Vertigo is a medical term that refers to the sensation of motion that is out of harmony with reality. For example, a patient with vertigo may feel like he is spinning while he is sitting still, or one may experience the feeling that the room is spinning. Often, vertigo begins immediately following a movement of the head. This is referred to as positional vertigo.
How Common Is Vertigo?
Vertigo is one of the most common reasons that people go to a physician. Overall, vertigo affects as much as 10% of the population. However, this condition becomes more common as a person ages and as much as 40% of the 40-and-over population will experience vertigo at some point. A 10-year-long study of emergency rooms in the United States revealed that about 2.5% of ER visits are vertigo-related.
Vertigo and Increased Fall Risk
With the increasing prevalence of vertigo in connection with age, it is no wonder that annually 1 in 4 seniors over the age of 65 will fall. In fact, research performed in Sweden has revealed that those under the age of 80 have a 17.8% prevalence of dizziness and 16.5% risk of falling. However, those over the age of 80 experience a 31% incidence of dizziness and a 31.7% fall risk.
Though vertigo is usually considered benign or non-life-threatening, the increased risk of falling that has been clearly identified is certainly a danger and should be addressed.
Central and Peripheral Vertigo-Associated Disorders
Vertigo is considered a symptom rather than a condition on its own. As a result, it is important to address to disorders and conditions that are associated with vertigo. Understanding the cause is a major step in finding a viable solution.
First, conditions must be divided into two categories, peripheral and central. We will address what these two classes of vertigo are and several potential causes of each type.
Causes of Peripheral Vertigo
The inner ear is a major component in how the body controls balance. As a result, a problem with the inner ear can easily lead to symptoms like vertigo. Peripheral vertigo involves something wrong with either the inner ear itself or the vestibulocochlear nerve (CN VIII) that communicates between the ear and the brainstem.
Peripheral vertigo causes include:
- Positional vertigo – Benign paroxysmal positional vertigo (BPPV) is often considered an idiopathic condition in which crystals contained in the otolith organs become dislodged, enter one of the inner ear’s three loop-shaped canals, and produce vertigo when the head is moved into certain positions. It can also be caused by head trauma, an ear infection, surgery, or prolonged bed rest.
- Medication side effects – Medications that may result in peripheral vertigo include diuretics (water pill), aminoglycoside antibiotics, certain cancer drugs, and salicylates.
- Head or neck trauma – The onset of vertigo frequently begins following head or neck injuries such as a concussion or whiplash. It is thus associated with post-concussion syndrome.
- Vestibular neuronitis – This condition is an acute attack of severe vertigo caused by inflammation of the vestibulocochlear nerve. Vertigo usually last about a week to a week and a half but may be followed by less severe vertigo attacks in the following weeks.
- Labyrinthitis – Similar to vestibular neuronitis, labyrinthitis involves inflammation of the inner ear or vestibulocochlear nerve.
- Meniere’s disease – This is a rare vestibular condition that causes vertigo, hearing loss, tinnitus (ringing in the ears), and a feeling of pressure in the affected ear. Vertigo attacks can last for hours or even days and may be severe enough to cause falls, nausea, and vomiting. Diet changes and medications are often encouraged to reduce fluid in the inner ear.
Causes of Central Vertigo
The central nervous system plays a key role in the interpretation of the signals concerning where the body is located in regard to its environment. Thus, an issue with the brainstem, which receives the signals from the vestibulocochlear nerve, can result in balance and spatial orientation issues like vertigo.
Causes of central vertigo include:
- Migraines – Vertigo is a symptom for up to 40% of migraine patients. Vestibular migraines may present with vertigo but without the severe headache that is usually associated with migraines. As a result, these may be referred to as silent migraines. However, vertigo can occur along with common migraines as well.
- Medication side effects – Medications that commonly cause central vertigo include anticonvulsants, antidepressants, analgesics, anesthetics, anti-inflammatory drugs, sedatives, tranquilizers, blood pressure medications, contraceptives, and diabetes medications. Overindulgence in alcohol can also cause central vertigo.
- Multiple sclerosis (MS) – This is a condition that affects the central nervous system. It is generally considered to be immune-mediated in nature. The body attacks the nerves, specifically destroying the myelin sheathe that protects the nerves and causing scar tissue. As a result, degenerative nerve damage occurs, leading to many symptoms. Vertigo is usually one of the first symptoms.
- Vascular disease – Numerous blood vessel diseases can result in vertigo including hypertension (high blood pressure), atherosclerosis (clogged arteries), and peripheral artery disease (narrowing of the arteries).
- Stroke – Stroke occurs when some of the brain’s blood supply is cut off. If enough the blood supply is cut off for a long enough time, death can result. Stroke is a medical emergency, and if other symptoms accompany vertigo to indicate a stroke, emergency medical attention should be sought.
- Tumors – Tumors, both cancerous and non-cancerous, can cause vertigo. If these tumors affect the function of the brain, especially the brainstem, the resulting vertigo is considered central. There is also the possibility of a tumor affecting the vestibulocochlear nerve and causing peripheral vertigo.
- Seizures – A rare condition called epileptic vertigo can cause vertigo to occur multiple times per day. This happens when a head injury has damaged the temporal lobe. As a result, signals from the vestibulocochlear nerve are not processed As a general rule, injuries that lead to epileptic vertigo are forceful enough to cause a person to lose consciousness.
Traditional Care for Vertigo Patients
For cases of positional vertigo, a doctor may attempt to get the crystals of the ear to fall back into place by a s eries of movements called the Epley Maneuver. A doctor or physical therapist will usually assist a person to make the proper maneuvers. A simplified version called the home Epley Maneuver has been developed so that an individual may try to reset the crystals of the ear at home should a sudden attack of positional vertigo occur.
Most doctors will recommend a water pill (diuretic) for a person dealing with chronic vertigo. This is because these drugs reduce fluid retention in the body. Since the excess fluid in the inner ear is often blamed for vertigo, reducing fluid retention has become a standard care practice. However, as noted above, these and other medications can actually cause vertigo.
In some cases, such as in a severe case of Meniere’s disease, doctors may recommend injections to the inner ear or even surgery in an attempt to relieve fluid buildup inside the ear. But whether we are talking about surgery or repositioning of the crystals of the ear, these all involve treatment of symptoms after the fact. Some patients would rather seek natural and preventative care methods to stop the next vertigo attack from happening.
A Shift to Natural Care for Vertigo
It has been noted that many cases of vertigo begin after a head or neck trauma, whether major or minor. Concussions, whiplash injuries, slip and fall injuries, sports injuries, and other forms of head and neck trauma often lead to vertigo whether the symptom begins immediately or even years later.
As a result, there is substantial evidence that vertigo may relate to a misalignment of the upper neck. Let’s consider several studies that have been performed to connect vertigo and related conditions, such as Meniere’s disease, to such a misalignment. In this way, we will introduce you to a form of care that is helping many.
Upper Cervical Chiropractic Case Studies Regarding Vertigo
In one study involving 60 patients with vertigo, 48 saw complete relief after seeking upper cervical chiropractic care, and the other 12 all saw significant improvement in frequency and severity. It is interesting to note that 56 of the 60 could recall a particular head or neck trauma that occurred at some point before vertigo began. This study helps to connect vertigo to injuries that cause upper cervical misalignments and shows the positive effects of upper cervical specific care.
Another study was performed involving 139 Meniere’s patients. After just 1 to 2 adjustments, 136 patients saw a dramatic reduction in vertigo severity as well as a reduction in other symptoms of the condition. Continued care helped patients find even more benefits. As a result, after two years of care, the average severity of vertigo attacks dropped from an 8.5 out of 10 to just 1.4 out of 10. It is important to note that in this study, all 139 patients had suffered an upper cervical misalignment due to car accidents or other whiplash-type injuries that had previously been undiagnosed.
The same upper cervical chiropractor was moved to conduct and even longer and larger study involving 300 Meniere’s disease patients over the course of 6 years with similar outstanding results. 291 of the 300 patients (97%) saw a dramatic reduction in vertigo severity. The six-year reduction in severity brought the 8.5 out of 10 average to a mere 0.8 out of 10 average – an improvement of about 90%. Once again, the study focused on patients with both vertigo and a history of whiplash trauma. As a result, the paper concluded with the recommendation to refer all vertigo patients with a history of trauma to an upper cervical chiropractor for examination.
Besides these larger studies, there have also been a number of individual case studies conducted involving vertigo patients. For example, a 45-year-old man had been displaying Meniere’s symptoms for 12 years and had received an official diagnosis five years prior to upper cervical care. After five months of upper cervical adjustments, he remarked an 85% improvement in his symptoms.
Another example involves a 52-year-old man who was suffering from vertigo due to Meniere’s disease along with tension headaches, back pain, and several other health problems. A 60% improvement was reported after only four adjustments. This and other studies help to show the efficacy of various forms of upper cervical chiropractic care.
How Is the Upper Cervical Spine Related to Vertigo?
These studies and many of the conditions noted above have some commonalities. These factors include brainstem function, blood flow to the brain, and cerebrospinal fluid drainage. When the C1 and C2 vertebrae become misalignment, pressure may be placed on the brainstem, thereby affecting its function. Also, upright MRIs have indicated that misalignments in this region can affect blood flow to the brain and cerebrospinal fluid drainage. These are all factors that can lead to vertigo.
It makes sense that correcting the misalignment that creates these conditions can give the body the opportunity to heal. As healing occurs, vertigo severity may be reduced. Thus, patients often see a rapid reduction in vertigo severity followed by ongoing improvements in the months and years ahead as occasional maintenance is performed to keep the atlas and axis (C1 and C2) in place.
Finding Natural Relief from Vertigo in your Area
The studies noted above show that real relief from vertigo is available and that for many people it doesn’t have to take the form of a pill with unwanted side effects. In fact, the sheer number of patients who benefit from upper cervical chiropractic care following head or neck trauma provides valid cause to seek care if you are experiencing vertigo or any other symptom that may have begun in the weeks, months, or even years following the injury.
This site is dedicated to introducing patients with symptoms that are often related to upper cervical misalignments to this natural and gentle form of care. If you are experiencing vertigo, especially if you have suffered an injury involving the head or neck, upper cervical chiropractic may be the non-drug alternative you have been searching for. Find an upper cervical doctor in your area to schedule a consultation today.
Latest posts by Dr. Davis (see all)
- A Safer Alternative to Ibuprofen for Back Pain - March 17, 2017
- Why Neck Pain Is Frequently Related to Migraines - February 5, 2017
- Post-Concussion Syndrome Relieved Through Chiropractic Care - December 19, 2016