Dizziness is one of the more common complaints that we hear about in our clinic (The overall incidence of dizziness, vertigo, and imbalance is 5-10%, and it reaches 40% in patients older than 40 years (1)). The symptom dizziness is unspecific but it can be very debilitating and sometimes dangerous for patients suffering with this condition, sometimes resulting in nausea, vomiting, instability, and falls.
The causes of dizziness are complex. For some it is possible that the inner ear is involved, and a visit to the GP will often result in a diagnosis of Benign Paroxysmal Positional Vertigo or BPPV. Other more common causes such as hypoglycaemia (low blood sugar) and postural hypotension (low blood pressure on standing) should also be ruled out.
BPPV refers to all manner of problems relating to the inner ear. The 3 semi-circular canals in your ear are partly responsible for your balance, and we can test their function by doing a test called Epley’s maneuver:
This test will show up where the problem is, and may also help with the dizziness. If this and other inner ear clearing procedures are ineffective, other sources of BPPV need to be investigated.
When we encounter a patient with dizziness we will always enquire if there are any additional symptoms such as headache, neck pain or neck stiffness. Frequently our patients who suffer with dizziness will also have some of these other symptoms as well.
It has been found that the muscles and joints at the top of the spine (the area just below the bottom of your skull) contain a very high proportion of balance receptors (proprioceptors). Studies have shown that the feeling of dizziness can be generated by hyperstimulation of these areas of the spine (2-6) It is thought that if these joints and muscles are compromised then the feeling of being unsteady and dizzy may result, and manual therapy (including chiropractic treatment) to this area has been successful in reducing dizziness symptoms in many cases. (7)
Some of the nerves that supply the inner ear also originate in this area of the spine. Nerve irritation may also be to blame for feelings of dizziness relating to the neck.
Dizziness that stems from this part of the neck is called cervicogenic dizziness.
You are more likely to have cervicogenic dizziness if you have been in a car accident, or any other accident replicating the whiplash movement – this is the most common cause of BPPV in sufferers under 40.
Simply put – if you are suffering from dizziness and particularly if you also have neck pain, stiffness or headaches then it is a good idea to see a health professional to get it checked. You must also always get checked after a car accident, regardless of how small or insignificant you feel it is.
At Banchory Chiropractic Clinic our chiropractors are fully trained to accurately assess and treat BPPV, with techniques that safely address all the various causes of this condition.
If we cannot help you we will always try to find someone who can, or refer you back to your GP if we feel that further investigation is necessary.
For more information or to book an appointment please call 01330 824040 or email us at firstname.lastname@example.org.
- Cohen LA: Role of eye and neck proprioceptive mechanisms in body orientation and motor coordination. ?Journal of Neurophysiology 1961, 24:1-11. PubMed Abstract | Publisher Full Text
- Biemond A, de Jong JMBV: On cervical nystagmus and related disorders. ?Brain 1969, 92(2):437-458. PubMed Abstract | Publisher Full Text
- de Jong PTVM, de Jong JMBV, Cohen B, Jongkees LBW: Ataxia and nystagmus induced by injection of local anesthetics in the neck. ?Annals of Neurology 1977, 1(3):240-246. PubMed Abstract | Publisher Full Text
- Wapner S, Werner H, Chandler KA: Experiments on the sensory-tonic field theory of perception: 1. Effect of extraneous stimulation of the visual perception of verticality. ?Journal of Experimental Psychology 1951, 42(5):351-357. PubMed Abstract
- Brandt T, Bronstein AM: Cervical vertigo. ?Journal of Neurology Neurosurgery and Psychiatry 2001, 71(1):8-12. Publisher Full Text
- Reidar P Lystad*, Gregory Bell, Martin Bonnevie-Svendsen and Catherine V Carter: Manual therapy with and without vestibular rehabilitation for cervicogenic dizziness: a systematic review. Chiropractic & Manual Therapies 2011, 19:21 http://www.chiromt.com/content/19/1/21