Understanding Vertigo

with Tiffany Sudol, DPT, CPT

What is vertigo?  It’s a type of dizziness in which a person experiences the perception of motion (usually spinning) due to dysfunction of the vestibular system. Other symptoms associated with vertigo are nausea, vomiting, abnormal eye movements, ringing sensation in the ears, difficulty balancing, visual disturbances, weakness, or difficulty walking. This is not to be confused with light headness or the sensation of fainting.

Ok, so now what’s the vestibular system?  

It is the system in the body that helps us to maintain upright posture and balance. It consists of three major components.

1) What we sense in our surroundings or the peripheral nervous system including the inner ear, sensations that are felt at the bottom of the feet, and vision.

2) The central nervous system or processor, which is like the computer of the body, taking all of the information and compiling it.   Creating the motor output, the third major portion of the vestibular system.

3) The motor output is anything from how hard we push off when we walk, to small adjustments in the body as a ballerina turns, or even creating an appropriate response in the body like throwing our hands forward when we are about to fall.

What causes vertigo?   

A fall, whip lash, a migraine, trauma to the brain, cervical injury or pain, a concussion or knock to the head, an infection, and sometimes we really aren’t sure, but the good news is that you don’t have to live with it.

How can this be treated?

A physical therapist will take a thorough history and objective exam that will provide the information necessary to make decisions about treating the patient. There are simple steps to treating most vertigo. It could be as simple as a few positions which can easily be done and taught in a couple treatment sessions, relieving most if not all of your symptoms.

The problem could be coming from the neck, which is easily treated through functional manual therapy addressing pain and range of motion, postural corrections and awareness, and strengthening of core and cervical/neck stabilizers. Once the mechanical deficits have been addressed we have to begin training the vestibular system. This is an important component to caring for this particular ailment.

Why train the vestibular system?

If you think about it, as children we are constantly swinging and spinning. This is giving our vestibular system feedback and essentially providing it with exercise. So ask yourself, when was the last time that you got on a swing, or spun around and around until you fell down? To be clear we don’t make you spin around until you fall, but we do retrain your body with easy visual cues and head movements that gradually become more difficult and challenging stimulating your vestibular system until you no longer have that sensation of dizziness.

So what’s the moral of the story?

If you have the sensation that the room is spinning or that you are uneasy on your feet because of a sensation of dizziness you don’t have to live with it. You don’t have to take a medication for it. There are non-invasive simple interventions that can get you back on your feet and literally keep you there.

Always remember that your healthcare provider is the best source of information for questions and concerns related to your medical problem.