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What Are Dizziness and Vertigo?
Dizziness and vertigo are two of the most common reasons for doctors’ visits in Australia and throughout the rest of the world. The term dizziness refers to a range of uncomfortable sensations, including feeling light-headed, feeling faint, losing your normal sense of balance, feeling woozy and having a false feeling of your body spinning around or moving to one side. The term vertigo refers more specifically to a false sense of spinning or sideways movement. Technically, this means that vertigo is a particular form of dizziness. However, many laypeople use both terms to refer to the same range of symptoms, and doctors frequently treat the two conditions as connected health issues.
What Are Dizziness and Vertigo?
In most cases, dizziness accompanied by vertigo is the result of some sort of dysfunction in the body’s peripheral vestibular system. This system, found inside the inner ear, contains a group of connected structures which give all human beings the ability to maintain body balance, body stability and awareness of the body’s position relative to its surroundings. Some of the vestibular structures (the semicircular canals) do their job by detecting the presence or absence of motion, while others (the otolithic organs) detect changes in the speed of motion.
The peripheral vestibular system connects to the central nervous system through the vestibular nerve, which links the inner ear to the brainstem at the base of the brain.
The most common sources of dizziness and vertigo in the peripheral vestibular system include:
- Benign paroxysmal positional vertigo (BPPV), a condition which occurs when head injuries or other problems lead to the accumulation of small calcium crystals inside the semicircular canals.
- Meniere’s disease, a chronic disorder probably triggered by fluid abnormalities in the inner ear
- Labyrinthitis, an infection-related form of inner ear inflammation, and
- Mal de Debarquement syndrome, which produces disorientation in the aftermath of traveling in a boat, airplane, train or car.
In addition, more than one-third of all people affected by migraine headaches experience a condition known as a vestibular migraine or migraine accompanied by vertigo (MAV).
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How Common Is the Problem?
10%
Current statistics indicate that roughly five to ten percent of all people experience occasional or recurring bouts of dizziness, body imbalance and/or vertigo.
40%
In individuals over the age of 40, the rate of these issues rises sharply to 40 per cent.
25%
Roughly one-quarter of all people over the age of 65 experience dizziness- or vertigo-related issues that result in a fall.
What’s the Impact on Your Health?
Some people only experience brief or mild symptoms of dizziness and vertigo. However, others experience symptoms that last for long periods of time or recur periodically or randomly. In addition, some people experience severe forms of dizziness and vertigo that seriously degrade their quality of life and impair their ability to carry out even the simplest daily tasks.
For example, if you have Meniere’s disease, you have a good chance of experiencing intense bouts of vertigo that produce dizziness and loss of body balance for up to a full day at a time, as well as nausea and vomiting. If you make sudden movements, these symptoms can rapidly worsen.
Chronic labyrinthitis can also lead to severe episodes of vertigo, as well as nausea, vomiting, loss of body balance, impaired vision and either hearing loss or a disruptive ear condition called tinnitus. In many cases, people dealing with chronic dizziness and vertigo are periodically forced to seek extended bed rest for their condition. Current research shows that vestibular rehabilitation and certain forms of brain-based therapy are helping many people with dizziness and vertigo conditions. Dr Carlo Rinaudo, Sydney Chiropractor (Neuro-Rehabilitation) is harnessing the remarkable benefit of neuroplasticity (brain adaptability) in his care for patients.
Medical and clinical neuroscience research is SUPPORTING the use of VESTIBULAR REHABILITATION THERAPY for the management of DIZZINESS AND VERTIGO CONDITIONS
- Martins E Silva DC, Bastos VH, de Oliveira Sanchez M, Nunes MK, Orsini M,Ribeiro P, Velasques B, Teixeira SS. Effects of vestibular rehabilitation in the elderly: a systematic review. Aging Clin Exp Res. 2016 Aug;28(4):599-606.
- Hillier S, McDonnell M. Is vestibular rehabilitation effective in improving dizziness and function after unilateral peripheral vestibular hypofunction? An abridged version of a Cochrane review. Eur J Phys Rehabil Med. 2016 Jul 12.
- Kendall JC, Hartvigsen J, Azari MF, French SD. Effects of Nonpharmacological Interventions for Dizziness in Older People: Systematic Review. Phys Ther. 2016 May;96(5):641-9.
- Hall CD, Herdman SJ, Whitney SL, Cass SP, Clendaniel RA, Fife TD, Furman JM, Getchius TS, Goebel JA, Shepard NT, Woodhouse SN. Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Evidence-Based Clinical Practice Guideline: FROM THE AMERICAN PHYSICAL THERAPY ASSOCIATION NEUROLOGY SECTION. J Neurol Phys Ther. 2016 Apr;40(2):124-55.
- Arnold SA, Stewart AM, Moor HM, Karl RC, Reneker JC. The Effectiveness of Vestibular Rehabilitation Interventions in Treating Unilateral Peripheral Vestibular Disorders: A Systematic Review. Physiother Res Int. 2015 Jun 25.
- McDonnell MN, Hillier SL. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2015 Jan 13;1
- van der Scheer-Horst ES, van Benthem PP, Bruintjes TD, van Leeuwen RB, van der Zaag-Loonen HJ. The efficacy of vestibular rehabilitation in patients with benign paroxysmal positional vertigo: a rapid review. Otolaryngol Head Neck Surg. 2014 Nov;151(5):740-5.
- Wegner I, Niesten ME, van Werkhoven CH, Grolman W. Rapid Systematic Review of the Epley Maneuver versus Vestibular Rehabilitation for Benign Paroxysmal Positional Vertigo. Otolaryngol Head Neck Surg. 2014 May 20;151(2):201-207.
- Cabrera Kang CM, Tusa RJ. Vestibular rehabilitation: rationale and indications. Semin Neurol. 2013 Jul;33(3):276-85.
- Herdman SJ. Vestibular rehabilitation. Curr Opin Neurol. 2013 Feb;26(1):96-101.
- Hunt WT, Zimmermann EF, Hilton MP. Modifications of the Epley (canalith repositioning) manoeuvre for posterior canal benign paroxysmal positional vertigo (BPPV). Cochrane Database Syst Rev. 2012 Apr 18;(4
- Lystad RP, Bell G, Bonnevie-Svendsen M, Carter CV. Manual therapy with and without vestibular rehabilitation for cervicogenic dizziness: a systematic review. Chiropr Man Therap. 2011 Sep 18;19(1):21.
- Hillier SL, McDonnell M. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2011 Feb 16;(2)
- Cohen HS, Gottshall KR, Graziano M, Malmstrom EM, Sharpe MH, Whitney SL; Barany Society Ad Hoc Committee on Vestibular Rehabilitation Therapy. International guidelines for education in vestibular rehabilitation therapy. J Vestib Res. 2011;21(5):243-50.
- Merck Manual Professional Version: Dizziness and Vertigo
- Vestibular Disorders Association: The Peripheral Vestibular System
- Medscape: Dizziness, Vertigo and Imbalance
- Johns Hopkins Medicine: Vestibular Migraine
- Vestibular Disorders Association: Benign Paroxysmal Positional Vertigo (BPPV)
- U.S. National Library of Medicine: Meniere’s Disease
- Vestibular Disorders Association: Labyrinthitis and Vestibular Neuritis
Solution for Vertigo & Dizziness
ASSESS
• Physical examination
• Neurological testing
• Metabolic and nutritional
• History questionnaires
EXPLAIN
• Report of findings
• Clear answers
• Options for treatment
• Solution recommended
TREAT
Physical therapy and exercises
Neurological and brain-based therapy
Vestibular (balance) rehabilitation
Metabolic and dietary
