Vertigo – What are Common Causes?
Most of us have experienced a bout with vertigo (dizziness) at some point in our lives. Whether it’s the memory of playing dizzy-bats as a kid, a college night out with too many adult beverages, or a trip on our not so favorite carnival ride; the sensation of the world around you spinning is something that is pretty familiar. But take a moment and think about how it would feel to have your world start to spin without any warning or known cause to think of.
This is a reality for an estimated 25-35 million people in the US each year. Vertigo is part of a wide spectrum of problems known as Vestibular Disorders. A vestibular disorder is a problem that targets the control centers of balance for your entire body. Most of these cases are reported in people older than 65. As you lose your ability to maintain balance, falls can occur leading to fractures of the hip, spine, or shoulder as we grow older.
In order to understand what must be done to help someone with dizziness, we have to understand what is causing the symptoms to begin with. Unfortunately, Vertigo is not a one size fits all diagnosis…..in fact, it’s barely a diagnosis at all, you’re basically being told that you have dizziness…..in Latin. In either case, the appropriate management of vertigo is dependent on finding out what is causing the problem.
So what are some common causes? Let’s break a few of them down:
1. Meniere’s Disease – a disease of the inner ear where the prominent symptoms are dizziness, hearing loss, ringing of the ears (tinnitis), or a sense of fullness in the ear. It can range in severity and typically affects people in their 40’s-50’s. It’s a chronic condition, but there are a variety of alternative and traditional therapies that can address the symptoms. It is associated with fluid buildup called lymph in the inner ear which disrupts the sensors that transmit information to the brain for hearing and balance.
2. Benign Paroxysmal Positional Vertigo (BPPV) – the most common diagnosis for people suffering with vertigo. It’s thought to be caused by the build up of crystals in the inner ear. When the head changes positions, these crystals are thought to shift and affect the nerve endings of the inner ear triggering bouts of vertigo.
3. Labrynthitis – a disorder in which the primary organ of the vestibular system becomes enflamed. It is usually a result of a viral infection, but can occur from bacteria, traumatic head injury, allergies, and medication. It is usually occurs after a recent upper respiratory infection. Labrynthitis is typically very treatable pending no permanent nerve damage has occurred.
4. Cervicogenic vertigo – a vestibular disorder that is usually associated with a neck injury. Though it is considered to a rare form of vertigo compared to the ones listed above, my experience in practice tells me that it is more common than one might think. There are no diagnostic tests to find out if vertigo is related to the neck, but it is labeled as such when dizziness accompanies neck pain, or follows some sort of whiplash injury.
As a Structural Chiropractor, I’ve had the opportunity to see patients from all 4 categories. I wish I could say that one kind of Vertigo responds great, while others not so much. I’ve seen many with Meniere’s get full recovery, while some get little relief at all. I’ve seen plenty with BPPV do great, while others will go in and out of relapse. The truth of the matter is, Vertigo is a complicated problem with multiple factors that make each person’s situation unique.
The one commonality is that the each person’s vestibular system is reacting inappropriately. The vestibular system is one of the most complex systems in the body. It takes input from your eyes, inner ear, and spine and organizes it to fit what is happening in reality. Here’s how it works:
Let’s say that you’re driving in a car. While you’re in the car and you’re facing forward, your eyes, ears, and spine tell you that you’re moving in the same direction and all is well. Now lets say you’re bored, so you decide to read a book. While you’re reading, your ears and spine still sense movement, but your eyes are locked on a fixed point. All of a sudden, you start to get dizzy and woozy.
I bet you can think of several scenarios like this. Take the spinning bats game. You’ve got your head down on a bat, you spin around and around and you’re okay while you’re spinning. Suddenly, you come to a stop. Your spine and eyes say you’re not moving, but the fluid in your ears say that you are, and the same dizziness starts to hit again.
We all know that your eyes and ears can affect your balance because we’ve all done things to our eyes and ears that give us that dizzy feeling. However, head positioning has a huge impact on balance, and that’s where Atlas Displacement comes into play.
As you can see in the image below, the positioning of the head on top of the C1 and C2 Vertebra are closely related to the Vestibular nucleus, aka, the control center for the entire vestibular system. The positioning of the head and neck can affect the way that the eustachian tubes function, it can dictate how fluid in the inner ear is moving, and more importantly, it acts as a gate keeper for all of the signals coming into the brain that say what the spine is doing.
The point of this isn’t to say that Structural Chiropractic is a treatment for vertigo, because it’s not. However, if you want your vestibular system to work the way that it was intended, then the upper cervical spine and the brain stem has to be functioning correctly to make that happen.
With proper structural alignment, then the help of medical doctors and vestibular rehab specialists can help stop the world from spinning.
Here are some great case studies showing the impact of upper cervical spine on patients with vertigo.