Understanding Vertigo: Before getting treated for vertigo, it is important to understand that there are different types and depending on which type you have, different treatments may be most beneficial. Dizziness is a phrase that describes a symptom of being woozy, or lightheaded. Sometimes when patients are dizzy, they think they may have vertigo, but that’s not always the case. Dizziness is one of the most common complaints by patients at a doctors’ office. That is why going to a health care professional is important in the diagnosis of vertigo.
Types of Vertigo
Benign paroxysmal positional vertigo
Benign paroxysmal positional vertigo(BPPV) is one of the very common types of vertigo. With this type of balance disorder, the episodes are recurring and usually only last from 10-60 seconds. Symptoms many times are triggered after turning the head, certain head positions, or lying on the side in bed.
One of the theories about how BPPV is cause, is that calcium carbonate crystals are dislodged from their normal position in the ear, and end up in the semicircular canal. The other possible causes of BPPV are head/neck trauma, an infection or degeneration. The exact cause is still unknown.
Symptoms with BPPV can be severe. Many times there can be weeks or months between episodes leading BPPV patients to have anxiety about driving, sleeping, and normal activities.
Meniere’s Disease is a balance disorder with a list of symptoms that include severe bouts of vertigo, ringing in the ears(tinnitus), hearing loss, feeling of fullness in the ears, and nystagmus.
Many times Meniere’s Disease sufferers have chronic vertigo symptoms that seem to stay for weeks or months at a time. Many Meniere’s Disease patients say they feel like they are on a boat. After severe episodes patients can feel extreme tiredness. Anxiety about the tinnitus, or driving is a common side effect.
There is no known cause for Meniere’s Disease, but it continues to be one of the more common types of vertigo.
Vertigo caused by Multiple Sclerosis
Multiple Sclerosis(MS) is a disease that demyelinates the spinal cord, brain stem and cerebellum. The brain stem and cerebellum are key components for balance and coordination of the body. Damage to these areas can cause vertigo or dizziness symptoms. MS patients also take many medications that can have dizziness or light headedness as a side effect. Episodes can last for days or weeks at a time.
An acoustic neuroma is a non-cancerous tumor that account for 6-10% of all brain tumors. The tumor usually grows slowly over a period of years. Symptoms can be mild or severe. The first sign is usually tinnitus (ringing in the ear), but as the tumor grows the brain stem and cerebellum become compressed and can cause vertigo and dizziness symptoms. An MRI is the best way to locate an acoustic neuroma, and observation, surgical removal, or radiation are the typical treatment options. Acoustic neuromas make up only a very small percentage of people that experience vertigo. (1)
Migraine Associated Vertigo
About 25-35% of migraines sufferers experience migraine associated vertigo(MAV). MAV usually will usually show up at the beginning of a migraine and can last from a few hours to a few days. Common symptoms that are associated with MAV are sensitivity to head movement, pressure in the ears, and motion intolerance. Nausea and dizziness are also common with MAV.
Vertigo can cause different types of symptoms like:
A feeling like the room is spinning
Inability to stand up
Inability to drive
Some of the common forms of treatment with vertigo and vestibular disorders:
If you end up at the ER with vertigo or a MD, you may be treated with meclizine hydrochloride (Antivert) scopolamine transdermal patch (Transderm-Scop) promethazine hydrochloride (Phenergan). These medications can lessen a severe attack, but are not very helpful in long term correction.
The Epley Maneuver
This is a procedure that is typically performed by a physical therapist, MD, occupational therapist, osteopath, or chiropractor and can be taught to do at home. The Epley maneuver involves going through a series of movements that move that flushes the fluid in the inner ear to get the crystals back into place. The procedure induces vertigo in order to get rid of it, so some patients do not prefer this procedure.
Half Somersault Canalith Repositioning
Similar to the epley maneuver the goal is to reposition the crystals in the inner ear. This procedure is more comfortable for manty patients.
Gaze stabilization exercises
These are eye exercises that are used to improve the control of the eyes, so vision can be clear during head movement. This may be used as part of vestibular rehabilitation therapy.
These are exercises designed to improve a patients balance and coordination over time. Things like balancing on one leg for longer and longer periods of time.
Upper cervical chiropractic
One very effective form of treatment for vertigo is upper cervical chiropractic. Upper cervical chiropractic focuses on correcting misalignments to the top two bones in the neck called the atlas and axis. These bones protect the brain stem and cerebellum which controls many important bodily functions like balance, coordination, and posture. Due to head trauma, neck trauma, or poor posture over time the atlas and axis can shift out of place putting pressure to the brain stem, and cerebellum causing vertigo symptoms. A misalignment can be caused by something as simple as bumping your head getting in to the car. The treatment is very gentle and involves no twisting, cracking or popping. In a 2016 study, 300 vertigo patients underwent upper cervical chiropractic. The results were that 97% claimed a dramatic improvement in vertigo. (2)
If you have vertigo, the first step is to get checked to see what’s causing your symptoms. Visit an upper cervical doctor to find out if the problem is coming from your neck, inner ear, or somewhere else. Schrier Family Chiropractic is an upper cervical chiropractic office in Delray Beach. Call for a complimentary consultation 561-316-3480, or book online at www.drelan.com .
Video Testimonial of a vertigo patient after upper cervical chiropractic treatment- Patient with vertigo gets better with upper cervical chiropractic in Delray Beach
“What is Acoustic Neuroma?” Acoustic Neurona Association, www.anausa.org/learn-about-acoustic-neuroma/what-is-acoustic-neuroma#important-points .
Burcon, Dr. Michael T. “Health Outcomes Following Cervical Specific Protocol in 300 Patients with Meniere’s Followed Over Six Years.” JUCCR, Spring 2016, no. 2, www.uppercervicalsubluxation.com/ .