Have you ever heard someone say they’ve had vertigo before? Or maybe you have experienced it yourself. The terms vertigo and dizziness are often used interchangeably, but they refer to two different phenomena. Dizziness is more of a broad term that describes feeling off-balance, whereas vertigo is defined as the sensation of the room moving around you. Both issues can affect your balance, make you nauseous or sick, or even put you at risk for.
Dizziness can be caused by a wide variety of conditions including blood pressure and cardiac issues, dehydration, low blood sugar, head trauma, anxiety, sensory and neck issues, medications, brain-related issues, and visual problems. Vertigo, on the other hand, is more often caused by issues that affect the vestibular system (inner ear) or the central nervous system (brain and spinal cord). In some cases, multiple systems may be affected. Physiotherapy can help determine what the cause of the dizziness or vertigo may be, and what types of treatment will help in resolving it.
As mentioned above, vertigo is described as a sensation of the room moving around you, and is often accompanied by nausea and vomiting. This is happens because of the mismatch in signals coming from your visual and vestibular inputs. The vestibular system is located in the inner ear and is comprised of structures that sense movements in different planes of motion (up/down, forward/backward, side to side, rotation, and head position related to gravity). These organs normally communicate with the visual system and brain to tell us where our head is in space. If there is injury to these organs (such as with head injury, inner ear infections or inflammation), vertigo and/or dizziness can occur.
The most common type of vertigo is called Benign Paroxysmal Positional Vertigo (BPPV), which can be broken down as:
- Benign = not life-threatening
- Paroxysmal = sudden onset of symptoms that come and go
- Positional = symptoms occur when the head moves in certain positions
- Vertigo = described as a “room spinning” sensation
In the majority of cases, there is no known cause of BPPV. Patients with BPPV often notice their symptoms most when lying down, moving their head up or down, or with rolling onto their side. With BPPV, tiny crystals are dislodged from the inner ear organ and are left free-floating in another nearby structure called the semicircular canals. The brain interprets these misplaced crystals as movement, even when you are no longer moving, which is what causes the “spinning” sensation.
Luckily, most cases of BPPV can be resolved with between 1-3 physiotherapy treatments. Treatment for BPPV focuses on repositioning the misplaced crystals through a series of head and body movements guided by your physiotherapist. The maneuvers usually take around 10 minutes to complete, and may need to be repeated in subsequent sessions. It is normal for treatment to elicit vertigo-like symptoms, but these symptoms should be short-lived. Your physiotherapist may also recommend exercises to help re-establish proper communication between your vestibular system, visual system, and brain. Such programs may involve balance exercises, eye exercises, and positioning exercises.
If you, or someone you know, are suffering from vertigo or dizziness, book an appointment today with our vestibular therapist! Please note that for safety reasons, we require all vestibular assessments to have someone drive them to and from their appointment. We look forward to helping you get back to what you love doing!