By Annick deGooyer, Registered Physiotherapist, Certificate in Vestibular Rehabilitation
Dizziness can be a scary and very unpleasant thing to experience. There are many things that can cause dizziness, and it is not always related to the vestibular system, but it can be and often is.
The vestibular system provides information to our brain and eyes about our body’s movement and head position. This allows us to move safely over uneven ground, see clearly when we are in motion, and maintain an upright position. Part of our vestibular system is in our inner ear and contains the semi-circular canals, otolith organs, and a nerve that communicates with the brain. This is called the peripheral vestibular system. It is connected to the central vestibular system which is in the brain and includes complex processing of information coming from the inner ear. When the vestibular system is working properly, as it most often does, we don’t notice what it does. When things go wrong however, it is often all we can think about.
Let’s talk briefly about the words vertigo and dizziness. Vertigo is a term used to describe a feeling of you or your surroundings spinning or moving when you are actually still. Dizziness is not the same thing as vertigo. Dizziness is a word used to describe feelings of light headedness, disorientation, weakness or unsteadiness. Although it sounds like it shouldn’t really matter how you describe it, it is helpful to your doctor and physiotherapist if you are able to differentiate between the two as it will allow them to determine more accurately what your condition is.
Many people have heard the term “crystals” related to an inner ear or vestibular problem, and assume that if they have vertigo or dizziness they have “crystals”. Benign Paroxysmal Positional Vertigo (BPPV) is a condition in which calcium particles called otoconia move from the area of the inner ear where they belong, into one of the semi-circular canals where they do not belong. If you have this, when you move your head the otoconia will move and create ‘confusion’ in your central vestibular system and you will perceive you’re moving when you’re not (vertigo). BPPV is treated with a re-positioning maneuver in which the crystals are moved out of the canal back to where they belong and the symptoms resolve.
It is important to know that BPPV is not the only thing related to your vestibular system that can cause vertigo or dizziness. It is possible to have inflammation or infection of the vestibular nerve or the inner ear caused by a virus or bacteria. To make things more confusing, there are other vestibular disorders such as Meniere’s disease and vestibular migraines, as well as things like concussion, MS, and strokes that can also cause symptoms of dizziness or vertigo. These conditions cannot be treated quickly with a maneuver but instead will require vestibular rehabilitation consisting of specific exercises which will need to be done regularly as you recover.
If you experience vertigo or dizziness it is important that you see your physician so that appropriate investigation can be done. Your doctor may then refer you for vestibular therapy. Here at Orchard Chiropractic & Physiotherapy we use specialized testing including an infrared goggle system to identify the problem, and from there we’re able to explain to you what your condition is, what the treatment will involve, and then get started on helping you along the road to recovery.