If you, like me, are one of the many people out there that had a hard time on the carnival rides at the Berrien County Youth Fair this last summer you are not alone. That spinning sensation may be fun to many brave souls, but for some of us it can’t end quickly enough. Imagine if that spinning sensation did not in fact stop, but happened all the time; not so fun now, is it? People with vertigo know that the law of gravity prevails, but their brains get confused. They feel like they are tilting or spinning in space, or that the world is spinning or moving around them. Unlike other types of dizziness, vertigo—an illusion of movement when no movement takes place—is a disorder that can be objectively tested.
The most common cause of vertigo is benign paroxysmal positional vertigo (BPPV) which accounts for 65-70% of all vertigo cases. BPPV is a result of otolithic stones, or calcium debris in the inner ear that causes the sensation of motion due to a disconnect between what you are seeing and what your inner ear is telling your brain. Vertigo can also be caused or exacerbated by a wide variety of medications as well as other disease processes such as diabetes, thyroid issues, and food allergies/gluten sensitivity. Other patients’ vertigo issues can be traced to motor vehicle accidents, falls, or work-related and other types of traumas or illnesses. Past trauma and/or poor posture can result in muscle and joint imbalances leading to vertigo caused by the cervical spine. This is known as Cervicogenic Vertigo and is treated differently than BPPV.
What can we do to help?
When we evaluate the cause of vertigo in our office we perform a thorough examination, including a variety of head and body positioning tests, to check if they will reproduce the sensation of motion you are experiencing. The Epley maneuver—a repositioning treatment in which the patient is moved in specific ways to shift the calcium deposits to less sensitive areas of the inner ear—helps the majority of patients with BPPV. Studies show that up to 80 percent of patients recover after a single treatment with the Epley maneuver, and most BPPV cases respond to two to three Epley treatments. BPPV, however, has a tendency to recur. About 15 percent of patients will experience BPPV again within 12 months of the first episode; in 20 percent, BPPV comes back after 20 months, and in 37 percent, after 60 months. This is why we will also recommend vestibular rehabilitation exercises for you to perform at home. These exercises paired with the Epleys maneuver have a much higher success rate and lower rates of reoccurrence.
For patients with cervicogenic vertigo, we are uniquely equipped as chiropractors to work on the joint and muscular imbalances that are causing the problem. For most patients cervicogenic vertigo is exacerbated by a sedentary lifestyle or working in certain positions for an extended period of time, like at a desk or driving in the car. In patients with cervicogenic vertigo, an adjustment, soft tissue release work, stretches, and a general ergonomic assessment of work and lifestyle activities can help improve the condition greatly. Once ideal joint mobility and posture are obtained, cervicogenic vertigo is alleviated, usually for good.
If your world is spinning out of control, you do not have to just live with it. There are many treatment options available to get you grounded and back to living your life to the fullest.
Originally published in the December 10, 2011 issue of MailMax for Michigan’s Great Southwest