What is Vertigo?
If you've ever felt like the room is spinning around you, even when you are standing still, that might be vertigo. Vertigo is a sensation of dizziness or disorientation that makes you feel like you or the environment is spinning. Vertigo is not a disease or a condition itself but is instead a symptom resulting from an underlying issue, often related to problems of the inner ear, where the vestibular system is located. It can cause dizziness, balance problems, nausea, falls, and eye movement problems. Sometimes, it can be accompanied by involuntary eye movements called nystagmus, which can be identified using specific diagnostic testing technologies that examine the eyes. But, to understand vertigo, we must understand the vestibular system.
Table of Contents:
What is the Vestibular System?
Let’s imagine we are on a merry-go-round or any ride at the fair you spin on. I know, there are a lot, aren’t there. You are on the merry-go-round and close your eyes while it's spinning. When you stop, the world feels like it’s spinning, right? That spinning sensation is because of your inner ear, specifically the vestibular system. The system communicates with your brain and tries to give you a sense of balance amidst different types of movement.
The vestibular system is like the body’s built-in balance beam. It’s located deep inside your inner ear. It is incredibly small but plays a vital role in balance, posture, spatial orientation, eye movement coordination, and even maintaining nausea and vomiting. This system is constantly at work even if you are not moving.
What are the Parts of the Vestibular System?
The Vestibular System (located in the inner ear) has two main parts:
Semicircular Canals: These canals can be better described as “tiny tubes filled with fluid.” These tubes sense when the head is rotating, moving up and down, turning side to side, or tilting. How the fluid moves tells the brain which way the head is moving.
Otolith Organs: Otolith organs are essentially “tiny organs with crystals.” Yes, crystals. Calcium carbonate crystals, to be exact. These tiny organs (or crystals) sense what’s known as linear acceleration or straight-line movements like starting, stopping, or changing direction. These crystals will shift depending on your position in space, which notifies the brain and helps you maintain stability and balance. These tiny organs also sense your head’s position in relation to gravity.
All of this information is sent to your brain, which uses it for a few cool tricks:
Balance: The brain uses this input from the vestibular system to keep you upright and stable, whether balancing on one foot during yoga or riding a skateboard.
Eye Movements: When the head moves, the eyes automatically track things you are looking at. This is thanks to the vestibular system, working with the eyes for smooth coordination.
Keeps Your Stomach Settled: The vestibular system also helps prevent nausea. However, if the system is not working correctly, it can cause dizziness or vertigo. As we’ll soon discover, many causes and explanations for why the vestibular system may not be working properly contribute to the often debilitating symptom known as vertigo, which usually occurs due to a problem in the vestibular system.
Vestibular Dysfunction & Vertigo
Let’s come back to the merry-go-round example. Usually, once we stop spinning, the fluid in the tiny tubes in the inner ear settles down, and the brain receives the correct input that we are stationary. However, with vertigo, something disrupts this process. Sometimes, messages sent from the vestibular system to the brain don’t match what the eyes see, or the body feels on the ground. This can be caused by problems in the inner ear (the vestibular system), like crystals getting dislodged and floating around in areas they’re not supposed to, causing vertigo. It is important to note that the muscles and joints also signal our position in space to the brain. If the brain receives mixed signals from the muscles and joints, this can also cause vertigo.
The result is the feeling of dizziness or spinning, even if you are completely still. While it can be pretty debilitating or disorienting, remember that vertigo is just a symptom resulting from an unresolved and often unidentified underlying issue. Remember to seek a healthcare professional or clinic like Better Brain & Body that can help identify the underlying cause of vertigo.
Two Types of Vertigo:
Before we list some common causes of vertigo, we must establish that there are two primary types: Peripheral and Central Vertigo. While both create a feeling of dizziness and spinning, their causes differ:
Central vertigo: Originates from problems within the brain, specifically in the brainstem or cerebellum, which are responsible for processing balance signals and coordinating movement.
Peripheral vertigo: Originates from dysfunction in the inner ear, particularly in the vestibular system, which is responsible for sensing head movement and position.
Peripheral Vertigo Causes:
Benign paroxysmal positional vertigo (BPPV): This is the most common cause of vertigo, involving tiny calcium crystals dislodging and moving within the inner ear canals, leading to brief episodes of vertigo, especially with specific head movements.
Labyrinthitis: An inflammation of the inner ear, often caused by a viral infection, that can lead to vertigo, hearing loss, and tinnitus (ringing in the ears).
Meniere's disease: This inner ear disorder involves abnormal fluid buildup, causing episodes of vertigo, hearing loss, tinnitus, and a feeling of ear fullness. Tinnitus is a symptom that produces ringing in the ears.
Otosclerosis: A condition where abnormal bone growth in the middle ear can affect hearing and balance and sometimes lead to vertigo.
Central Vertigo Causes:
Migraines: Some people who experience migraines may also experience vertigo as a symptom, often accompanied by headache, nausea, and visual disturbances.
Head injury: Injuries to the head, even mild ones, can sometimes disrupt the inner ear and lead to vertigo.
Certain medications: Some medications, such as antibiotics, anticonvulsants, and certain antidepressants, can list vertigo as a side effect.
Inner ear surgery: In rare cases, surgery on the inner ear can lead to vertigo as a complication.
Stroke: Strokes affecting certain areas of the brain, particularly the brainstem or cerebellum, can sometimes cause vertigo.
Multiple sclerosis (MS): This neurological condition can affect various parts of the nervous system, including the areas responsible for balance, and can sometimes cause vertigo as a symptom.
While this list contains many causes, there are others, including POTS. Postural Orthostatic Tachycardia Syndrome can induce vestibular dysfunction and symptoms such as vertigo. As one of the leading clinics in the United States for POTS treatment, if you are suffering from vertigo due to POTS, our Charlotte-based clinic will help you get to the root cause of your symptom and address POTS, if applicable.
Diagnosing Vertigo & Vestibular Dysfunction:
Videonystagmography is used to help correctly diagnose vestibular dysfunction. We use infrared goggles to examine what the eyes are doing in the dark and can deduce possible vertigo symptoms or vestibular dysfunction by analyzing the eyes.
Computerized Postural Stability Assessment (CAPS) is a diagnostic tool used to evaluate various aspects of balance. CAPS allows our team to measure balance down to a 100th of an inch. This helps us look closer at the vestibular system's control of the body's balance and stability.
Virtualis Motion VR: Virtualis is a virtual reality therapy and diagnostic device that can assess and diagnose vestibular dysfunction holistically and provide patients an immersive experience that gives patients an alternative avenue for assessing their condition.
Dix-Hallpike Maneuver is a test used by Dr. Alicia Brown and other providers to diagnose BPPV, the most common cause of vertigo. Your doctor will have you perform a series of simple movements that they will analyze by looking at the eyes. The doctor observes the eyes, looking for nystagmus, an involuntary eye movement that indicates BPPV.
Medical history and a thorough physical exam will help a healthcare professional further in a diagnosis of vertigo or vestibular dysfunction. Other diagnostic tests are used in a diagnosis including CT scans, blood tests, and audiometric testing. However, these tests are not performed at Better Brain & Body.
Treatment Options
Treatment specifically depends on what the cause is. Once our doctor, Dr. Alicia Brown, identifies the cause of your vertigo, she will set up a treatment plan that fits accordingly. Below, find a list of vertigo treatments used at Better Brain & Body:
Vestibular Rehabilitation: Certain doctors and physical therapists help people with vertigo using specific movements or exercises to stimulate the vestibular system. Talk with your doctor or Dr. Alicia Brown about exercises and movements you can perform independently or alongside your treatment plan.
GyroStim Therapy: Unlike traditional vestibular rehab exercises, the GyroStim is the only FDA-approved "breakthrough medical device" for treating balance disorders and vestibular dysfunction. While the technology might seem daunting, trained technicians control its movements, ensuring a safe, comfortable, and slow rotation designed to optimize your vestibular system's function. The GyroStim's benefits extend beyond vertigo, potentially aiding other conditions and athletic performance.
Canalith Repositioning Maneuvers: These are specialized head movements performed by a qualified healthcare professional. Often used for BPPV, they help dislodge and relocate the misplaced calcium crystals in the inner ear that may be causing vertigo. There is a high effectiveness and success rate with canalith repositioning. Aside from others, this is one of the main techniques used at Better Brain & Body for BPPV related vertigo.
Virtualis Motion VR: Virtualis is the most recent technology to arrive at our clinic. With broad applications for use, this virtual reality therapy stands out for its ability to assess and rehabilitate patients with vestibular dysfunction and balance disorders in ways that aren't possible with traditional physical therapy. By addressing vestibular dysfunction with Virtualis, inherently, vertigo or other symptoms are addressed as well, including PPPD.
Vertigo and Age-Related Falls
The odds of having vestibular dysfunction, balance disorders, and vertigo increase as we age. Like many systems in the body, as we age, they begin to lose their full function. According to Robby Vanspauwen, elderly people are three times more likely to experience vestibular dysfunction (2018). This is a growing public health issue because vertigo and vestibular dysfunction can cause falls, which are the leading cause of death in individuals over the age of 65 (CDC, 2023). In fact, one in four adults over 65 will fall each year.
For older individuals, receiving proper vestibular rehabilitation treatment is essential. It can even be a preventative countermeasure against the realities of age-related vestibular dysfunction that can contribute to vertigo and, therefore, falling. At Better Brain & Body, we also specialize in neurodegenerative disease treatments and brain-based therapy for age-related cognitive decline. If you or a loved one are looking to optimize your brain function, it is never too late to enhance brain and body function.
Closing Out:
Unlike traditional clinics, Better Brain & Body offers a holistic approach to treating vertigo and other conditions. We avoid medications and surgery, specializing in non-invasive, cutting-edge therapies that empower patients to choose a holistic path to healing. If you or a loved one are struggling with vertigo, give us a call at 704-752-8100 or schedule an appointment online using the button below. We’ll schedule you a complimentary 15-minute phone consultation with Dr. Brown to discuss your situation and possible treatment avenues.
Reviewed by Dr. Alicia Brown, DC, DACNB.
Sources:
Keep on Your Feet—Preventing Older Adult Falls. Centers for Disease Control and Prevention. Found on the internet at https://www.cdc.gov/injury/features/older-adult-falls/index.html
Vanspauwen R. (2018). Dizziness and (Fear of) Falling in The Elderly: A Few Facts. The journal of international advanced otology, 14(1), 1–2. https://doi.org/10.5152/iao.2018.0201815