VERTIGO

 Introduction:

Vertigo is a sensation of feeling off balance. If  it have these dizzy spells, might feel like  spinning or that the world around is spinning.

Causes of Vertigo

Vertigo is often caused by an inner ear problem. Some of the most common causes include:

BPPV. These initials stand for benign paroxysmal positional vertigo. BPPV occurs when tiny calcium particles (canaliths) clump up in canals of the inner ear. The inner ear sends signals to the brain about head and body movements relative to gravity. It helps to keep our balance.BPPV can occur for no known reason and may be associated with age.

 

Meniere’s disease: This is an inner ear disorder thought to be caused by a buildup of fluid and changing pressure in the ear. It can cause episodes of vertigo along with ringing in the ears(tinnitus) and hearing loss.

Vestibular neuritis or labyrinthitis: This is an inner ear problem usually related to infection (usually viral). The infection causes inflammation in the inner ear around nerves that are important for helping the body sense balance

Less often vertigo may be associated with:

• Head or neck injury
• Brain problems such as stroke or tumor
• Certain medications that cause ear damage
• Migraine headaches

Symptoms of Vertigo

Vertigo is often triggered by a change in the position of patients head.

People with vertigo typically describe it as feeling like they are:

• Spinning
• Tilting
• Swaying
• Unbalanced
• Pulled to one direction

Other symptoms that may accompany vertigo include:

• Feeling nauseated
• Vomiting
• Abnormal or jerking eye movements (nystagmus)
• Headache
• Sweating
• Ringing in the ears or hearing loss

Symptoms can last a few minutes to a few hours or more and may come and go.

Treatment for Vertigo:

Treatment for vertigo depends on what’s causing it. In many cases, vertigo goes away without any treatment. This is because brain is able to adapt, at least in part, to the inner ear changes, relying on other mechanisms to maintain balance.

For some, treatment is needed and may include:

Vestibular rehabilitation. This is a type of physical therapy aimed at helping strengthen the vestibular system. The function of the vestibular system is to send signals to the brain about head and body movements relative to gravity.

Vestibular rehab may be recommended if you have recurrent bouts of vertigo. It helps train other senses to compensate for vertigo.

Canalith repositioning maneuvers. Guidelines from the American Academy of Neurology recommend a series of specific head and body movements for BPPV. The movements are done to move the calcium deposits out of the canal into an inner ear chamber so they can be absorbed by the body. It will likely have vertigo symptoms during the procedure as the canaliths move.A doctor or physical therapist can guide  through the movements. The movements are safe and often effective.

Medicine. In some cases, medication may be given to relieve symptoms such as nausea or motion sickness associated with vertigo.If vertigo is caused by an infection or inflammation, antibiotics or steroids may reduce swelling and cure infection.For Meniere’s disease, diuretics (water pills) may be prescribed to reduce pressure from fluid buildup. 

Surgery. In a few cases, surgery may be needed for vertigo.

If vertigo is caused by a more serious underlying problem, such as a tumor or injury to the brain or neck, treatment for those problems may help to alleviate the vertigo.

Treating Vertigo and Dizziness with Physiotherapy:

Vertigo and dizziness may not seem like issues that could be helped by physiotherapy, but it has been shown that certain physiotherapy exercises can help people suffering from frequent spells of vertigo or dizziness. This is known as Vestibular Rehabilitation Therapy, and to understand how it works, we first need to understand what that means. The vestibular system is made up of the parts of the inner-ear and brain that control balance. Therefore, damage to this system can lead to dizziness, difficulty balancing, and vision problems. If the damage to the system is permanent, the body can be retrained to compensate for the damage.

Treatment

Vestibular Rehabilitation Therapy is comprised of three main types of exercise:  habituation, gaze stabilization, and balance exercises.

Habituation exercises are used to treat people who experience dizziness as a result of damage to their vestibular system. The dizziness can be brought on either as a result of the patient moving or by visual stimuli e.g. watching TV or driving. The exercises aim to reduce the frequency and strength of the dizzy spells over time. This is accomplished by inducing light dizzy spells and gradually increasing the level of exposure, which enables the brain to get used to the stimulus, as well as build its tolerance for dizziness up.

Gaze stabilization is used for patients who have difficulty controlling the movements of their eyes, particularly when they are moving their heads. This not only makes it difficult for people to see their surroundings, but can lead to other issues such as headaches. Gaze stabilization exercises can help people regain more control over their eyes. One of the most common exercises for gaze stabilization is having the patient focus their eyes on a stationary object in front of them while moving their head from side to side. This helps to separate the movement of the eyes from the movement of the head. Another exercise is for the patient to keep their head still while following an object, such as a pen, from side to side with their eyes. This helps them to move their eyes without having to move their head as well.

Balancing exercises will vary more widely on a case by case basis than habituation or gaze stabilization exercises. The exercises required will depend on the stimulus that triggers the issue. People may have difficulty balancing when walking outside, inside, on elaborately patterned floors, or around obstacles, to name a few examples. Performing tasks while standing or walking can be a major issue for people who have trouble balancing, as can moving through crowds or being surrounded by people.

These exercises can help people who are struggling with issues such as vertigo, dizziness, focus or balance. Few of the exercises are particularly strenuous, and most will get easier over time, but commitment and determination are necessary to get results. As each case is unique, a physiotherapist will need to examine the patient’s case and lay out the appropriate exercises. Some of these can and will need to be done alone, although only under the instructions of a therapist. Improper exercises could exacerbate the problem, and there could be a risk of injury,  particularly for those who have balancing issues.

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THANK YOU,

SRIKUMARAN PHYSIOTHERAPY CLINIC & FITNESS CENTER