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Vertigo is a common problem experienced by many people for a wide variety of reasons. When you experience vertigo, you have a sense of spinning dizziness, balance problems, and lightheadedness. A person will feel as if their head or the room around them is spinning or moving. It is not an illness. It is considered a symptom of another condition, such as a problem with the inner ear, brain, or the sensory nerve pathway.
Symptoms of Vertigo
Vertigo can lead to other symptoms including, balance problems, lightheadedness, ringing in the ear, nystagmus (when the eyes move uncontrollably from side to side), motion sickness, nausea and vomiting, and a feeling of fullness in the ear.
Causes of Vertigo
Eighty percent of vertigo cases are caused by Peripheral vertigo that usually results from problems in the inner ear. The other 20 percent of vertigo cases are related to the Central Nervous System (CNS) and stems from a problem in a part of the brain stem or cerebellum.
The most common cause of vertigo is called Benign paroxysmal positional vertigo (BPPV). It is due to what is called “loose crystals” that become dislodged and travel into one of the semicircular ear canals, where they disrupt the fluid creating a false sense of movement. When this occurs any type of head movement such as looking from up to down, changing positions from standing to lying down, and rolling over cause a vertigo sensation.
While BPPV is the most common cause of vertigo, there are several other disorders related to vertigo including Labyrinthitis, Vestibular neuritis, and Cholesteatoma – all of which develop from an infection and cause inflammation in the inner or middle ear. Labyrinthitis controls nerves signals to the brain about head motion, position, and sound and an infection here can also cause ear pain, vision changes, headaches, and hearing loss. Vestibular neuritis causes vertigo and may accompany blurred vision, severe nausea, and an off-balanced feeling. Cholesteatoma is when a non-cancerous skin growth develops in the inner ear, damaging the middle ear’s bony structures, leading to hearing loss and dizziness.
Meniere’s disease is a buildup of fluid in the inner ear and causes attacks of vertigo, ringing in the ears, and hearing loss. It usually occurs in people between the ages of 40 and 60-years-old. It’s thought to be caused by a viral infection or an autoimmune reaction, but the exact cause is not known. Meniere’s also can be hereditary.
Vertigo may also accompany and be a symptom of migraine headaches, head injuries, shingles, stroke, ear surgery, and Multiple Sclerosis. Pregnancy is also a common cause of vertigo because hormonal changes affect the fluid balance in the body, bringing about alterations in the inner ear.
Treatment of Vertigo
BPPV is very easy to diagnose and one of our physical therapists’ can determine if you have BPPV by performing the Dix-Hallpike test. The PT will conduct this test in only minutes by taking you through a series of simple head movements and watching your eyes for involuntary movements called nystagmus. The direction of the eye movements will tell us where the crystals are loose in the inner ear. The primary treatment for BPPV is the Epley Maneuver. This treatment relocates the affected free-floating crystals in your ear back to where they need to be and resolves vertigo in 95 percent of our patients. Usually, it only takes 2-3 treatments and our staff will often follow up with other treatments such acupuncture, balance and strength training, and designing an exercise program for you that will help build your endurance.