Benign Paroxysmal Positional Vertigo (BPPV)
I recently suffered my 2nd episode of vertigo - more specifically BPPV. Benign (not life-threatening), Paroxysmal (it comes in sudden, brief spells), Positional (it gets triggered by certain head positions or movements) Vertigo (a false sense of rotational movement). Several people have asked me about it - How do you treat it? Prevent it? And so, I thought I would write a blog post explaining my own experience with BPPV.
First, let's look at the allopathic definition of What is BPPV? According to http://vestibular.org/understanding-vestibular-disorders/types-vestibular-disorders/benign-paroxysmal-positional-vertigo, "BPPV is a mechanical problem in the inner ear. It occurs when some of the calcium carbonate crystals (otoconia) that are normally embedded in gel in the utricle become dislodged and migrate into one or more of the 3 fluid-filled semicircular canals, where they are not supposed to be. When enough of these particles accumulate in one of the canals they interfere with the normal fluid movement that these canals use to sense head motion, causing the inner ear to send false signals to the brain." It is important to note that there are other causes of vertigo including ear infections and more serious conditions like Meniere's disease. Vertigo can also be a symptom of stroke. So, as always, it's best to get a diagnosis from a doctor. There is a very simple test they do to confirm BPPV. From the Hopkins medicine website: https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/vestibular/conditions/benign_paroxysmal_positional_vertigo.html "Benign paroxysmal positional vertigo (BPPV) is the most common of the vestibular disorders and is easily treated. This condition can affect people of all ages, but is most common in people over the age of 60. BPPV symptoms include episodic vertigo when your head is tilted up, or when you are turning over in bed or maneuvering out of bed. " "Once you get a diagnosis of BPPV, your specialist may treat you with the Epley maneuver, a simple physical therapy procedure. The Epley maneuver addresses the root cause of BPPV – calcium crystals in a chamber of the inner ear, called the semicircular canals, which are responsible for balance and perception. The Epley maneuver uses gravity to move the calcium crystals out of the chambers of your ear. Afterward, the crystals are harmlessly absorbed by the body over several days to weeks. Sometimes the crystals fall back into the semicircular canal and get stuck again before the body has time to reabsorb them. If this happens, your doctor can repeat the Epley maneuver or recommend that you perform the Epley maneuver at home." (For more information on the Epley Maneuver: https://www.hopkinsmedicine.org/healthlibrary/test_procedures/other/home_epley_maneuver_135,405 ) It is important to note that this maneuver doesn't work the same for everyone. When I experienced BPPV the first time, I had to repeat the maneuver twice a day for 4 days before I felt better. The 2nd time I experienced BPPV, I decided to explore it from an Ayurvedic perspective. (This is NOT medical advice, and I am not a doctor. This is simply an accounting of how I worked with my vertigo, since several people have asked me if yoga or herbs can help BPPV.) From an Ayurvedic perspective, I treated my BPPV as a "Vata" disorder - as Vata governs movement, including nerve impulses and the movement of the blood via the circulatory system. My 2nd attack happened at 3am when I simply turned over in the middle of the night. I opened my eyes and the room was spinning uncontrollably. Because I had had it before, I knew what it was. I rolled slowly back onto my other side and closed my eyes until the room stopped spinning. I lay there, and tried to ground myself until I got up at 5:30am. I was nauseous from the spinning, so I held Adhi mudra, and did my own body relaxation exercise, allowing my body to be heavy and sink into the bed. When I got up, I moved very slowly, especially when positioning my head. I got on the floor and actually did some yoga. I felt a need to ground down and be close to the earth. Depending on which ear has dislodged particles, and how the particles are dislodged, different people may experience vertigo in different positions and movements. For me, I could not lay on my back when I had BPPV. This last time, my back and shoulders were hurting badly from a poor nights sleep lying on one side, so I sat on the floor and began with gentle shoulder circles and neck stretches. I was able to slowly turn my head and stretch my neck. (this may not work for everyone - the key is SLOW movement - if you begin to feel vertigo - STOP!). I should mention that I am an inquistive person about my own body and through yoga, I have learned to listen to what it needs. I got on all fours and did some cat/cow and sunbird stretches for my back and legs. I came into Child's pose and rested my forehead on the backs of my hand. Some will say that forward folds are contraindicated for vertigo in general, but this is really an individual thing. Folding forward is grounding for me and hasn't yet triggered my vertigo. However, going backwards (onto my back) does trigger vertigo for me. Twists are also generally NOT a good idea with vertigo. I was able to do downward facing dog, and come forward to plank and lie down on my belly, which felt good for my nausea. I did some back stretches here, including 1/2 shalabasana with opposite arm and leg. I came back to downdog and stepped to uttanasana. Coming up was not easy, so I squatted, bending my knees and leaning forwards, coming up very slowly. I was able to do a few standing poses and ended seated again. I did several rounds of alternate nostril breathing to clear my focus. Vertigo often makes you feel nauseous and some people even experience vomiting. For me, I had mild nausea, and I wanted to fill my empty belly with earthy, grounding foods. Warm, liquidy foods are good to counter excess vata - like oatmeal or soup. Yogurt, eggs and oily foods like nuts and seeds may also be helpful. I ate oatmeal for breakfast and later made kitchari for lunch - a highly digestible Indian dish made with basmati rice and yellow mung beans and Indian spices that are good for the digestive system. Ginger tea is helpful because it is warming and helps counter the nausea. Gingko leaf is also good for stimulating circulation to the brain, and may be helpful long term in preventing future episodes, but this has not researched (to my knowledge), and I have not yet tried it for this condition. Also, because vertigo is a Vata disorder, it may be helpful to oil the nose and ears. I have never done the ear oiling. I do use Nasya oil for my nostrils sometimes, but haven't yet tried it for vertigo. One of the keys to dealing with BPPV is moving slowly and mindfully, so as not to trigger the vertigo. - If you are experiencing this condition of high Vata - perhaps your body is telling you to slow down and ground yourself. I hope this is helpful! Namaste.