Dizziness Explained - When is it Vertigo?
Dizziness is a symptom commonly experienced and a term often thrown around, but what does it really mean?
Dizziness is a term that can be used to describe a range of feelings including feeling faint, giddy, unsteady, off-balance or light-headed. Vertigo is specific type of dizziness that feels as though you or the room around you are spinning. Dizziness can be triggered by various factors, including changes in position, inner ear problems, neurological disorders, medication side effects, dehydration, or low blood sugar levels. Dizziness can be extremely frustrating but also dangerous as you may have a fall and injure yourself.
How do we balance normally?
Balance is quite amazing! A complex series of messages from your body give your brain information about where you are in relation to your surroundings. Your brain then analyses this information and provides feedback to your body about how to stay upright. There are three main components to this system:
Vision - your eyes give feedback about where your body is in space.
Proprioception - sensors around your body give information to your brain about where your body is in space.
Inner ears - your inners ears feature three loops called semicircular canals. The semicircular canals respond to the rotation of the head. Near the semicircular canals are the utricle and saccule, which detect gravity and back-and-forth motion. Hair cells and fluid inside the canals move when your head or body moves. The hair cells send messages to your brain through the acoustic nerve.
If the brain can’t process signals from all of these systems, or if the messages are not functioning properly, you may experience a loss of balance.
Common causes of dizziness
When you present to us complaining of dizziness, we will ask you a variety of questions in order to determine what the cause is to help determine the most appropriate treatment for your symptoms. Some of these causes we can help with and others will require referral - you can see from the list below why all the questions we ask are so important and hep us understand what is most likely to be causing your symptoms.
cardiovascular or circulation problems including blood pressure issues
head injury eg concussion
injury to the ear or vestibular system;
medication side effects
neurological diseases or disorders
sudden hearing loss or vision changes
anxiety disorders
viruses and other infections
inner ear disorders eg BPPV, vestibular neuritis and Meniere’s disease
Inner ear disorders cause about half of all dizziness cases including:
Benign paroxysmal positional vertigo (BPPV) – involves intense, brief episodes of dizziness related to moving your head, often when turning over in bed or sitting up. It gives a sensation of spinning (vertigo). The cause of BPPV is not always known, but it usually the result of ageing or head trauma. The key features of BPPV are that it only occurs with head movement, the spinning fatigues and stops usually with 1-2min (or faster) and happens due to stopping your head moving, there is often nausea and when we examine you while experiencing this spinning, there are characteristic involuntary eye movements called nystagmus.
Acute vestibular neuritis or labyrinthitis – an inflammation of the inner ear causes sudden, intense vertigo that may persist for several days, with nausea and vomiting. This can be very disabling and may require bed rest initially. Fortunately, vestibular neuritis generally subsides and clears up on its own. The cause of this condition is unknown but it may be a viral infection. The spinning, unlike BPPV, does not fatigue or stop, and is present even when the head is not moving.
Meniere’s disease – involves the build-up of fluid pressure in the inner ear. This leads to repeated sudden episodes of vertigo lasting 20 minutes or longer, with hearing loss, a feeling of fullness in the ear and buzzing or ringing in the ear (tinnitus). The cause of Meniere’s disease is unknown. Treatment options are limited and are largely lifestyle modifications, including reducing salt intake.
Vestibular migraine – can cause vertigo lasting from minutes to days with or without headache. Attacks may be triggered by quick head turns, being in a crowded or confusing place, driving or riding in a vehicle, or watching movement on TV. Vestibular migraine may also cause unsteadiness, hearing loss, and ringing in the ears (tinnitus).
BPPV - what is it and how can we help?
BPPV is one of the most common causes of vertigo, especially among older adults. This is a condition that we are well placed to treat. It occurs when tiny calcium carbonate crystals called otoconia become dislodged from their usual position within the inner ear and float into the semicircular canals. The movement of these crystals in response to head movements triggers abnormal signals to the brain, leading to brief episodes of intense vertigo. Most commonly one of the three semicircular canals is where the crytals cause a problem. This canal is called the posterior canal. Occasionally the crystals may make there way into one of the other two canals so it is important to get an accurate diagnosis as the corrective manoeuvre is different depending on which canal is causing the problem.
Our osteo Anthony is trained in diagnosing and treating BPPV. If the diagnostic test is conclusive, and then the appropriate corrective manoeuvre (Epley’s for the posterior canal) then applied, it seems amazing, almost unbelievable that something so simple could correct something that makes you feel so terrible. The manoeuvre simply uses a sequence of head and body movements, with the aid of gravity, to reposition the crystals.
Can osteo/physio help with other causes of dizziness?
In addition treatment for BPPV, we may also be able to help with other causes of dizziness and vertigo. An increasingly more recognised cause is the neck. Dizziness caused from the neck, called cervicogenic dizziness or cervicogenic vertigo, is not always a spinning feeling, but can be associated with some of the more vague symptoms reported with dizziness such as light-headedness, feeling a bit off balance or giddy, and is often associated with head movement and neck pain. Our osteos and physios are well placed to help you with this.
Some causes of dizziness and vertigo, such as concussion and vestibular migraine can be helped with vestibular rehabilitation exercises designed to improve balance and reduce symptoms of dizziness. These exercises focus on promoting adaptation and compensation mechanisms within the vestibular system to enhance overall balance and reduce sensitivity to triggers.
If you are experiencing dizziness or vertigo and you need help, then be please book in with Anthony. Book here