Table of Contents
- What Vertigo Is and What It Isn’t
- The Different Types of Vertigo
- So, Can Chiropractic Help with Vertigo? Yes!
- How Your Local Chiropractor Can Help
- A Word About The Smart Chiropractor
What Vertigo Is and What It Isn’t
Have you ever felt the room spinning around you? Or felt like you just walked off a boat that had been in a rough ocean, almost like you can’t balance on your own two legs?
Has it ever been so bad that it made you feel nauseous or “seasick”?
Those sensations and feelings are known as vertigo.
Vertigo is different from being light-headed as simple movements are unusually highly intense for people with vertigo. In more severe cases, nausea and vomiting can be associated.
Vertigo is a symptom of an underlying condition. It’s (loosely) a type of dizziness that is often described as the feeling that you are spinning or that the world is spinning around you (particularly as you change position).
It’s estimated that 40 percent of U.S. adults will experience vertigo at least once in their lifetime, with women slightly more likely to get it than men (likely leading a large chunk of both to Google about the whether or not chiropractic can help).
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The Different Types of Vertigo
There are two main types of vertigo: central vertigo and peripheral vertigo.
There is also a secondary type of vertigo called cervicogenic vertigo that often has to do with mechanical disruption or disruption of joint motion in the cervical spine.
So, what about vertigo and chiropractic treatment? Can chiropractic help with vertigo? Read on.
1. Peripheral Vertigo (Inner Ear Issue)
When looking for an answer to the question of vertigo and chiropractic treatment, you’ll likely read about peripheral vertigo, one of the most common types of vertigo caused by an inner ear issue.
The inner ear controls your balance, and within the inner ear is an area called the vestibular labyrinth, also known as the semicircular canals.
This system of canals consists of an anterior, horizontal, and posterior canal.
These canals respond to the head and neck’s angular movement (rotating motion) voluntarily or by an accelerated force.
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Within the inner ear, there are also small calcium crystal-like formations called otoliths.
The otoliths’ job is to sense gravity and linear acceleration or motion.
If the structures in the inner ear are not working properly or are disrupted due to an injury or illness, it can easily cause dizziness, lightheadedness, or feeling unbalanced.
To determine which canal is inhibited, the patient will be asked to perform various head motions.
Evaluating the Inner Ear
Typically, a vertigo patient will be asked to nod their head back and forth – the typical “yes” motion.
If dizziness or vertigo-like symptoms are recreated, it can be determined that the issue might be coming from the anterior canal.
Then, a vertigo patient would most likely also be asked to tip their head from side to side (ear to shoulder).
If dizziness or vertigo-like symptoms are recreated, it can be determined that the issue might be coming from the posterior canal.
Finally, a vertigo patient would most likely be asked to shake their head back and forth as if they are saying “no.”
If dizziness or vertigo-like symptoms are recreated, it can be determined that the issue might be coming from the horizontal canal.
Interestingly, most of the time the posterior and anterior canals are the culprit versus the horizontal canal, which only has a 1-2% chance on average of being a vertigo patient’s primary issue.
Of course, that’s something most chiropractors and healthcare professionals already know (as you’ll read more about below).
You’re here for a high-level overview to help you understand how your local chiropractor may be able to help you find natural relief from your vertigo and the connection between vertigo and chiropractic treatment, so let’s move on.
The Different Types of Peripheral Vertigo
In order to best understand the different ways a chiropractor can help address vertigo symptoms, it’s smart to first give yourself a basic understanding of the different types of vertigo starting with the most common: peripheral vertigo.
Benign Paroxysmal Positional Vertigo (BPPV)
Let’s start with BPPV.
BPPV is best characterized by brief mild to severe episodes of dizziness or feeling like you are spinning or the room is spinning.
These episodes are often triggered by head movement or position.
Did You Know
BPPV is one of the most common types of vertigo.
Next, let’s look at labyrinthitis.
As you may have guessed, this type of vertigo is often caused by an infection in the inner ear – or labyrinth of the ear – where balance and hearing are controlled.
Common symptoms include feeling like you are moving when you are not and dizziness often accompanied by a headache, fever, or earache due to an infection.
The flu, the common cold, or bacterial infection usually causes this type of vertigo.
Next on the list is vestibular neuronitis.
This type of vertigo is caused by an infection that has spread to the vestibular nerve affecting the patient’s balance.
This type of vertigo almost always follows the flu or cold infection.
It is characterized by a sudden onset of symptoms that could cause earache, unsteadiness, nausea, or vomiting.
Finally, and most severe symptom-wise, is Meniere’s Disease.
This is a sudden, strong bout of vertigo that causes nausea and vomiting and can last up to 24 hrs.
It is also characterized by hearing loss, ringing in the ears, and a feeling of fullness in the ears.
The exact cause of Meniere’s Disease is unknown, but it seems to be due to an abnormal amount of fluid (endolymph) in the inner ear.
Improper drainage of fluid due to a blockage or anatomical blockage, abnormal immune response, viral infection, or a genetic predisposition are all things that could affect the amount of fluid in the inner ear.
Just a quick bit of supplemental information there – let’s move onto the second main type of vertigo: central vertigo.
2. Central Vertigo (Brain-Related Issue)
As we examine the question can chiropractic help with vertigo and the connection between vertigo and chiropractic treatment, it’s important to take a quick look at central vertigo, which is caused by an issue or problem within the brain or brainstem.
The Different Types of Central Vertigo
As one can imagine, these types of vertigo are often more concerning and severe.
Conditions that Often Cause Central Vertigo
- Blood vessel disease
- Certain drugs, such as anticonvulsants, aspirin, and alcohol
- Multiple sclerosis
- Seizures (rarely)
- Tumors (cancerous or noncancerous)
- Vestibular migraine, a type of migraine headache
Symptoms associated with central vertigo can include loss of consciousness, numbness, weakness, diplopia (double vision), dysarthria (trouble speaking), ataxia, loss of the visual field, difficulty swallowing, tinnitus, severe headache, or drooping of the eyelid.
It’s imperitive that you contact a medical professional if you experience any of the above.
That said, since we’re specifically looking at vertigo and chirorpactic treatement, let’s move on to cervicogenic vertigo.
3. Cervicogenic Vertigo (Neck Pain)
Cervicogenic vertigo is a clinical syndrome that is often differentiated by imbalance, dizziness, neck pain, limited range of motion, and at times accompanied by a headache.
The symptoms associated specifically with this type may have you quickly wondering “can chiropractic help with vertigo?”
To be considered cervicogenic vertigo, the cervical spine is considered the cause of dizziness when all other causes are ruled out.
The dizziness the patient feels is often closely related to cervical spine position and joint motion.
To follow that up for those of you who are particularly interested in the subjects of vertigo (and vertigo and chiropractic treatment), it has been suggested that faulty cervical proprioceptive inputs could be a factor or that there is a disruption of afferent signals (signals going toward the brain) from the upper cervical spine causing the brain not to be able to orient where in space the head is.
While it is unknown what specifically causes the symptoms of feeling off-balance, dizziness, disorientation, or unsteadiness, there are a number of reasons a chiropractor can help.
Let’s dive in.
So, Can Chiropractic Help with Vertigo? Yes!
Chiropractic care is, in fact, sought out for vertigo relief quite often.
There are several things that a chiropractor can do to help a patient suffering from peripheral and cervicogenic vertigo episodes in particular.
How Chiropractors Assess Vertigo
First, chiropractors have significant and specific training in diagnosing cervicogenic dizziness or vertigo from peripheral or central vertigo.
During the medical training a chiropractic student completes to become a doctor of chiropractic, they are taught how to assess cranial nerves for proper function, how to assess the cervical spine for proper joint motion, and how to determine if the bouts of vertigo are coming from a peripheral source, central source (brain or brainstem), or a mechanical source (cervicogenic vertigo).
Obviously, you’re here because you’re curious about finding an answer to the question can chiropractic help with vertigo, so let’s look at how that translates to the steps a chiropractor would take to assess you (or any patient) for vertigo.
How Chiropractors Assess Vertigo
- A comprehensive history of the patient vertigo symptoms
- A full look at the spinal range of motion and movement
- Testing specific head motions such as rotation, lateral flexion, flexion, and extension to see if symptoms can be reproduced
- Testing cranial nerves
- Looking at how your eye moves with specific motions
- Specific orthopedic tests that help determine the cause of your vertigo (swivel chair test, Dix-Hallpike, vertebral artery test, cervical position sense, Romberg test, roll test, nystagmus, finger-pointing test, and Babinski-Weil, saccadic eye motion test, smooth pursuit test, gaze coordination, cranial nerve test, and eye-head coordination test)
Then, when working to determine if cervicogenic vertigo and peripheral vertigo is likely present, your chiropractor will employ several exams.
For instance, during your exam your chiropractor will see if specific head movements recreate your symptoms (as we discussed earlier).
If symptoms are recreated with head movement and then are lessened with stabilization of head movement, it can be determined that the cause of vertigo could be BPPV, a type of peripheral vertigo.
On the other hand, if symptoms do not occur with head movement or if vertigo symptoms continue, it suggests that the vertigo is a central pathology such as the types listed in the central vertigo section.
That said, during the physical exam, your chiropractor will be looking for symptoms that do not indicate that BPPV is the origin of your vertigo.
Again, you’re here because your curious about the ways that chiropractic can help with vertigo, so below is an overview of some of the key characteristics and symptoms DCs will be on the lookout for.
How Chiropractors Rule Out Vertigo (BPPV)
- Head injury or trauma
- Vertebrobasilar insufficiency (VBI) (5 Ds: dizziness, diplopia, drop attacks (loss of power or consciousness), dysphagia (problems swallowing), dysarthria (problems speaking), 3 Ns: nystagmus, nausea or vomiting, other neurological symptoms, 5 others: light headiness or fainting, disorientation or anxiety, disturbances in the ears – tinnitus, pallor, tremors, sweating, fascial paraesthesia or anesthesia)
- Loss of consciousness
- Frequent unexplained history of falls
- Hearing loss
- Earache, ear infection, fullness in the ear
- Changes to or loss of your visual field
- Difficulty speaking
- Difficulty swallowing
- Facial or extremity paralysis
The above are all symptoms that suggest a more severe pathological or central cause of vertigo and should be addressed as soon as possible with you and your primary healthcare provider.
These symptoms may also spark concern, and you could be referred to a neurological specialist if needed.
Should youry chiropractor find none of the above are present, they’ll likely move on to a specific test for helping to determine if BPPV is present called the Dix-Hallpike test.
The Dix-Hallpike test is considered the gold standard for deciding posterior semicircular canal involvement and the standard orthopedic test for vertigo.
This test involves a series of head movements while the patient lies back quickly.
This motion will exacerbate the Vertigo symptoms if the cause is related to crystals in the inner ear.
If your Dix-Hallpike test is positive, cervicogenic vertigo can be ruled out and it can be determined that BPPV is present.
Vertigo and Chiropractic Treatment
If BPPV is determined to be present, canalith repositioning maneuvers and at-home exercises are the standard treatment.
At times an adjustment of the cervical spine can also help the patient’s symptoms decrease.
If a high velocity, low amplitude adjustment (HVLA) is not tolerated by the patient, instrument-assisted chiropractic adjustive techniques (IACMT) can be utilized with a tool called an activator.
Npw, cervicogenic vertigo is a diagnosis of exclusion, meaning that it is only diagnosed once all other causes of Vertigo have been eliminated.
Additionally, if vertigo is present but neck pain is not, then cervicogenic vertigo can be ruled out as the diagnosis.
If cervicogenic vertigo is determined to cause the patient’s vertigo, chiropractic care is the standard of treatment.
Manual adjusting, IACMT, manual massage, and exercises to improve the patient’s active range of motion can be very helpful in decreasing the symptoms.
How Your Local Chiropractor Can Help
Yes, chiropractic care can help you find relief from vertigo.
Patients should consult their chiropractors for patient-specific treatment plans.
There are many different types of vertigo and many other things that can cause vertigo.
Your local chiropractor is your best resource for helping you figure out what is causing your symptoms and what treatment can help decrease your symptoms.
They are also able to refer you to other medical specialists when needed.
All natural chiropractic care can help with vertigo.
If you know someone who is also wondering can chiropractic help with vertigo, we invite you to share article with them.
And, more importantly, if you suffer from vertigo or vertigo-like symptoms, there is treatment, and reaching out to your chiropractor can help you get the treatment and help you need.
A Word About The Smart Chiropractor
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