Saturday 12th October
Many people think of vertigo as a fear of heights but, although people with this fear do often experience ‘vertigo-like’ symptoms, it’s not true vertigo per se. In which case – if it’s not fear of heights, what is vertigo, and what causes it?
Vertigo results from one of 2 conditions – an inner ear disorder, or some type of ‘central vestibular pathway’ dysfunction. People with an intense fear of heights on the other hand have ‘acrophobia’, or ‘hipsophobia. It’s a type of mental health or anxiety disorder.
If you are curious about vertigo – what causes it, the symptoms, and more importantly, how seeing a chiropractor for vertigo may be able to help, this post is for you…
Vertigo per se describes that sense of ‘spinning’ or being off balance you might feel after a sudden movement. There may be some dizziness, light-headedness, and disorientation present as well.
In addition to the above, some vertigo sufferers find it difficult to stand or walk during an episode. Severe cases can experience motion sickness and nausea too. They may also have:
The sensations felt during a vertigo episode are the result of miscommunication between your brain and the structures in your inner ear that tell your brain where your head is in space and what it’s doing.
There are 2 types of vertigo – peripheral and central.
Your inner ear and vestibulocochlear nerve are part of your vestibular system. Along with the cochlea (hearing), they are housed within a structure called the ‘labyrinth’ and play an important role in your balance, movement, equilibrium, and spatial awareness.
Sometimes things go wrong in these structures, resulting in conflicting messages being sent to your brain. In other words, your brain doesn’t accurately know where your head is so it can’t relay the right information to your eyes and muscles to maintain your balance.
The result is that disoriented, tipsy feeling is common with vertigo.
Common causes of peripheral vertigo include Meniere’s disease, Benign Paroxysmal Positional Vertigo (BPPV), and infections like vestibular neuritis and labyrinthitis.
Head trauma that affects the inner ear structures can also contribute to peripheral vertigo. Similarly, some drugs have vertigo-causing side effects, as does excessive alcohol consumption!
Symptoms of peripheral vertigo typically include extreme dizziness, nausea, and difficulty standing or walking.
BPPV is relatively common. When you move your head or change position suddenly, it can trigger short bouts of dizziness and balance problems. You may also feel some motion sickness or nausea or have rapid eye movements.
Infections like vestibular neuritis and labyrinthitis cause inflammation within the inner ear that can result in vertigo.
Vestibular neuritis is commonly caused by a viral infection like the flu or common cold and inflames the vestibular nerve (relays signals from your inner ear structures to your brain). The inflammation interferes with this communication, resulting in episodes of vertigo if you move your head suddenly.
Labyrinthitis inflames both the vestibular nerve and the labyrinth itself so affects your balance AND hearing. Viral infections are a common cause of this condition, but bacterial infections, autoimmune diseases, and other factors can trigger it too.
Like vestibular neuritis, labyrinthitis can cause vertigo if you move suddenly. The main difference is that it comes with additional side effects like hearing loss and tinnitus.
Meniere’s disease is a chronic inner ear disorder that causes fluid build-up. If you have this, you’ll experience:
Head or neck injury that results in damage to your inner ear structures can trigger vertigo. Common types of trauma include whiplash, direct head impacts, and concussions. If you have this type of vertigo, you’ll likely suffer from persistent episodes of vertigo along with neck pain and headaches.
Vertigo can also be a side effect of certain types of drugs – antibiotics, diuretics, anti-seizure meds, and aspirin – which can damage the inner ear structures, or alter their function.
The good news with this type of vertigo is that it usually subsides, or even goes away, once you stop using the medication!
Alcohol affects the fluid balance in your inner ear, which affects the vestibular system, causing vertigo and dizziness. This is a large part of why you stumble home, with many falls, after a big night at the local pub!
If you have central vertigo, it originates with dysfunction in your brainstem (common) or cerebellum. These parts of your brain receive and co-ordinate the signals from your inner ear about your head position, and relay it back to your eyes and muscles.
Common causes of this dysfunction include brain injuries, migraines, strokes, or multiple sclerosis.
With this type of vertigo, you probably won’t experience the same type of severe spinning as you do with peripheral vertigo but it does affect your balance and coordination.
Central vertigo can be caused by head trauma that damages your brainstem or cerebellum and affects your ability to receive and coordinate the responses needed to keep your body balanced.
Vestibular migraines are a type of migraine that affects the vestibular system and causes dizziness, light and sound sensitivity, and nausea. You may also have a headache, but this isn’t the primary symptom – the vertigo is. The vertigo can last a few minutes, or hours.
MS affects the central nervous system. It can cause lesions within the brainstem, and damage the protective myelin sheath around nerve fibres in the brain and spinal cord.
These changes disrupt communication in the central nervous system, affecting spatial orientation and balance.
A stroke that affects the brainstem or cerebellum can impact their function, and cause a sudden vertigo episode. When it happens, it’s often accompanied by other neurological symptoms – weakness, numbness, vision problems, and speech difficulties.
Any type of tumour close to the brainstem or cerebellum can press against them and affect the pathways by which they receive and process spatial information, resulting in vertigo.
How long vertigo lasts depends on the cause and type of vertigo.
Some types, like BPPV, may only last a few seconds. Others, like those triggered by Meniere’s disease, can last 20 minutes to several hours, whilst a vestibular migraine could last days.
Drug and alcohol related vertigo usually subsides once you stop taking the drugs, or stop drinking. Similarly, vertigo related to infections and injuries will generally decrease as you recover from the infection or injury.
Vertigo associated with MS and tumours is likely to be ongoing unless the underlying conditions are treated.
Treatment for vertigo ranges from medications to rehabilitative therapies, diet changes, and chiropractic care.
Spinal adjustments can realign your spine, in particular your cervical spine. This is where the nerves that control the inner ear function originate. This can help reduce pressure on these nerves, resulting in improved inner ear function, and potentially relief from vertigo.
The Epley Manoeuvre is a series of movements that aim to remove dislodged canaliths from the semicircular canals back into the utricle where they belong. It is primarily used to treat BPPV.
Cervical Mobilisation techniques apply gentle movements and stretch to the neck to improve mobility and reduce tension.
Postural advice is useful for learning how to maintain good posture and alleviate pressure on your neck and spine, potentially reducing vertigo symptoms.
Soft Tissue Therapy such as massage and myofascial release can help reduce muscle tension and improve blood flow, supporting overall balance.
Vertigo is best described as a condition where you feel dizzy or disoriented after sudden movements. It can be accompanied by various other symptoms – nausea, difficulty standing, headaches etc.
These symptoms happen because something is interfering with a) the information your inner ear relays to your brain about your head and spatial position or b) how your brain processes the information received.
In some cases, chiropractic care can help manage vertigo, particularly when caused by misalignments in the spine that affect nerve function.
