Vertigo is the sensation that you or the things around you are spinning. It should not be confused with a fear of heights, a implied by a popular movie from years ago. Benign paroxysmal positional vertigo (BPPV) is the most common form of vertigo and is what we will be referring to in this article. BPPV can affect people of all ages but is most commonly seen in those over the age of 60.
Why Vertigo Happens
Benign paroxysmal positional vertigo happens when the micro-sized calcium crystals (called otoconia) contained within the inner ear move from their normal position on the utricle – an inner ear sensory organ. The otoconia usually lie on a bed of gelatin-like substance on top of the utricle.
If they become detached for some reason, they can move freely in the fluid-filled spaces of the inner ear, which includes the semicircular canals that are responsible for sensing the rotation of the head. If enough of the otoconia are floating around, they can clump together. This makes them heavy, and they might move into the lower part of the inner ear called the posterior semicircular canal.
Once they are located in this area, they begin to move when the position of the head changes. This can be when you look up or down or even roll over in bed. When these stones move, it causes an unwanted flow of fluid in the semicircular canal even when the head stops moving. This is what causes vertigo – the false feeling that you are spinning or the world around you is in motion.
Symptoms of Benign Paroxysmal Positional Vertigo
Those suffering from BPPV often experience the feeling of vertigo when turning over in bed, putting their head back to rinse their hair in the shower, or looking up at something on a high shelf or a place on the wall. This has to do with the way the stones are responding to the pull of gravity. When getting up from the bed, the patient may become unbalanced and may even fall. Nausea, vomiting, and other symptoms similar to motion sickness can be present.
Fear is often a side effect of BPPV as you may not understand what is happening at first. This condition often comes on suddenly, and you may worry you are having a stroke. Falling to the ground is not uncommon with vertigo. The symptoms may lessen as days go by but often linger for weeks or even years.
BPPV is mostly known for episodic vertigo related to the change in the position of the head. Some patients also have a mild degree of continuous unsteadiness.
What Makes Benign Paroxysmal Positional Vertigo Begin?
No one is really sure, especially in older adults, what causes vertigo to start. It seems that as one begins to age, the otoconia are more likely to be dislodged from their original position. Most of us have a few tiny stones floating around in our semicircular canals, just not enough to give us trouble. It is when they clump together and fall into one of the canals that problems ensue.
In some, the following reasons may have caused these stones to fall:
- Riding a bicycle on rough terrain
- Viral or vascular labyrinthine conditions
- Meniere’s disease
- Mild or moderate trauma to the head
- Vestibular migraines
- High-intensity aerobics
- Keeping the head in one position too long – such as in a dentist chair or on bed rest
Caring for Benign Paroxysmal Positional Vertigo
The goal in treating BPPV is to move the stones back out of the semicircular canals. Once completed, it is believed that they are naturally dissolved over a course of a few days or weeks. There is a certain amount of risk that once the stones are moved they can fall back into the canals. At this point, therapy can be repeated.
The Epley maneuver is one of the most popular methods of moving stones. It is made up of a series of specific movements and head positions that helps these stones to move from where they do not belong. During the procedure, the patient may experience strong vertigo sensations. It is a good idea to have a professional help you if this is something you decide to try for your BPPV. It is not always successful, however, and another form of care may be needed.
Upper Cervical Care and Vertigo
There is a possibility that vertigo you are experiencing is not due to the dislodgement of these crystals. If the above procedure does not help, you may need to look a little further into care. One thing that may be helpful and has helped other vertigo patients is that of upper cervical chiropractic care.
A study of 60 patients who had been diagnosed with various types of vertigo, including BPPV, revealed some interesting facts:
- 56 of the patients recalled having some previous trauma to their head or neck
- All 60 were found to have a misalignment in the bones of the upper cervical spine
- All 60 responded well to upper cervical chiropractic care
- 48 were symptom-free after care
- The remaining 12 reported a great improvement in their symptoms
A misalignment in the bones of the upper neck can cause the brainstem to send improper signals to the brain about the position of the body. This can bring about the symptoms of vertigo. By correcting this problem with a gentle, non-aggressive method, the body can begin to heal the damage done by the misalignment. Many of our patients have had similar results to those in the above study and have seen a great improvement and even an elimination of their vertigo.