Understanding Vertigo

A short discussion of common causes of vertigo and how to manage them

Vertigo is not a diagnosis, it is a symptom! Vertigo is described as a feeling of spinning, or of feeling the room spinning around you and can be brought on by a number of different problems with the vestibular system, a small organ in the inner ear that controls our balance. Where vertigo refers to a spinning sensation, dizziness refers to a sensation of imbalance, lightheadedness or instability.

 

In this article, you’ll learn about the anatomy and function of the vestibular system. Then, we’ll review a few different conditions that can cause vertigo or dizziness and what your treatment options are.

 

What is the vestibular system?

 

The vestibular system is composed of a set of small organs in the inner ear (peripheral vestibular system) and its connections to the brain (central vestibular system) which give us information about our head movement and positioning. The main parts of the peripheral vestibular system are the fluid-filled semicircular canals, which sense movement, and the otolith organs which sense speed. Information from the vestibular system, along with information from our eyes and position receptors in the rest of our bodies help us remain oriented and upright and balanced.

 

What common conditions cause vertigo?

 

Studies have shown that up to 15% of primary care visits are related to complaints of vertigo or dizziness. Let’s dive into what can cause this very common symptom.

 

Benign Paroxysmal Positional Vertigo

 

Benign Paroxysmal Positional Vertigo, or BPPV is the most common cause of vertigo. BPPV is characterized by brief (5-30s) intervals of vertigo, normally brought on by movements like rolling over, getting up from bed or tipping the head back. BPPV is caused when crystals which are normally found in the otolith organs break away and migrate into the semicircular canals. When this happens, rather than having smooth fluid movement through the semicircular canals, we also have small crystals floating around. Head movements will trigger movement of the fluid and the crystals, and set off brief episodes of spinning vertigo.

 

Other Common Causes of Vertigo

 

Other common causes of vertigo are vestibular neuritis and labyrinthitis, which are most often caused by viral infection of the vestibular nerve or of the whole vestibular system and associated structures. The vertigo tends to be more severe and prolonged than with BPPV, and in the case of labyrinthitis will be accompanied by hearing loss. The vertigo may last for hours to days, and once it passes, either on its own or with appropriate medication you may be left with dizziness, imbalance and residual vertigo. Menières disease is another cause of prolonged vertigo episodes, and it is thought to be caused by fluid buildup inside the vestibular system.

  

What to do if you experience vertigo or dizziness?

 

If you experience vertigo, the best thing to do is consult a knowledgeable health care professional such as your GP, or a vestibular physiotherapist. They will be able to screen you for potentially serious causes of vertigo of non-vestibular origin such as stroke, and refer you to the appropriate resource, either to a general physician, a specialized physician such as an otorhinolaryngologist or a trained vestibular physiotherapist. You may also be referred for a hearing test, or imaging of the brain. Once serious causes of vertigo have been ruled out and possible causes of the vertigo or dizziness have been identified, vestibular rehabilitation can be helpful in getting rid of the symptoms of vertigo and dizziness as well as improving balance and overall function.

 

Vestibular Rehabilitation for Vertigo and Dizziness

 

Vestibular rehabilitation is a branch of physiotherapy that aims to treat the vertigo, dizziness and loss of balance caused by BPPV or any other disorder that touches the peripheral or central vestibular system. 

 

BPPV is usually treated with specific exercises such as the Epley maneuver,  which encourage the crystals to exit the semicircular canals. Peripheral vestibular disorders like vestibular neuritis are most often treated with exercises that strengthen the vestibular system. These can include exercises that work on gaze stabilization and other vestibular reflexes. Your therapist may also prescribe specific balance or gait-based exercises. We can also work on something called sensory organization, which helps to strengthen your vestibular system by encouraging your brain to use sensory input from the vestibular system rather than the eyes for balance and orientation. 

 

Conclusion

 

Vertigo and dizziness are very common symptoms that can have many different causes, even beyond those covered in this article. If you experience vertigo or dizziness, consult a trained health care provider quickly. There are effective treatment and rehabilitation options for dizziness and vertigo of all causes, living with those symptoms isn’t the only option, and a trained vestibular physiotherapist can help!

Need help with your rehabiliation? Give us a call today at 514-647-4778 to make an appointment with one of our expert physiotherapists.