Dizziness and vertigo are common yet debilitating problems.
Dizziness is defined as feelings of unsteadiness and imbalance, sometimes
associated with fainting. Vertigo is the sensation that you or your
surroundings are moving, often described as spinning. Vertigo can be associated
with nausea and vomiting. These issues are often difficult to diagnose due to
their many possible causes. Though more serious health issues such as central
nervous system and cardiovascular disorders can cause symptoms of dizziness and
vertigo, there are several less serious and treatable causes. This article
focuses on two sources of dizziness and vertigo that can be successfully
treated by a rehabilitation specialist – benign paroxysmal positional vertigo
(BPPV) and cervicogenic dizziness.
BPPV is a disorder caused by changes in your inner ear that
confuse your vestibular system, or your body's way of sensing your movements
and orientation in space. This confusion can create intense vertigo, nausea,
and vomiting with movements of the head. As the most common vestibular system
disorder, it is estimated that 2.4% of all people will experience BPPV at some
point in their lives. As you age, this
disorder becomes even more prevalent. Approximately nine out of every 100 older
adults is diagnosed each year with BPPV. The mechanisms of this disorder occur
inside your inner ear where live small crystals called otoconia that help you sense
the position of your head in space. These otoconia can become dislodged, either
due to head trauma, infection, increased fluid pressure inside the ear,
vascular occlusion, or without a known cause. The dislodged otoconia travel
into one of the semicircular canals inside the ear and settle in the fluid that
surrounds the canals. With head motion, the otoconia shift and stimulate the
sending of false signals to the brain about where your head is in relation to
gravity. When this occurs, intense and significant symptoms of dizziness and
vertigo persist with head motion until the otoconia are replaced. Many rehabilitation
specialists such as physical therapists and chiropractors are trained in
diagnosis of BPPV and methods for repositioning the otoconia which typically
result in a quick recovery.
Cervicogenic dizziness is defined as dizziness secondary to
neck pain or injury, with the caveat that all other causes of dizziness have
been ruled out. With frequent dizziness
or any neck or head injury, it is important to see a medical doctor or
rehabilitation specialist to rule out any indications of serious medical
complications. With cervicogenic dizziness,
head movement or sustained positions of the head can elicit
symptoms of dizziness that are often associated with neck pain and headaches.
Patients with this disorder typically improve with sole treatment of the neck problem,
though others may require additional vestibular rehabilitation. Vestibular
rehabilitation includes eye exercises, balance training, and techniques for
adjusting to environments or activities that trigger dizziness. For best
results, these types of exercises should be administered by a trained
professional, such as a physical therapist that has a background in vestibular
treatment.
If you have persistent dizziness or vertigo, do not hesitate
to see a medical professional. These symptoms can make a large negative impact
on your life, yet they are very treatable. The sooner you seek treatment, the
sooner you can enjoy life again without the debilitating symptoms of dizziness
and vertigo.
Sara Bentley DPT
Doctor of Physical Therapy
