What is Vertigo?
Vertigo is a symptom in which it feels like the room is spinning. It is very similar to how you would feel if you just got off a playground roundabout.
In the medical sense, the word “vertigo” has nothing to do with heights. Often people describe the uneasy feeling we get up a height as vertigo, but in medicine it only refers to the symptom of feeling like the room is spinning.
Do I have Vertigo?
Vertigo is a symptom (like pain) rather than a diagnosis. If you sometimes get the feeling like the room is spinning when there is no reason to feel that way, you have the symptom of vertigo. The reason you have the vertigo has not yet been determined. You will need to be reviewed by a Physiotherapist or Physician to diagnose the cause of the vertigo.
What are the symptoms of Vertigo?
Vertigo is a single symptom in itself (room spinning). Depending on the cause of the vertigo other symptoms can often be present. These include:
- Feeling lightheaded
- Feeling dizzy or “dizzy spells”
- Unsteadiness or imbalance
- Balance loss
- Hearing loss
- Tinnitus (ringing in the ears)
- “Fullness” in the ears
- Neck pain
- Neck stiffness
What is the difference between Vertigo and dizziness?
People often say they feel dizzy when what they are really feeling is vertigo. These are similar but different. Dizziness is when you feel unsteady. Vertigo is when it feels like the room is spinning. Lightheaded is when your energy feels low, like you might faint.
What causes Vertigo?
Vertigo can be a symptom of a variety of diseases. The most common are listed below:
- Benign Paroxysmal Positional Vertigo (BPPV) or Benign Positional Vertigo
- Vestibular Hypofunction
- Vestibular Neuritis or Vestibular Neuronitis
- Ménière’s Disease
- Central Vertigo
Our sense of head position is detected by the movement of fluid within the labyrinth organ (the inner ear).
Benign paroxysmal positional vertigo (BPPV)
BPPV is caused by small salt crystals called ‘otoconia’ that become dislodged from one part of the labyrinth organ (inner ear) and get stuck in the canals of the labyrinth. The crystals disturb our sense of head position, making the brain think that we are spinning when we are not. BPPV can be treated by a Physiotherapist with training in Vestibular Rehabilitation.
If you have been specifically diagnosed with BPPV you can perform the appropriate maneuver yourself and expect significant relief. If you have not been diagnosed by a professional trained in vestibular pathology management, you should not attempt the maneuver before being evaluated. The maneuver performed must match your specific diagnosis to be effective.
Eppley maneuver to treat posterior canal BPPV
Lempert (BBQ) maneuver to treat horizontal or lateral canal BPPV
Deep Head-Hanging maneuver to treat superior or anterior canal BPPV
Semont maneuver to treat cupulolithiasis
This diagnosis basically means the balance system in your inner ear – the labyrinth organ – is not working properly for some reason. This can be the result of previous or current vestibular neuritis or labyrinthitis (see below), reactions to medications, blood clots, tumors or just the effects of aging. A Physiotherapist trained in Vestibular Rehabilitation can work with you to determine the cause of the problem and the best course of action to address it.
Labyrinthitis is an infection of the labyrinth organ (inner ear). It is usually caused by a viral infection and clears up on its own but sometimes it is caused by a bacterial infection and antibiotics can be used. Sometimes hearing loss can occur and if so you should seek medical attention as soon as possible. Labyrinthitis can be diagnosed by your Physician and usually clears up in a couple of months. If you have chronic symptoms from labyrinthitis, a Physiotherapist trained in Vestibular Rehabilitation can help.
Vestibular Neuritis or Vestibular Neuronitis
Vestibular Neuritis is a viral infection that causes inflammation of your vestibular nerve (the nerve connecting your labyrinth organ to the brain). This condition usually resolves over a few weeks on it’s own but it is best to have it diagnosed by your Physician or a Physiotherapist trained in Vestibular Rehabilitation.
Meniere’s disease is a disorder of the labyrinth organ (inner ear) that causes vertigo (room spinning), hearing loss and tinnitus (ringing). It also often causes a feeling of fullness in the ear.
The term ‘Central Vertigo’ is used when the vertigo symptoms (room spinning) are caused by problems within your brain or spinal cord – also known as the Central Nervous System. The cause can be a variety of things including migraine, brain tumor, multiple sclerosis etc. Central Vertigo can be diagnosed by your Physiotherapist or Physician but the underlying cause will likely require further testing and referral to a specialist.
How do you diagnose Vertigo?
As discussed above, vertigo is a symptom (room spinning) that can have many causes. To diagnose the cause of the vertigo a Physiotherapist trained in Vestibular Rehabilitation will ask you questions about your problem and then perform some clinical tests. These will include specific tests for the function of the vestibular organ as well as some tests of your vision and balance. If further testing is required you may be referred to a Physician or specialist.
Is there a cure for Vertigo?
Most causes of vertigo can be treated very effectively. The key is establishing the precise cause of the vertigo. For example, if the cause is BPPV, specific maneuvers can be performed to remove the crystals from the canals of the labyrinth (inner ear). If the cause is an infection it will usually clear up in 3-4 weeks on it’s own. If the cause is more chronic, Vestibular Rehabilitation can be used to reduce or eliminate the symptoms. Your Physiotherapist can help you determine the exact cause and propose a specific treatment plan.
What is Vestibular Rehabilitation?
Vestibular Rehabilitation Therapy (VRT) is a form of exercise training designed to reduce symptoms of vertigo and dizziness as well as improve balance and strength. Each Vestibular Rehabilitation program is specifically designed for an individual suffering from difficulties with vertigo (room spinning) and dizziness and the problems that come along with these issues, such as reduced balance, strength and mobility.
Your Physiotherapist will perform specific tests to determine what the problem is and what deficits have developed. This usually includes some tests of your vestibular (inner ear) function, visual function, balance, flexibility, strength and walking. Once a diagnosis has been made your Physiotherapist will work with you to develop a program of exercises based around what you want to be able to do. The exercise program often includes some specific exercises that will deliberately stimulate the feelings of vertigo or dizziness in order to allow your brain to ‘habituate’ to these movements. This will cause the symptoms of vertigo and dizziness to reduce. You may also be given some more general exercises to address any reduced strength, flexibility or mobility that have developed.
Will Vestibular Rehabilitation help me?
People who have been diagnosed or believe they have any of the following problems may benefit from Vestibular Rehabilitation. You can be examined by a Physiotherapist without referral from your family doctor to determine if Vestibular Rehabilitation can help you.
- Benign paroxysmal positional vertigo (BPPV)
- Vestibular Neuritis or Neuronitis
- Ménière’s disease
- Neck related dizziness
- Fear of falling
- Reduced mobility
If anything mentioned above rings a bell you will probably benefit from an assessment by a Physiotherapist trained in Vestibular Rehabilitation. I can liaise with your family Physician and help organize referral to a specialist if required.
You do not need a referral from your doctor to be assessed by a Physiotherapist. If you would like to book an assessment please get in touch.