Sometimes you may experience or sense a range of unexplained feelings like dizziness or spinning and wonder what could be the problem. In most cases, this dizziness or spinning could indicate vertigo. You may experience vertigo due to inner ear, sensory nerve, or brain problems.
Regarding vertigo, age does not matter, although it is more prevalent in the elderly. You can experience dizziness temporarily and it will go away, or you can have it long-term. Since vertigo can affect your daily life, you should consider consulting an experienced physiotherapist who will help you with exercises that will aid your balance.
Please keep reading to understand what vertigo is, its causes, and its treatments.
The Definition of Vertigo
Vertigo is the feeling or sensation of spinning or motion that you can describe as dizziness. You should note that the sense of vertigo is not being lightheaded. When you are suffering from vertigo, one thing you will experience is that you will feel as though you are spinning even when you are sitting still or as if the world around you is moving, spinning, or tilting.
When understanding vertigo, you should know that it is a symptom, not an actual condition. Sometimes, the feeling is barely noticeable, but it can also be severe enough that you can not even perform your daily tasks, as vertigo makes it challenging to maintain balance.
You may experience vertigo attacks that develop suddenly, lasting for a few seconds or much longer. When you are experiencing severe vertigo, the symptoms may last a couple of days and remain constant.
Sometimes, you may experience vertigo when on a funfair ride or in a moving vehicle as the world around you is moving while your body is sitting still. However, vertigo most happens when you have an inner ear problem.
Vertigo can occur when your sense of balance is not okay. In some instances, vertigo goes away by itself, but if it is persistent, you should seek medical help.
Signs and Symptoms of Vertigo
When you suffer from vertigo, you will feel like the space around you or your head is spinning or moving, and this sense usually worsens when you move your head. Some symptoms will solely depend on the type of vertigo you have. The signs and symptoms indicating you are suffering from vertigo may include:
Difficulty in swallowing.
Loss of balance.
Hearing loss in one ear or both.
Involuntary eye twitching or movements.
Buzzing or ringing in your ears.
Issues focusing on the eyes.
Loss of balance.
When you experience a sense of fullness in the ear.
When you experience a feeling of weakness in your limbs.
Common Causes of Vertigo
Causes of vertigo can be classified into two categories; central and peripheral vertigo.
Peripheral vertigo occurs due to inner ear problems in the part that controls balance. The part that controls balance in the inner ear is the semicircular canals, or vestibular labyrinth. Additionally, the nerve found between the brainstem and inner ear may also be affected, leading to balance issues.
Peripheral vertigo may be caused by:
Benign paroxysmal positional vertigo (BPPV)
BPPV is an inner ear disorder mainly triggered by your head's position. You will most likely experience vertigo when sitting up, turning over, or lying in bed; you will feel as if the room is moving or spinning. BPPV occurs when canaliths, which are tiny calcium particles, are dislodged from their position.
Although this experience can be problematic, BPPV is not a symptom of a severe medical condition; it should disappear within a couple of days after the first episode. However, if you are aged above 65 years, you should seek medical attention as the instability may cause you to fall, leading to fractures.
Some medications have side effects that could lead to vertigo since they are toxic. Some of these medications, such as antibiotics, aminoglycosides, diuretics, cisplatin, or salicylates, can affect the structures of the inner ear. You must check your medication leaflets before taking them to know if vertigo is one of its side effects.
If you experience vertigo after taking your medications, do not stop taking them; instead, consult with your health provider. Your doctor will prescribe alternative medication if you are worried about your current medications' side effects.
Meniere's disease is an inner ear disorder that occurs due to changing ear pressure and fluid buildup in the inner ear. Meniere's disease can cause tinnitus, hearing loss, vertigo, a sense of fullness(aural), and ringing in your ears.
When you have Meniere's disease, you will experience sudden vertigo attacks that could last for a couple of hours or even days. These attacks will result in nausea and vomiting. Though the cause of Meniere's disease is unknown, you can control it using proper medication and diet.
Cholesteatoma is a condition that develops when you suffer from repeated ear infections, resulting in the development of non-cancerous skin growth in the middle ear. Cholesteatoma can lead to vertigo, hearing loss, and dizziness.
Labyrinthitis is a deep inner ear inflammation problem caused by an infection. Labyrinthitis is a maze filled with fluid in the inner ear that helps control the body's balance and hearing.
Inflammation due to an infection will affect the transmission of this information to the brain. When the message to the brain is interrupted, the labyrinth sends different information to your brain. The data transmitted by the affected ear differs from that sent by the unaffected ear. This conflicting information may cause vertigo and cause you to experience vision changes, severe headache, tinnitus, vomiting, ear pain, fever, dizziness, and hearing loss.
Labyrinthitis is commonly due to a viral infection. This infection will cause inflammation around your inner ear nerves, affecting your balance.
Vestibular neuritis is the inflammation of the vestibular nerve that leads to vertigo. Additionally, the inner ear has a vestibulocochlear nerve found in the inner ear, and its work is to transmit information regarding the position, head motion, and sound to the brain. Vestibular neuritis does not affect your hearing but causes blurred vision and nausea.
Vestibular neuritis is caused mainly by a viral infection such as flu. This condition develops suddenly and can lead to other symptoms like nausea, vomiting, and unsteadiness. You will experience these signs for a couple of hours or even days, and they will clear on their own within six weeks.
You may experience a balance disorder due to a bacterial or viral infection affecting your head, ear, or blood circulation. These infections affect your brain or inner ear, causing a balance disorder. At other times, you may experience a balance disorder due to age, especially if you are over 65. Additionally, you can experience a balance disorder from your medications.
If you have circulatory and nervous system issues, they could affect your balance and posture. Other health issues that might contribute to a balance disorder are:
Problems with your visual or skeletal system.
Central vertigo results from a problem in the brain. This problem mainly emanates from the cerebellum, the back part of your brain, or the brain stem, which is the lower part of the brain and connects with the spinal cord.
In most cases, central vertigo may be caused by:
Multiple sclerosis affects the spinal cord and the brain( central nervous system)
Certain drugs, like aspirin, anticonvulsants, and alcohol.
Acoustic neuroma is a rare benign brain tumor. This tumor grows on the acoustic nerve, which controls balance and hearing.
Migraines- a severe headache that you will feel like a throbbing pain emanating from one side or the front of your head. Younger people usually experience migraines.
Other causes of vertigo may include:
Prolonged bed rest.
Keri lymphatic fistula occurs when the food found in the inner ear leaks and flows into the middle ear.
Low blood pressure.
When you visit your healthcare provider with vertigo symptoms, they will carry out some tests to make a diagnosis. Depending on how you answer your healthcare provider's questions, they may refer you to further examinations.
When diagnosing vertigo, your doctor will ask questions to establish the cause of your symptoms. Your healthcare provider will want you to describe your first episode and what you experienced in detail. For instance, they may ask whether your room was tilting, spinning, or if you felt lighthearted.
It is crucial to tell your doctor if you have experienced other symptoms like nausea, hearing loss, vomiting, fullness in one of your ears, lack of balance, or tinnitus. Also, let your doctor know the duration of your vertigo episodes and how often they occur. Also, let your GP know if these symptoms affect your daily routine, like walking. If you cannot walk when you have an episode, what do you think might be triggering the attacks.
If you note that a specific movement affects your vertigo episodes, positively or negatively, mention it.
Your doctor will perform some physical examinations after listening to your explanations to establish the cause of your vertigo. These physical examinations may include looking at your eyes for uncontrolled movements or twitching and checking your ears. The doctor can also try to recreate the signs and symptoms of your vertigo by asking you to sit up quickly from a lying-down position and vice versa.
How to Test for Vertigo
Once you realize that your vertigo episodes are not going away, you should visit your doctor. Your doctor or health provider will examine you and conduct some tests to show:
Eye movements or involuntary twitching(nystagmus)
Walking problems due to imbalance
Weakness in the limbs.
Lack of proper coordination
Some of the tests that the health provider will carry out include:
When experiencing hearing loss or tinnitus, your healthcare provider may refer you to an ENT specialist. The ear, nose, and throat specialist will examine you and conduct some tests. These hearing tests will include:
The Rinne, or Tuning Fork Test
When conducting this test, your tester will place a tuning fork on your mastoid bone, or outer ear, since this fork produces sound waves that can be used to check on your hearing. When the tuning fork is placed on both sides of your head, the tuning fork generates sound waves, and air conduction uses the ear( ear canal, pinna, ossicles, and tympanic membranes) to direct and amplify the sound. When your tester places the tuning fork on your mastoid bone, bone conduction takes place, allowing the vibration of the sound to reach the inner ear.
An Audiometry Test
Your ENT healthcare provider will use an audiometer, a machine that produces sound in different pitches and volumes. You will listen to the sound via headphones and then signal by pressing a button or using your hand when you hear a sound.
This test is used to check the organs that help with your balance. The test is mainly used to check for signs and symptoms of nystagmus, and your tester will place some special goggles over your eyes. The tester will then ask you to look at various moving and still targets. Since the goggles have a video camera, it will record your eyes' movements.
For this test, the tester will use electrodes placed on your eyes instead of goggles. The tester will then ask you to look at various moving or still objects and note down your eye movements.
The specialist will blow warm air or water into your ear, and they will conduct this test within 30 seconds. They will use this test to gauge how your inner ear works as the temperature change stimulates your inner ears' balancing organs.
You should not be worried about this test as it is not painful, but you may experience a dizzy spell that can last for a few minutes after the test.
Sometimes your healthcare provider may test your balance by using a machine that will give them valuable information on how your vision, hearing, and sensations from your joints and feet (proprioception) are helping with your balancing.
CT and MRI Scans
Sometimes, your healthcare provider may request scans to check for the causes of your vertigo. The scans will help identify if you suffer from non-cancerous brain tumors (acoustic neuroma).
When it comes to treating vertigo, the treatment will solely depend on the cause of your symptoms.
Lie still in the dark and quiet room
When you are experiencing a vertigo attack, you should lie still in a dark and quiet room as this will help reduce the symptoms of feeling like you or the room is spinning and nausea.
Sometimes, you should avoid anxiety and stressful situations as they may worsen the vertigo symptoms.
Avoid Alcoholic drinks
If you notice that alcoholic drinks affect your balance, you should avoid taking them.
Take regular breaks
Sometimes, tiredness may significantly contribute to the symptoms of your vertigo worsening; if this is your case, try to take several breaks from your daily routine.
Leave Your Bed Slowly
If you are experiencing vertigo due to BPPV, you should always get out of bed slowly and avoid participating in activities that involve looking upwards. While waking up, take your time while rising out of bed and sit on your bed's edge for a minute before standing
Perform Epley Manoeuvre
When performing an Epley manoeuvre, you will move your head in four separate and different positions. Each movement will help to move the fragments that are dislodged in your inner ear back to their place and, by doing so, eliminate vertigo symptoms. You should hold each position for at least 30 seconds; if you experience vertigo during the exercise, it should not worry you.
Your vertigo symptoms should improve shortly after the exercise, and you should recover completely within two weeks. However, if your symptoms do not go away after performing these exercises, you should return to your healthcare provider.
Sometimes you might be unable to try the Epley manoeuvre, or it may not work in your situation. If this is your scenario, you can try Brandt-Daroff exercises. Your healthcare provider will show you how to perform them unsupervised at home. It would help if you performed these movements two to four times a day. Within two weeks, you should note some changes in your vertigo symptoms.
If you try both the Epley manoeuvre and Brandt-Daroff exercises without much success. In that case, your GP may recommend surgery, especially if your vertigo takes months or years with no sign of improvement. The surgery will involve the blockage of the fluid-filled canals in your ears.
Change your Diet
If your vertigo is due to Meniere's disease, you should try a low salt diet.
Use of hearing aids
Your ENT can recommend the use of hearing aids for the treatment of hearing loss.
In some instances, your doctor may prescribe some medications to aid in treating vertigo that results from Meniere's disease, vestibular neuronitis, central vertigo, or if your dizziness is from an unknown source.
Some medicines that your doctor may prescribe are antihistamines and prochlorperazine, which are successful in treating vertigo signs and symptoms. Your GP may prescribe that you take medication for a couple of days or when you experience a vertigo episode. However, your doctor may prescribe long-term medicines to treat some conditions, like Meniere's disease.
Consider Safety Measures
When you experience episodes of vertigo, there are some safety measures that you can consider. They include:
Inform your family and friends
Inform your family and friends, as this will ensure that they are vigilant about your safety. You should also let your employer know about your condition, especially if your job involves climbing ladders or operating machinery.
Make your home safer
Make your home safer, as this will help reduce the risk of sustaining an injury if you fall.
Episodes of vertigo will affect your driving, and to be safe, you should avoid driving as you may experience an attack while driving.
As vertigo may take some time before the symptoms disappear, you should try to exercise to correct some of its symptoms. These exercises include using two pillows to raise your head slightly while sleeping.
Avoid extending your neck, especially when picking items on a high place, like a high shelf. Also, try to avoid bending down to collect things.
While performing your daily activities, move your head slowly and carefully.
Try to do activities that you think trigger your vertigo regularly, as this will help your brain get used to them and reduce the severity of your symptoms. Ensure you take these exercises in a safe environment where you can not fall and injure yourself and where you have support if you need it.
Contact an Experienced Physiotherapist Near Me
Experiencing vertigo can be a traumatizing experience, especially if you are alone. Once you realize the pattern of your vertigo, you may decide to seek the help of a healthcare provider who will help you with the management and treatment of the symptoms. Sometimes, the symptoms of vertigo may weaken your muscles, and one way of regaining your balance is to undertake physiotherapy treatment.
At Suarez Physical Therapy, our physiotherapist will work with your GP or ENT specialist to ensure you receive the best care available. If you reside in Las Vegas or its environs, our offices are centrally located and you can schedule an appointment with us. Also, if you have any questions regarding physiotherapy or vertigo, do not hesitate to call us at 702-368-6778, and we will answer them.