Because of the considerable number of structures (bone, spinal cord, brain, ligament, intervertebral disc, muscle, joint capsule, and tendon) involved, recover can take months or years. However, most cases of whiplash resolve themselves of severity in a few months or less.

    A classification of whiplash was offered by the Quebec Task Force (a group that did extensive study on Whiplash) :

    • No complaints about the neck, no physical signs.
    • Neck complaints of pain, stiffness, or tenderness only No physical signs.
    • Neck complaint AND Musculoskeletal signs (decreased range of motion and point tenderness).
    • Neck complaint AND neurological signs (decreased or absent deep tendon reflexes, weakness, and sensory deficits).
    • Neck complaints AND fracture or dislocation.

    X-rays and other diagnostics may be performed by your physician to rule out fractures.

    How can physical therapy help with Whiplash Associated Disorders?

    Physical therapy can be very helpful with the recovery of range of motion, strength, endurance, and the management of pain. Soft collars are of little benefit but rigid collars may be helpful in the acute stages of recovery. Early on, treatment will be gentle and focused on pain relief and gaining mobility. As you progress, treatment will focus more on strengthening and return to function and daily activities. Sometimes these injuries can be more challenging than other cases of neck pain and symptoms, so seeing a physical therapist to help you recover is even more important!

    Treatments

    Aerobic/Endurance Exercise

    Stationary cycling is usually prescribed for improving the strength and/or range of motion of the hips, knees, ankles as well as cardio-vascular endurance.

    Core Strengthening

    The trunk and its associated muscles make up the core. The extremities are the arms, forearms, hands, thighs, legs, ankles/feet. Strong core muscles provide a foundation for the extremities to attach to and work more efficiently. It is hypothesized that a weak core can cause excessive stress on the extremity muscles, tendons, ligaments and joints. Core strengthening is a multi-joint exercise, involving larger muscle groups such as the chest, back, abdominals, back, hip/thigh, and shoulder blade muscles. Core strengthening is often incorporated as part of a low back or neck rehabilitation program. Because recovery or enhancement of core strength provides a stable base for the extremities, it is also commonly part of an arm, forearm, thigh, leg or ankle program.

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Electrotherapeutic Modalities

    Possible Treatments

    • Neuromuscular Electrical Stimulation
    • Transcutaneous Electrical Nerve Stimulation (TENS)
    • Iontophoresis
    Heat Pack

    Heat is recommended to decrease chronic pain, relax muscles, and for pain relief. It should not be used with an acute or “new” injury.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Neck Active Range of Motion

    AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Neck Joint Mobilization

    Hands-on therapeutic procedures intended to increase soft tissue or neck joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.

    Neck Passive Range of Motion

    The movement of the neck, by the patient or therapist, through a range of motion without the use of the muscles that “actively” move the joint(s).

    Neck Resistive Range of Motion

    Exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

    Neck Traction

    A gentle longitudinal/axial pull on the neck, either manual or mechanical, intermittent or continuous for relief of neck pain, to decrease muscle spasm, and facilitate unloading of the spine.

    Posture Training

    Instruction in the correct biomechanical alignment of the body to reduce undue strain on muscles, joints, ligaments, discs, and other soft tissues. There is an ideal posture but most do not have it. Therapists educate patients about the importance of improving posture and body mechanics with daily activities. Stretching and strengthening exercises may be prescribed to facilitate postural improvement and to prevent further disability and future recurrences of problems.

    Proprioception Exercises

    Proprioception is the body’s ability to sense where it is in space. For example, close your eyes and touch your nose. How were you able to move your finger to your nose without seeing it? Proprioception exercises are used to help retrain your sensory system after the nerves have been damaged during a musculoskeletal injury. Your body uses its sensory system in the joints and muscles to know how they are moving. Balance and coordination both depend on your body’s proprioceptive skills.

    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound
    Stretching/Flexibility Exercise

    Exercise designed to lengthen a muscle(s) or soft tissue. Stretching exercises are usually prescribed to improve the flexibility of muscles that have tightened due to disuse or in compensation to pain, spasm or immobilization.

    Goals

    • Improve Fitness
    • Improve Function
    • Improve Muscle Strength and Power
    • Increase Oxygen to Tissues
    • Improve Proprioception
    • Improve Range of Motion
    • Improve Relaxation
    • Self-care of Symptoms
    • Improve Safety
    • Improve Tolerance for Prolonged Activities

    Resources

  • Temporomandibular disorder (TMD), is a term that describes an entire group of disorders involving the temporomandibular joint or joints (TMJ).

    The TMJs are the jaw joints. There is one on each side of your head just in front of your ear canals. Like many other joints in the body, they consist of:

    • muscles that control joint movement,
    • ligaments that hold the bones together,
    • cartilage that provides a smooth surface for the bones to move on,
    • a disc that helps with proper movement, of the bones,
    • elastic tissue that helps hold the disc in place.

    One or more of the above tissues can cause symptoms. In fact, studies suggest that one third of the population at any one time experiences TMJ symptoms such as pain with chewing, yawning, or jaw opening. Women seem to have TMJ problems much more often than men and it is estimated that 3-6% of the population might benefit from treatment.

    There are a variety of temporomandibular disorders. The muscles (myogenous), joint(s) (arthrogenous), or a combination of the two may cause pain.

    Since physical therapists treat muscle and joint problems, they are ideally suited to address a TMD. Moreover, a majority of patients diagnosed with TMD, also have associated neck pain. Both respond well to treatment provided by a physical therapist. No other healthcare practitioner is better suited to address both the TMD and neck pain.

    TMD may appear to be a complex condition and it shouldn’t be. This website and your physical therapist can help to insure the following:

    • You are properly educated,
    • that your treatment is conservative, cost-effective, and reversible,
    • goals are realistic,
    • your examination is brief and meant to identify your source(s) of pain.

    When a physical therapist performs the examination, they will be able to classify you as having one or more of the following:

    • An inflammatory condition
    • Limited jaw range of motion
    • Excessive jaw range of motion
    • Arthrogenous Disc Displacement
    • Jaw muscle pain
    • Neck pain causing related headaches (sometimes mistaken as TMD)

    Once the involved structures are identified, the therapist will be able to provide you with the appropriate treatment.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Electrotherapeutic Modalities

    Possible Treatments

    • Neuromuscular Electrical Stimulation
    • Transcutaneous Electrical Nerve Stimulation (TENS)
    • Iontophoresis
    Heat Pack

    Heat is recommended to decrease chronic pain, relax muscles, and for pain relief. It should not be used with an acute or “new” injury.

    Iontophoresis

    Medications are propelled through the skin by an electrical charge. This modality works on the physical concept that like charges repel each other, therefore, a positively charged medication will be repelled through the skin to the underlying tissues by the positively charged pad of an iontophoresis machine. Iontophoresis is usually prescribed for injuries such as shoulder or elbow bursitis.

    Neck Traction

    A gentle longitudinal/axial pull on the neck, either manual or mechanical, intermittent or continuous for relief of neck pain, to decrease muscle spasm, and facilitate unloading of the spine.

    Posture Training

    Instruction in the correct biomechanical alignment of the body to reduce undue strain on muscles, joints, ligaments, discs, and other soft tissues. There is an ideal posture but most do not have it. Therapists educate patients about the importance of improving posture and body mechanics with daily activities. Stretching and strengthening exercises may be prescribed to facilitate postural improvement and to prevent further disability and future recurrences of problems.

    Proprioception Exercises

    Proprioception is the body’s ability to sense where it is in space. For example, close your eyes and touch your nose. How were you able to move your finger to your nose without seeing it? Proprioception exercises are used to help retrain your sensory system after the nerves have been damaged during a musculoskeletal injury. Your body uses its sensory system in the joints and muscles to know how they are moving. Balance and coordination both depend on your body’s proprioceptive skills.

    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound
    Stretching/Flexibility Exercise

    Exercise designed to lengthen a muscle(s) or soft tissue. Stretching exercises are usually prescribed to improve the flexibility of muscles that have tightened due to disuse or in compensation to pain, spasm or immobilization.

    Goals

    • Decrease Risk of Reoccurrence
    • Improve Function
    • Improve Muscle Strength and Power
    • Improve Proprioception
    • Improve Range of Motion
    • Improve Relaxation
    • Self-care of Symptoms
    • Improve Tolerance for Prolonged Activities

    Resources

  • Epley Maneuver is Helpful for Vertigo

    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.

    More on Vertigo at the Mayo Clinic