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What's Up Doc? Is it Vertigo?

While we may have seen Bugs Bunny dizzy at the top of a building or actually had a diagnosis, what is vertigo, truly? 

Vertigo is a sensation of motion, where you feel like the world is spinning around you, even if it’s not. Some symptoms surrounding vertigo include dizziness, fogginess, nausea, vomiting, and balance disturbances. These are reactions our bodies are having due to a change in our muscles, joints, and even our inner ears. There are many conditions that can create these debilitating symptoms but there is only one that is a true vertigo. Our job as practitioners is to determine the cause of the vertigo and treat it, giving relief and a return to normal function. 

BPPV: Benign Paroxysmal Positional Vertigo 

One big long name for one small area of complaint. This type of vertigo is caused by a change in the function of the inner ear. Yes, the inner ear; we have more than one! The structure of our ears include the outer, fleshy parts we all see and use, and the intricate and delicate inner, bony parts. In our skull, right behind our ears, there are tubes in our bone that are filled with fluid, three per side, all arranged on an axis. This structure, called the Labyrinth, allows us to determine where our head is in space. 

Now, let’s imagine in these tubes, the fluid is swishing back and forth with each head movement, sending signals to our brains, saying “Hey! We just turned our head to the left to check out that cutie over there!”. Our brain sends back, “All clear for takeoff, let’s go introduce ourselves!” Thus, a love connection can be made! 

Next, let’s add some crystals to the fluid of those canals. Our brains get the signal from our labyrinth as our head whips around, “Cutie alert! Approach?” However, due to an obstruction of the crystals, the brain has a warped message of “Cutie alert! But, no, down is up and up is down!” Our brain then translates this into dizziness, nausea, loss of sense of self in space, and others; very similar to the reaction you may have at seeing your ex... We end up missing that potential love connection due to misinformation. Instead, we have a check engine light on in our brains, that creates havoc through the rest of the body. 

Chiropractors and physiotherapists know how to correct this dysfunction between our inner ears and our brains. We use techniques such as the Epley Maneuver, soft tissue massage, vestibular reflex training, adjusting of the joints, and many others to reconnect the structures and start the conversation again.

Cervicogenic vertigo 

Unlike BPPV, this type of vertigo is not caused by crystals in the inner ear. The structures involved in this condition are the upper cervical spine joints, the very top of the neck where the head rests on the spine. 

Our heads are what I call our bowling balls that rest on top of our golf tees. Heads weigh between 8-10 lbs in adults, which connect to the cervical spine (neck) in the longest, most difficult balancing act ever seen! Gravity is constantly pulling our heads down which creates force to translate into our bodies via our spines. To keep this force even down our spine, we have many receptors that send signals back to our brains, letting us know where our head is in space in relation to the rest of us, called proprioceptors. These little receptors rest in the muscles and joint capsules of our neck, constantly sending signals to the brain and receiving commands back to move and correct our posture. 

As we start to add more and more force to our head and spine with sustained postures, like sitting at our computers, we start to overload the delicate balance our brains have maintained. Our muscles respond by tightening, overreacting, and locking down our joints. This causes our receptors, the proprioceptors, to mix up the signals to our brains. We miss yet another love connection due to miscommunication! Our brains respond by sending back commands and signals in an attempt to figure out where our head is. “Nobody move! We’ve lost our head! Did we leave it somewhere?” Thus, we end up with symptoms of vertigo; dizziness, loss of balances, fogginess, etc.  

Chiropractors are ideal to assist in this type of condition causing vertigo, since we adjust the upper cervical spine routinely. The goal is to relax the muscles of the neck, bring back the full function of the joints in the neck, retrain the brain and muscles, and prevent another episode. We reconnect the brain to the body and lose the vertigo. 

There are other types of conditions that create vertigo, all of which we treat at Momentum Health and Evidence Sport & Spine locations. We pride ourselves in getting long-lasting results, often without the use of pharmaceutical intervention. Ask your practitioner today about a specific appointment for vertigo if you or anyone you know is having these types of symptoms.

Dr. Victoria McArthur, DC, MSc, BSc, BKin, Functional Integrated Acupuncture, is a Chiropractor at Momentum Health Seton.

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