Many readers know someone or may have personally experienced vertigo. Vertigo is an abnormal sensation often characterized by a feeling of being off balance or feeling like the room is spinning.

Vertigo can begin seemingly out of nowhere with no prior symptoms or may be an ongoing issue. It can be a simple condition or a sign of something more complex.

Many cases of vertigo are diagnosed as a harmless condition known as benign paroxysmal positional vertigo. In this condition the symptoms of being off balance and experiencing a spinning sensation may be primarily related to a patient’s body position. The patient may feel fine in some positions but experience symptoms when they sit up, stand or make other changes.

Vertigo is a neurological symptom often resulting from problems within the inner ear. There are extremely sensitive organs within the inner ear that provide constant input to our nervous system to make us aware of our body position. This marvelous system works phenomenally in the background of our brain — until it doesn’t.

When something goes wrong, suddenly our brain cannot make sense of the signals that are coming from the inner ear. The tiny organs are sending signals to the brain that we are tilted, but our eyes are telling the brain that we are not. For this reason some patients feel better when their eyes are closed.

In many cases of BPPV, the problem amounts to a simple issue. Tiny calcium crystals have become displaced in the small tubes within the inner ear. When this happens the crystals can improperly stimulate the sensors that provide input for our brain about our body position. This can cause a disturbing sensation of spinning, leaning to one side or falling.

Vertigo can be accompanied by other symptoms such as nausea, vomiting, headache, migraine, dizziness, ringing in the ear and, in some cases, sweating.

For simple cases of vertigo such as BPPV the solution can often be provided by a special physical maneuver to reposition the calcium crystals within the ear canals. This is called the Epley maneuver. It can be administered by chiropractors or physical therapists.

I recently experienced vertigo while on a trip. On Friday evening I began to experience nausea. Thinking it may be related to the long drive, I decided to eat a small meal and relax for the evening. After eating I felt better.

However, during the night I awoke with vertigo. It wasn’t too bad at first, but by morning I could barely walk in my hotel room. There would be no way for me to drive or carry on normal activities.

Since I knew how to do the Epley maneuver for patients, I decided to try it in my hotel room. Patients can be taught how to do the procedure on their own, so I thought I would try it. Nothing ventured, nothing gained, right?

The maneuver is actually quite simple but must be done correctly to obtain best results. The patient, in this case me, is instructed to turn their head a certain way, lie back on a treatment table (or bed), turn their head in a specific manner and then sit up. (There are obviously more details to do it correctly.)

I tried it and felt a slight sense of improvement, but the spinning sensation persisted. I waited a few minutes and tried it again. To my surprise, the spinning stopped immediately. The symptoms stopped and have not returned. That is how quickly the maneuver can help in some cases.

Obviously not all cases will respond so quickly and easily. Some patients require multiple treatments and may require additional treatment as well.

There can be other causes of vertigo that are not related to BPPV. Vertigo can be a symptom of more complex and possibly serious conditions.

The brain takes in information from multiple parts of our body to determine body position and coordinate movement. For example, in addition to using signals from the inner ear, the brain uses visual information and stimulation from the joints of the neck to determine body position.

An often-overlooked cause of chronic vertigo is related to neck problems. A condition known as cervical vertigo can cause chronic sensations of spinning or balance issues. This can result from a prior neck or head injury, arthritis or even postural issues. Chiropractic care, acupuncture or physical therapy can often be helpful for cervical vertigo.

Because the sensation of spinning and balance problems are actually neurological symptoms, they may be related to other types of medical issues. Ongoing vertigo should be evaluated by an appropriate health care provider.

Often patients with ongoing vertigo have given up on trying to find a solution. I recommend that patients continue their search, maybe seeking second or third opinions. In addition to the unpleasant sensations, vertigo can present a fall risk or contribute to driving impairments. It is important to seek an effective solution.

Dr. Mark Kestner is a licensed chiropractic physician and acupuncturist with 30-plus years of experience focused primarily on treating complex and chronic spine, joint and neurological conditions in Murfreesboro. His office is at 1435 NW Broad St. Contact him at mkestner@DrKestner.com.

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