Vertigo refers to a sense of being off balance. Classic vertigo is when it feels like the room is spinning. Some people use the term to explain a feeling of light-headedness or when they feel like they are spinning but the room is still.
This sensation of being off balance can affect many things:
- Some people feel nauseous and even vomit due to it
- Walking may be difficult and they may fall to one side. This is termed Ataxia or an Ataxic Gait
- They may feel dizzy when they roll over in bed or it may affect them when they rise from sitting
- They may feel anxious – it is, after all, a very unpleasant sensation.
The causes of dizziness are varied and range from low blood sugar to being a sign of significant pathology in the brain.
If you feel dizzy regularly, then we would advise that you seek an assessment from your doctor to clear any medical cause of the dizziness.
If this assessment clears you of any medical issues, then physiotherapy can help with your dizziness by assessing whether it is one of the following:
1. BPPV (benign paroxysmal positional vertigo)
This is where crystals in the inner ear dislodge and become lodged in the semicircular canals (also in the inner ear). This causes the firing of the balance nerve (vestibular nerve) in response to movement to be inaccurate – hence, causing vertigo.
2. Cervicogenic dizziness
This means that due to tightness in the muscles and/or joints of the upper neck (just below the base of your skull), your neck does not signal movement and posture changes to your brain as accurately as it could. Joints in our body have receptors in them called proprioceptors. These are responsible for telling the brain about movement and position of our head in space. So if there is tightness in the neck, the information from the neck conflicts with information from the ear and eyes about movement. The result of this mismatch is dizziness (or vertigo). Physiotherapists can assess for this and treat appropriately with non-manipulative stretches and mobilisation to the muscles and joints.
Before assessing your neck and ears for BPPV, the physiotherapist will screen you for any blood vessel-related problems. In the neck, there is a vessel called the vertebrobasilar artery that winds around the top joint (C1/2). Before assessing the neck you will be screened for symptoms of reduced flow in this artery, and any medical follow up advised as appropriate.
Once the cause of your dizziness has been established, then a course of treatment will be discussed and negotiated with you.