Vertigo is defined as the sudden sensation that you are spinning or the world is spinning around you. Vertigo can have many causes based on if there is a problem in your peripheral nervous system (Nerves outside your brain and spinal cord) or in your central nervous system (brain and spinal cord).
Peripheral vertigo may be caused by:
- Benign positional vertigo (benign paroxysmal positional vertigo)
- Certain medicines such as aminoglycoside antibiotics, cisplatin, diuretics, or salicylates
- Injury (such as head injury)
- Inflammation of the vestibular nerve (neuronitis)
- Meniere’s disease
- Pressure on the vestibular nerve, usually from a noncancerous tumor such as a meningioma or schwannoma
Central vertigo may be caused by:
- Blood vessel disease
- Certain drugs such as anticonvulsants, aspirin, and alcohol
- Multiple sclerosis
- Seizures (rarely)
- Tumors (cancerous or noncancerous)
Of these causes, Benign Paroxysmal Positional Vertigo (BPPV) is the most common. BPPV is something that can be absolutely debilitating for anyone experiencing it. Imagine constantly being in a state where you felt like you just got off the spinning tea cups ride at Disney Land. Some associated symptoms can include nausea or vomiting. I explain to my patients what the three main causes of BPPV are, but first lets take a look at balance in general.
Balance relies on 3 main body functions, the inner ear, the spine, and the eyes. If one of these 3 body functions is not communicating the same information as the other 2, you get the sense of vertigo.
The inner ear is our balance center. It works with what are called “semicircular” canals that are oriented in three planes, x, y, and z. Depending on how your head is positioned, gravity pulls differently on what are called hair cells. Hair cells are in each of the semicircular canals.
The hair cells are the blue colored spikes. Depending on which way they are bent, you get the sensation of your head being tilted or turned.
In the cupula, which is a jello like blob that the hair cells insert into, there are small calcium rocks called “otoconia.” Otoconia sometimes get knocked loose due to head trauma or they fall on their own. When they are rolling around loose in the semicircular canal, they cause the sensation that your head is moving when it’s not. Since this is saying something different to your brain then what your eyes are, you have the sensation of being VERY dizzy.
The good news is that this is very easy to treat. Using a maneuver called the “Epley Maneuver,” the calcium rocks are rolled out and away from the hair cells. Getting them out of the semicircular canals causes almost immediate relief.
The cervical spine, in particular, the upper cervical spine can be a source of vertigo. This is called cervicogenic vertigo. In every joint in your body, there are movement receptors that are constantly sending signals to your brain where your body is in space. This is why you can touch your nose with your index finger with your eyes closed. This process is called “proprioception” and accounts for close to 90% of the information that gets transmitted to your brain from your body.
Of all the joints in your body, the first two vertebrae of your spine contain the most movement receptors. They are called the atlas and axis:
If either of these joints are out of alignment or cannot move properly, they send false information to your brain. Your brain thinks your neck is somewhere its not.
Chiropractic adjustments restore motion to these vertebrae and returns them to their normal function. Several studies have reported approximately 75% of patients with cervicogenic vertigo improve with this type of treatment (Galm, et al; Reid SA, et al; Kalrberg M, et al; Wing LW, et al)
Think of Balancing becomes a lot more difficult with your eyes closed. This is because we rely heavily on keeping our eyes level with the horizon and having points of reference to orient our bodies to. If there are any problems with your eyes and how they move or interpret movement, this could be one cause of vertigo. If you have ever been to a fun house at a carnival you may have experienced this first hand while going through a “Cyclone Tunnel.” As you go through, your entire environment spins around you causing you to grab on to the hand railings.
If this is the cause of your vertigo, it is best to see a eye specialist because there are many disorders that could be causing this. The treatment would dependent on your diagnosis.
Disclaimer: If you are experiencing symptoms of vertigo, go see a healthcare professional. As you saw in the beginning of this post, there are some serious causes to vertigo. Although some causes are extremely rare, it is recommended to have a full history and exam completed to get a proper diagnosis.