Vertigo is a frequently encountered symptom in chiropractic patients, and it often occurs after head and neck trauma. Fortunately, in most cases, it is a treatable condition. While it is more common among the elderly, it can affect individuals of all ages, both men and women. Often, vertigo serves as an early warning sign of inner ear or neurological issues. Dealing with vertigo and dizziness can be quite distressing and uncomfortable, as it can significantly impact daily life. These symptoms manifest as a sensation of dizziness or spinning while stationary and can be accompanied by symptoms like nausea, tinnitus, vomiting, sweating, fatigue, and headaches. If you or someone you know is experiencing these symptoms, it's important to seek professional care and evaluation.
Types of Vertigo:
There are two types of vertigo that chiropractic care can try to correct. These are benign paroxysmal positional vertigo (BPPV) and cervicogenic vertigo. By far the most common type of vertigo is BPPV. Chiropractors are trained to differentiate between these types of vertigo using orthopaedic assessments and to rule out other potential causes of dizziness (and refer if necessary).
Other Varieties of Vertigo:
The treatment for vertigo stemming from different conditions depends on each individual case. Identifying the cause of dizziness is crucial to finding an appropriate solution.
Vertigo associated with migraine headaches, which may also be linked to poor neck mechanics, cervical osteoarthritis, or progressing spinal disc disease should include dietary adjustments like reducing or eliminating aspartame, chocolate, alcohol, and caffeine. Additionally, exercise, soft tissue and bone mobilization techniques, stress reduction, adequate sleep, and vestibular rehabilitation exercises are part of the treatment.
Vestibular neuronitis and labyrinthitis, often attributed to viral infections, can also be managed with vestibular exercises. Patients with cervicogenic vertigo may benefit from a general ergonomic evaluation of their work and daily activities to identify contributing factors.
Collaborating with your chiropractic doctor to address postural issues can bring relief to patients whose vertigo worsens due to a sedentary lifestyle or extended periods in specific positions.
Causes of Vertigo:
- Vertigo can be caused by many problems, most of which originate in the peripheral or central nervous system.
- The causes of vertigo that stem from the peripheral nervous system include benign paroxysmal positional vertigo (BPPV), acute vestibular neuronitis, labyrinthitis and Ménière’s disease.
- Acoustic neuroma, migraines, cervicogenic vertigo and multiple sclerosis are all related to the central nervous system. Click here for a research abstract with respect to " Cervical-induced vertigo may be caused by degenerative or functional disorders of the cervical spine".
- With respect to cervicogenic vertigo producing dizziness that arises from the neck, irritation or injury to the joints... muscles or ligaments of the neck can overstimulate proprioceptors (nerve endings that detect position sense) in the neck giving rise to vertigo.
- Insufficient hydration tends to increase the frequency and intensity of vertigo episodes.
- Inner ear viral infection.
- Insufficient blood flow to the brain (ischemia).
- Vertigo can also be caused by a wide variety of medications such as antidepressants, anticonvulsants, antihypertensives, diuretics, barbiturates, salicylates (e.g., aspirin), sedatives or hypnotics, some antibiotics taken in high doses over prolonged periods of time can damage the vestibular system, some prescription and over-the-counter cold medicines, and some antibiotics and antineoplastics.
- Low blood pressure, low blood sugar (hypoglycemia), anemia, anxiety, multiple sclerosis, diabetes mellitus, hypothyroidism, high blood triglycerides, food allergies or gluten sensitivity, and various inner ear problems can also cause or worsen vertigo.
- Motor vehicle accidents, falls or other types of traumas or illnesses can also be associated with vertigo especially if they cause head trauma.
Working with your doctor of chiropractic to improve postural issues can also bring relief to the patients whose vertigo is exacerbated by sedentary lifestyle or working in certain positions for extended periods. To diagnose the cause of vertigo, your healthcare provider will conduct an examination, including various positioning tests to check if they reproduce the sensation of motion. Additional tests may be required and may necessitate referrals to medical specialists.
Chiropractic Care of Vertigo:
Uncomplicated cervicogenic vertigo can be treated and well managed by a chiropractor incorporating: mostly painless and effective soft-tissue and muscle work such as trigger point release or stretching, and/or the Epley. Additionally, spinal and associated joint manipulation and adjustment, physiotherapy modalities and/or low-level laser acupuncture may also be utilized depending on the physical examination and any radiological findings. The goal is to balance the biomechanics of the neck and associated soft-tissues in order to promote a more rapid and complete recovery of the damaged tissues and any abnormal postural mis-alignments. Working with your doctor of chiropractic to improve postural issues can also bring relief to the patients whose vertigo is exacerbated by sedentary lifestyle or working in certain positions for extended periods.
The treatment used obviously depends on the cause. Don't rely totally on symptomatic relief such as taking tablets for this condition is not always the answer. That is why the chiropractor has to do a thorough consultation and examination when prospective patients first come in for treatment. In some cases a referral to your physician, neurologist or an ear/nose/throat (ENT) specialist may be required for further assessments especially if any 'red flags' are presented (see below). But, the good news is that the most common causes respond well to conservative care.
Vertigo Red Flags That Requires Medical Care:
By itself, vertigo is usually benign. However, if a patient experiences symptoms such as double vision, slurred speech, difficulty swallowing, numbness, nausea and/or unsteadiness when walking, (even if temporary), they should seek immediate emergency medical care.
Vertigo patients who present with the following signs below should immediately go to the emergency room. Patients experiencing progressive worsening of symptoms or dizziness accompanied with fever and/or infection should also see a medical health care provider....
- double vision - difficulty swallowing - numbness - headache - fainting or collapse - weakness - nausea - difficulty speaking such as slurred speech - difficulty waking up or staying awake - difficulty walking, even if temporary - inappropriate actions - difficulty controlling arms or legs - abnormal eye movements.
Click here for more information about "Vertigo" (HealthLine)
Click here for more information about "Vertigo" (Cleveland clinic)