Complaints of dizziness are not uncommon and can severely impact the quality of life, independence and the risk of injury due to falls. There are four main categories or sub types of dizziness, which patients may describe including vertigo, near fainting, imbalance and light-headedness.
Of the four, vertigo is the most common and is defined by the illusory sense that the environment or ones own body is revolving and is generally thought to be a result of an imbalance within the ear (vestibular system). Although there are a number of causes of vertigo, the most common presentation is benign paroxysmal positional vertigo (BPPV) where symptoms may occur spontaneously or following head trauma. BPPV is often characterized by brief attacks of dizziness, nausea or vomiting or nystagmus (rapid eye beating) triggered by certain changes in head position such as lying down, turning over in bed, bending over or looking up. The causes of symptoms are due to small calcium crystals (otoconia), which can be spontaneously dislodged in the inner ear (semicircular canals) rolling around and striking the inner walls (capula) on movement of the head. Fortunately BPPV is a simple disorder to manage if diagnosed and treated correctly.
Dizziness associated with upper neck/cervical injury and dysfunction is also not uncommon especially in whiplash patients. This is due to altered input by neck receptors (proprioceptors) leading to a sensory mismatch in information about position and movement with other sensory organs such as the eyes, ears and/or postural stability system. These patients typically do not experience vertigo, but rather a feeling of imbalance or unsteadiness. Diagnosis is dependant on correlating symptoms with neck dysfunction while excluding vestibular disorders based on history and examination. Vestibular dysfunction can, however, also lead to cervical dysfunction due to the associated movement compensations and adoption of a rigid neck in patients with vertigo. Treatment of this disorder is often successful with specific and individualized management involving manual therapy and cervical muscle and other sensory re-training.
Symptoms of dizziness or any of the sub types, nystagmus, ringing in the ear, ear ache/deafness, nausea or vomiting, difficulty reading/focusing/blurred vision may be indicative of neck and/or vestibular dysfunction, which may be treatable if accurately assessed and diagnosed. It is also critical to rule out other more serious causes of these symptoms. At Back in Action physiotherapy, our post graduate physiotherapists specialize in the management of these disorders so don’t wait to get “back in action.”