Vertigo and Dizziness

Vertigo is characterized by the sense of spinning and disorientation.  People will often feel dizzy, lightheaded, nauseous, sweaty, weak, and will sometimes experience vomiting, hearing loss, ringing in the ears, and speech problems.  This is an extremely uncomfortable experience.  But what is it that causes vertigo?  While there may be a few different reasons, the two most common types are:

**Cervicogenic:  Arising from the neck

**Vestibular:  Arising from the inner ear

Often, whiplash injuries or head injuries precipitate dizziness and vertigo.  Many times, this symptom manifests soon after the injury, but there are times when the symptoms take a month or longer to manifest, or the patient may simply disregard the symptom for quite some time due to other symptoms, such as pain, being so intense.  Let's look closer into the two most common types of dizziness and vertigo.

**Cervicogenic dizziness and vertigo:  A thorough history will reveal any potential injuries, either acute, subacute, or chronic repetitive, that would indicate an insult to the neck or head region.  Then a specific physical exam is performed.  It is known that the receptors in the cervical spine (neck) have an important role in the maintenance of equilibrium.  Sensory impulses in the nerves originating from nerve receptors in the upper neck project to areas in the brain stem.  Injury or insult to the neck region may result in the disturbance of nerve messages to the brain stem, creating vertigo symptoms and cervical nystagmus (where your eyes move in a dysfunctional way).  Treatment is tailored to each individual, but consists of a combination of mobilization and adjustment to the spinal bones, exercises, and postural training.  Treatment duration is dependent on an individual's condition, but generally is between 2 and 10 visits.

**Vestibular dizziness and vertigo:  A thorough history will reveal any potential injuries, specifically noting any whiplash or head injuries.  A specific physical exam is performed.  Anatomically, the inner ear (semicircular canals) are lined on the inside with tiny hairs with otoconia crystals at their base.  If these otoconia are disrupted, they can build up at the base of the hairs.  If enough of the otoconia debris is present, it will cause the hairs to be dysfunctional, creating an abnormal signal to the brain, which the brain then processes as a balance and equilibrium problem.  This is always a positional problem, so the exam is gentle specific positioning, looking for abnormal eye movement, or nystagmus, in order to determine which side is involved.  Treatment is a gentle positioning technique.  The treatment duration is between 1 and 4 visits, until there is no more dizziness.