If you’ve ever turned your head quickly and felt like the world is spinning around you, then this insight is for you! This sensation is called vertigo, but as scary as vertigo feels, it’s most likely due to a condition that we commonly treat in clinic – called Benign Paroxysmal Positional Vertigo (BPPV). This insight will cover what causes it, what it feels like, and how a chiropractor can help fix it.
What causes vertigo?
Firstly, it’s important to differentiate between “dizziness” and “vertigo” as they’re often confused. Dizziness refers to feeling faint, or lightheaded. Whereas vertigo specifically refers to the feeling of spinning, or that the world is spinning around you, when nothing is actually moving. This occurs when there is an issue in the inner ear, which controls our balance and coordination. There are many different causes of vertigo, but by far the most common is BPPV. Figure 1. shows the three canals in our inner ear that tells our body where we are in space. These are filled with fluid and small crystals called otoconia. When these crystals become dislodged, it tells the body that we’re moving, even though we are not!
Figure 1. Diagram of BPPV
What are the symptoms and triggers of BPPV?
BPPV is more common in older people (50-70 years). The most common trigger for patients is sudden head movement, usually rotation or laying down (1). Patients often describe rolling over in bed, or looking over their shoulder as the most aggravating. Since BPPV usually only effect one ear, that means you may feel okay looking one way, but trigger vertigo by looking in the other direction. The spinning usually only lasts a few seconds, but a feeling of unsteadiness may linger for a few minutes. Many patients also describe feeling nauseous, vomiting or having a headache. This can be very debilitating, restricting the daily activities people can do due to the onset of vertigo, such as driving.
How a chiropractor can help
Firstly, it’s important to get an accurate diagnosis of vertigo, as it’s possible to be caused by more serious conditions, like infection. As chiropractors, we are trained to screen and identify more serious causes of dizziness/vertigo, and can arrange the appropriate referrals if needed. However, as mentioned, the most common cause is BPPV – which we can have great success treating in clinic!
After an accurate diagnosis, the main treatment used is called the Epley’s maneuver . This is performed by the chiropractor, but can also be done by yourself at home. The aim of this technique is to reposition the dislodged crystals and restore the normal sense of movement. It involves holding onto the patient’s head, and moving it through a series of specific angles as shown in Figure 2. Many people recover after using the Epley maneuver once, whereas for some it might take a few attempts. One study found that this technique results in 91% success rate when patients were followed up 1 year later (2).
Figure 2. Epley’s maneuver
In addition to vertigo, patients with BPPV may also experience upper back pain, neck pain, and headaches due to the reduced head movement, and stiffness associated with the condition. Once the vertigo has reduced, chiropractic care can help to reduce pain in these other areas and improve mobility to restore your previous function and wellbeing. If you or someone you know is suffering from vertigo, get in touch with the clinic today.
About the authors
David McNaughton is a clinician, researcher and lecturer. He is the director and principal chiropractor at DMC Health & Wellness. He has an extensive background in the diagnosis and management of chronic pain. In addition to his clinical studies, David holds a Master’s of Research and PhD in Psychology. He regularly publishes his research in peer reviewed medical and psychology journals. David has taught both undergraduate and postgraduate studies in Chiropractic and Psychology.
Isaac Searant completed a Bachelor of Chiropractic Science, Master of Chiropractic and Master of Research at Macquarie University. His research aims integrate chiropractic and physiotherapy into general practice for the effective management of low back pain. His clinical interests include spinal pain (neck and back) and sporting injuries. Regardless of the condition, his goal as a chiropractor is to work collaboratively with patients.
References
- Palmeri R, Kumar A. Benign Paroxysmal Positional Vertigo. [Updated 2022 Dec 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470308/
- Bruintjes TD, Companjen J, van der Zaag‐Loonen HJ, van Benthem PP. A randomised sham‐controlled trial to assess the long‐term effect of the Epley manoeuvre for treatment of posterior canal benign paroxysmal positional vertigo. Clinical Otolaryngology. 2014 Feb;39(1):39
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