Vertigo (dizziness) accounts for over eight million primary care visits in the US each year. Vertigo describes the sensation of the room spinning or your head spinning. It can be associated with nausea and vomiting. It may arise from one or more structures. The first type of vertigo is called “Central” and it originates in the brain stem, cerebellum or cerebrum. The second type of vertigo is called “Peripheral” and it originates in the vestibular, visual, or spinal proprioceptive systems. The most common cause of vertigo is from a peripheral source: the cervical spine. Proprioceptive input (the nerves that tell your brain where your joints are) from the cervical spine plays a critical role in the maintenance of balance. The joints of the upper cervical spine are highly innervated, and if there is a subluxation (misalignment), there will be abnormal stimulation of the nerves from these joints to the brain and it will conflict with input to the brain from the eyes and from the vestibular (inner ear) system. This sensory mismatch between visual, vestibular, and cervical mechanoreceptive input “confuses” the brain into a temporary state of dizziness. The most common type of vertigo (peripheral) responds really well to 1 of 2 simple solutions that we provide here in the office.
Benign paroxysmal positional vertigo (BPPV) is the most common type of vertigo — the sudden sensation that you’re spinning or that the inside of your head is spinning. Benign paroxysmal positional vertigo causes brief episodes of mild to intense dizziness. Benign paroxysmal positional vertigo is usually triggered by specific changes in the position of your head. This might occur when you tip your head up or down, when you lie down, or when you turn over or sit up in bed. Although benign paroxysmal positional vertigo can be a bothersome problem, it’s rarely serious except when it increases the chance of falls.
The signs and symptoms of benign paroxysmal positional vertigo (BPPV) may include:
A sense that you or your surroundings are spinning or moving (vertigo)
A loss of balance or unsteadiness
I have seen many patients over the years with a range of mild to severe attacks of vertigo, and the majority of them have resolved with 1 of the 2 following solutions. Most respond to a series of specific upper cervical adjustments to correct the subluxation which is sending “bad data” to the brain and confusing the balance system. As the research says: most vertigo comes from the neck.
The 2nd group of people do not have a subluxation but have BPPV caused by a problem in the inner ear. The semicircular canals are found inside your ear. They detect motion and send this information to your brain. The utricle is a part of the inner ear. It contains calcium crystals (canaliths) that help it detect movement. Sometimes these crystals detach from the utricle and end up inside the semicircular canals. When these crystals move into the canals, they may send incorrect signals to your brain about your position. This can cause vertigo. The solution is a series of changes in the head position called the “Epley Maneuver” to relocate these crystals to their normal position. I can perform this maneuver here in the office and teach you how to continue it at home, or you can easily locate a description and video on-line and perform this procedure at home.
If you or someone you know has vertigo, the first step is to come in for an assessment to determine which type of vertigo you have, so we can determine the appropriate correction. I know it is a miserable experience because years ago, I personally had a severe episode of vertigo, with days of dizziness, vomiting and staggering around as if I were drunk on a ship. It was a terrible experience. My vertigo resolved completely after 2 adjustments. Another chiropractic miracle. I love it when that happens!
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