What is Vertigo? Understanding Causes, Symptoms, and Chiropractic Treatment Options

• Spinning sensation: The hallmark symptom is feeling like you or your environment is rotating or spinning.
• Nausea and vomiting: Many people experience these symptoms due to the sensation of movement.
• Balance problems: Difficulty maintaining balance or walking straight is common during episodes.
• Headaches: Some individuals may experience headaches alongside other symptoms.
• Nystagmus: Involuntary eye movements can occur during episodes.

The condition can have a profound and far-reaching impact on an individual’s daily life, affecting various aspects of personal and professional activities. The unpredictable nature of episodes can lead to a constant state of anxiety, as individuals may fear experiencing symptoms in public or during important tasks.

This anxiety can result in social isolation, as people might avoid social gatherings or outdoor activities to minimize the risk of an episode. Furthermore, it can significantly impact work performance, potentially leading to reduced productivity, increased absenteeism, or even job loss in severe cases.

Peripheral vertigo is the most common type and originates from problems in the inner ear or vestibular system. This system is responsible for our sense of balance and spatial orientation.

Key features of peripheral vertigo include:

• Benign Paroxysmal Positional Vertigo (BPPV): The most common form, caused by displaced calcium crystals in the inner ear.
• Ménière’s disease: A disorder of the inner ear that can cause vertigo, hearing loss, and tinnitus.
• Labyrinthitis: An inflammation of the inner ear labyrinth, often caused by viral infections.
• Vestibular neuritis: Inflammation of the vestibular nerve, which sends balance and head position information to the brain.

Positional vertigo, a subtype of peripheral vertigo, is particularly notable as it’s triggered by specific head movements or positions.

Central vertigo stems from problems in the brain or central nervous system. While less common than peripheral, it can be more serious and often requires immediate medical attention.
Causes of central vertigo include:

• Stroke or transient ischemic attack (TIA)
• Multiple sclerosis
• Brain tumors
• Migraine headaches
• Traumatic brain injury

Central vertigo often presents with additional neurological symptoms and may be less responsive to position changes compared to peripheral vertigo.

While peripheral and central vertigo are the main categories, there are other less common types:

• Cervicogenic vertigo: Related to neck problems or injuries
• Psychogenic vertigo: Associated with anxiety disorders or panic attacks
• Mal de Débarquement syndrome: A persistent sensation of rocking or swaying, typically after sea travel

Understanding the different types is crucial for proper diagnosis and treatment, as each may require a specific approach.

The inner ear plays a crucial role in our sense of balance and spatial orientation. Within the inner ear, we find the vestibular system, which includes:

• Semicircular canals: Three fluid-filled tubes arranged at right angles to each other. These canals detect rotational movements of the head.
• Otolith organs (utricle and saccule): These structures detect linear accelerations and head tilts.

The semicircular canals are particularly important in understanding vertigo. When we move our head, the fluid in these canals shifts, stimulating hair cells that send signals to the brain about our head’s position and movement. In conditions like BPPV, displaced particles in these canals can cause false signals, leading to symptoms.

The vestibular nerve plays a critical role in our balance system, serving as the primary communication pathway between the inner ear and the brain. This nerve transmits crucial information about head position, movement, and spatial orientation from the vestibular organs in the inner ear to the vestibular nuclei in the brainstem.

The vestibular nerve is actually composed of two distinct branches: the superior vestibular nerve, which innervates the utricle and two of the semicircular canals, and the inferior vestibular nerve, which innervates the saccule and the remaining semicircular canal. Any disruption or inflammation of the vestibular nerve, such as in vestibular neuritis, can lead to severe symptoms as it interrupts the normal flow of balance information to the brain.

Balance is maintained through a complex interplay of multiple sensory systems and the central nervous system, working together to keep us stable and oriented in our environment. The vestibular system in the inner ear detects head position and movement, while the visual system provides information about our surroundings and spatial relationships.

Additionally, the proprioceptive system, which includes sensory receptors in our muscles, tendons, and joints, provides feedback about body position and movement. The brain, particularly the cerebellum and brainstem, integrates all this information to maintain balance and coordinate movements.

When any part of this intricate system is disrupted, whether due to inner ear problems, visual disturbances, or neurological issues, it can result in balance problems.

Several diagnostic tests can help identify the cause:

• Dix-Hallpike test: Used to diagnose BPPV by observing eye movements after specific head position changes.
• Electronystagmography (ENG) or Videonystagmography (VNG): These tests record eye movements to assess inner ear and motor functions.
• Rotation tests: Evaluate how well the eyes and inner ear work together to process movement.
• Posturography: Measures how well you maintain your balance in different conditions.
• Imaging studies: CT scans or MRIs may be used to rule out central nervous system issues.

These tests help healthcare providers distinguish between different types of vertigo and guide treatment decisions.

During a physical exam, a healthcare provider may:

• Observe eye movements: Looking for nystagmus, which can indicate inner ear problems.
• Perform balance tests: Assessing your ability to maintain balance in various positions.
• Conduct hearing tests: Some inner ear disorders can affect both balance and hearing.
• Check blood pressure: Sudden drops in blood pressure when standing can cause dizziness.
• Evaluate neurological function: Testing reflexes, muscle strength, and sensory function to rule out central causes.

These physical examination techniques provide valuable information about the potential causes of symptoms.

While occasional mild dizziness may not be cause for concern, certain symptoms warrant immediate medical attention:

• Symptoms accompanied by severe headaches, vision changes, or difficulty speaking
• Episodes with loss of consciousness or fainting
• New onset of symptoms after a head injury
• Sudden hearing loss

If you experience any of these symptoms, it’s crucial to seek medical care promptly to rule out serious underlying conditions and begin appropriate treatment.

A vertigo chiropractor may employ various techniques to address symptoms:

• Epley Maneuver: This specialized technique is used to treat BPPV by repositioning displaced calcium crystals in the inner ear.
• Cervical spine adjustments: Gentle manipulations of the neck vertebrae can help alleviate tension and improve nerve function.
• Canalith Repositioning: Similar to the Epley Maneuver, this technique aims to move displaced particles in the inner ear.
• Vestibular rehabilitation exercises: A chiropractor may guide patients through exercises designed to retrain the balance system.

• Non-invasive approach: Chiropractic care provides a drug-free alternative to managing symptoms.
• Addressing root causes: Rather than just treating symptoms, chiropractic care aims to correct underlying issues.
• Holistic treatment: Chiropractors often take a whole-body approach, considering lifestyle factors that may contribute to the condition.
• Potential for long-term relief: By correcting misalignments and improving overall function, chiropractic care may offer lasting relief for some sufferers.

A vertigo chiropractor can be a valuable part of a comprehensive treatment plan, especially for those seeking non-pharmaceutical approaches to managing their symptoms.

Adapting daily routines can help minimize episodes and their impact:

• Slow, controlled movements: Avoid sudden head or body movements that may trigger symptoms.
• Use assistive devices: Walking sticks or handrails can provide additional support and reduce fall risk.
• Organize your environment: Keep frequently used items easily accessible to minimize the need for bending or reaching.
• Plan rest periods: Schedule regular breaks throughout the day to avoid overexertion.
• Maintain good lighting: Ensure adequate lighting to help with balance and spatial awareness.

While not all episodes can be prevented, certain strategies may help reduce their frequency:

• Identify and avoid triggers: Keep a journal to track potential triggers like certain foods, activities, or environmental factors.
• Stay hydrated: Proper hydration is crucial for inner ear function and overall balance.
• Manage stress: Stress can exacerbate symptoms, so finding effective stress management techniques is important.
• Regular exercise: Gentle exercises like tai chi or yoga can improve balance and reduce risk.
• Proper sleep: Maintain a consistent sleep schedule to support overall health and potentially reduce episodes.

Living with this condition can be challenging, but support is available:

• Support groups: Connecting with others who have vertigo can provide emotional support and practical tips.
• Educational resources: Organizations like the Vestibular Disorders Association offer valuable information and resources.
• Occupational therapy: Can help develop strategies for managing daily activities and work responsibilities.
• Mental health support: Counseling or therapy can be beneficial for coping with the emotional impact of chronic vertigo.
• Family and friend education: Helping loved ones understand the condition can improve their ability to offer support.

By implementing these coping strategies and utilizing available resources, individuals with vertigo can often lead full, active lives despite their condition.