Dizziness is a fairly common occurrence, with between 20 and 30% of the general population complaining of some form of dizziness at least once. Feeling dizzy can be an extremely disconcerting experience but in most cases, the cause of the dizziness is not serious.
Dizziness can broadly be classified into 4 main groups. By far the most common classification is “vertigo”, accounting for as much as 50% of all cases. Suffers are most likely to describe a feeling of their surroundings spinning around them. Vertigo can be separated into “episodic” as the feeling comes and goes and “persistent” where the symptoms remain for the duration of the disease. The most likely reason for episodic vertigo is BPV (benign positional vertigo) where small particles in your inner ear canals behave in an unusual way. The vertigo “attacks” usually last for a short period and are related to the sufferer changing positions (like sitting up in bed). Once accurately diagnosed the treatment most often involves your chiropractor (or other physical therapist) performing specific movements with your head and body to re-orient the particles. A less common reason for episodic vertigo is Meniere’s disease which is caused by fluid build-up in the ear. We are not sure of the cause of this. Meniere’s disease is usually characterised by a feeling of pressure in the ear, tinnitus and reduced hearing. There is no cure for this disease but it can be reasonably well managed with a low salt diet and certain medications. Persistent vertigo is most likely as a result of “vestibular neuritis” or “labyrinthitis”. Vestibular neuritis and labyrinthitis are both caused by inflammation of the vestibulocochlear nerve (most likely as a result of a viral infection). They both cause sudden, severe vertigo often with severe nausea and even vomiting. Labyrinthitis can often be distinguished by the additional symptoms of hearing loss, ear pain, tinnitus and sometimes a raised temperature. Both diseases are treated with medication to reduce the symptoms and occasionally with antibiotics or antivirals. Sufferers will often also need to undertake a balance rehabilitation program. Much less commonly sufferers present complaining of feeling “light headed”. Sufferers usually provide a vague description of dizziness. The most common reasons for this feeling are as a result of: hyperventilating due to increase stress and anxiety; becoming dehydrated (whether from excessive exercise in a hot environment, or due to vomiting and/or diarrhoea, or from having a high fever); experiencing a sudden drop in blood sugar as can happen with poorly controlled diabetes; or as a result of excessive alcohol intake, use of recreational drugs and certain prescription medications (most commonly blood pressure and anti-depressants). A less common cause of dizziness is called “presyncope” or “near fainting” where the sufferer feels like they are likely to black out. People with postural hypotension (low blood pressure that drops or is slow to adapt when they move from sitting to standing), or who have heart arrhythmia’s (fast, irregular heart beat), or who have been diagnosed with atherosclerosis (restricted or blocked arteries from build-up of plaques) are most likely to describe this feeling. The final classification of dizziness is “disequilibrium” and describes sufferers who feel that a fall is imminent or that they need additional support to move around. This is most commonly seen in people that have suffered a stroke, have been diagnosed with Parkinsons disease or that have a diabetic neuropathy.
It is noteworthy that as much as 25% of migraine sufferers experience dizziness as one of their complex of symptoms, while as much as 50% of whiplash trauma can cause the unfortunate victim to experience dizziness.
Recently a new diagnosis has shown up in the literature of “cervicogenic vertigo” relating to dizziness as a result of dysfunction of head and neck posture and the related muscles and joint.
It is worth remembering that if you are unfortunate to suffer from dizziness that a chiropractor has the necessary knowledge to make an accurate diagnosis and the skills to effectively treat the conditions that fall within their scope of practice. Chiropractors would also be able to make appropriate referrals to other health professionals if indicated.
https://www.nhsinform.scot/illnesses-and-conditions/ears-nose-and-throat/vertigo
https://www.nhs.uk/conditions/vertigo/
