Vertigo is the sensation that you or the things around you are spinning, but there is actually no movement at all. The most common type of vertigo is called benign paroxysmal positional vertigo or BBPV. The name is a bit long and intimidating, but breaking it down makes it so much easier to understand:
- Benign: Not life-threatening
- Paroxysmal: Occurs suddenly and briefly
- Positional: Triggered by movement or head position
- Vertigo: A false sense of rotational movement
What Happens When BPPV Occurs?
Benign paroxysmal positional vertigo happens due to a mechanical problem within the inner ear. Calcium carbonate crystals, called otoconia, are normally located in the gel of the utricle. If they move out of this position and migrate into one or more of the 3 semicircular canals that are filled with fluid, they can begin to cause problems. If enough of these small particles accumulate in one of the ear canals, they interrupt normal fluid movement which is used to sense head movement. This makes the inner ear send wrong signals to the brain about the body’s position.
The fluid that is located in the semi-circular canals does not normally obey the rules of gravity. However, the crystals do, and this causes the fluid to move when it would normally remain still. This moving fluid stimulates the nerve endings in the canal, and a message is sent to the brain telling it the head is in motion when it is not. This information does not coordinate with what the eyes are seeing, the ears are sensing, or what the muscles and joints are doing. This mismatched information is read by the brain as vertigo and usually lasts less than one minute.
What does BPPV not do? It will not:
- Cause constant dizziness
- Affect your hearing
- Cause you to faint
- Give you a headache
- Cause you to have numbness or pins and needles feeling
- Cause you to have trouble speaking
- Make you unable to coordinate your movements
If any of these symptoms occur, it is a good idea to seek the advice of your healthcare professional as soon as possible.
Who Gets Benign Paroxysmal Positional Vertigo?
BPPV is quite common. It is rare in children but can happen to adults of any age at any time, especially as they get older. The majority of cases often happen with no apparent reason. Many report that they simply got out of bed one day, and the room felt as if it were spinning. However, research has revealed this type of vertigo can be sometimes associated with trauma, inner ear infections, migraines, or other illnesses such as diabetes, osteoporosis, and reduced flow of blood.
Caring for Benign Paroxysmal Positional Vertigo
Medication is often recommended for vertigo. However, there is no supporting evidence that it really helps with this condition. In some extreme cases, surgery is recommended. In many instances, BPPV can be corrected mechanically. Your healthcare provider will need to determine the location of the crystals, and then they will be able to recommend the proper maneuver for you. The maneuvers make use of gravity to help guide the crystals back into their original position.
One of the most popular maneuvers for this condition is called the Epley maneuver. How is it performed?
- You sit on the doctor’s exam table with your legs extended in front of you. The doctor turns your head so that it is not quite looking all the way to the side. While holding your head still, the doctor guides you back quickly so that your shoulders are on the table but your head is hanging off the edge. You will be held in this position for about 30 seconds or until your vertigo stops.
- Next, without lifting your head, the doctor turns your head to the same angle but on the other side. Again, you are held here for 30 seconds or until your vertigo stops.
- The doctor now will help you roll in the same direction you are facing so that you are lying on your side. Again, you must stay in this position for at least 30 seconds or until your vertigo stops.
- You will next be helped to sit back up with your legs hanging off the table on this same side.
This is done with assistance by a physical therapist or a doctor and a single, 10- to 15-minute session is usually all that is required. Once the crystals within the ear are rearranged, vertigo will often go away.
Natural Vertigo Relief Through Proper Spinal Alignment
For those who do not find relief through the Epley maneuver or another type of maneuver, it may be important to seek an alternative route of care. Vertigo has been seen to be connected to a misalignment in the bones of the upper cervical spine. Upper cervical chiropractors have seen success in helping patients with BPPV and other types of vertigo. A misalignment in the atlas or axis bones – the top two bones of the spine – can cause pressure to be placed on the brainstem. The brainstem is the communication highway of the body. If it is put under stress, it may send improper signals to the brain about the body’s location, leading to the sensation of vertigo.
We use a method in our office that is different from traditional chiropractic. We examine our patients through the use of imagery and measurements to find the exact location of the misalignment. We then use a gentle procedure that is designed to help the bones realign themselves naturally without the need to pop or crack the spine. Many patients report seeing immediate relief of their symptoms.