You know it’s a good day when you don’t feel like you’re about to fall over or your head is not spinning. You feel liberated. What better way to celebrate your temporary vertigo or disequilibrium freedom than to hurry to the gas station before the next price hike, or scrub that toilet which has been begging for some TLC.
Living with disequilibrium, dizziness and vertigo can be daunting. You have to be cautious with how you move your head and neck. Turning or moving your head suddenly may send you to the tilt-a-whirl.
Unless it’s an existing patient, the chance of someone initially consulting with a chiropractor for positional vertigo or the feeling of unsteadiness is very slim. Almost all of the positional vertigo or disequilibrium patients whom I’ve treated have already been attended by medical specialists. And in many cases, there is no pathology associated with their inner ears and eyes. So, why are these people continuing to experience cheap thrill rides when they turn their heads, look up or lie down? Why do they need to sleep with extra pillows to reduce their head spinning?
There are three things that influence your balance, stability and spatial orientation: your vision, your inner ear and the mechanoreceptors in your neck. Mechano what? Oh, stop it. Get back here and sit down–it’s not that hard. And besides, the toilet can wait.
Mechanoreceptors are specialized sensory receptors located in your joints and soft tissues. They provide spatial positioning and joint angle and detect movement in joints and soft tissues. Guess what? The facet joints and soft tissues in your neck are saturated with mechanoreceptors.
What will happen to your balance and stability when spatial positioning of your head and neck and movement feedbacks provided by the inner ears, eyes and sensory receptors in your neck do not coincide with each other? And what does this have to do with unsteadiness, head spinning and positional vertigo?
Ahh, the million dollar question! What causes you to feel like you’re about to fall over or the spinning in your head when you sudden turn, bend or tilt your head? I take dizziness very seriously, especially if there are associated headaches. Cerebral aneurysm, subdural hematoma, complications of brain injury, vestibular neuronitis, acoustic neuroma and otitis interna must be ruled out. Certain prescription drugs can cause nausea and dizziness. So, check the side effects of the medications that you’re taking. Ensure that your eye prescription is correct.
Dizziness can be misleading. There are four kinds of dizziness: light-headedness, presyncope, disequilibrium and vertigo. Light-headedness is a feeling of cloudiness in the head. It is commonly associated with orthostatic hypotension as in when you experience light-headedness standing up too quickly from sitting down for a while. Presyncope is a feeling of faintness without actually fainting. Disequilibrium is a feeling of unsteadiness and imbalance. With disequilibrium, you’ll feel like you’re about to fall. And finally, vertigo is a sensation of movement. Vertigo takes the form of head spinning especially with head turning.
If you experience a feeling of unsteadiness and imbalance or feel that your head is spinning with sudden turning of your head or moving your head side to side during daily activities, there are four conditions to consider for your disequilibrium or positional vertigo.
- Cervical disequilibrium does not involve rotational vertigo or the sensation of head spinning. People suffering from cervical disequilibrium often complain of feeling of imbalance and unsteadiness or feeling like they’re going to fall over. They feel that they’re going to fall to one side when the position of their heads is changed in relation to their bodies. Sudden turning of the head or moving the head side to side during daily activities can cause people to feel like they’re going to fall over.
- Benign paroxysmal positional vertigo (BPPV) is characterized by brief, intensive attacks of vertigo. Whenever there is a change in the position of your head relative to space, your head will be spinning like a disco ball. Your eyes will also jerk back and forth (nystagmus) during most BPPV attacks. Lying down or getting out of bed changes the position of your head in relation to the surrounding space. This kind of head movements often provokes BPPV attack.
- Meniere’s disease can also cause the sensation of head spinning. Like BPPV, Meniere’s disease primarily involves the inner ear. Positional vertigo from Meniere’s disease is less intensive, but lasts longer. Nausea, vomiting, tinnitus and partial hearing loss are often found with Meniere’s disease.
- And finally, unlike BPPV, cervicogenic vertigo produces brief attacks of head spinning when the position of your head is changed in relation to your trunk. Changes of head position relative to the trunk stimulates the mechanoreceptors in your neck. Sudden turning of your head or moving your head side to side during daily activities can cause unexpected, cheap tilt-a-whirl ride. Vertigos from cervicogenic vertigo are not as severe as those from BPPV. And there’s no nystagmus associated with cervicogenic vertigo. There is usually a history of neck trauma such as whiplash injury or concussion associated with cervicogenic vertigo.
If all vascular, inner ear and eye disorders are ruled out, there is a good chance that your feeling of falling over or head spinning from sudden head movements is from cervical disequilibrium or cervicogenic vertigo.
As I mentioned before, mechanoreceptors in your neck play a vital role in maintaining balance, stability and spatial orientation. Traumas to the head and neck cause structural damage to the facet joints and injury to the associated soft tissues. And there are abundance of mechanoreceptors in the cervical facet joints and soft tissues.
It’s beyond the scope of this friendly and exciting article for me to fully discuss the complex neurological interactions between the cervical mechanoreceptors, cerebellar and brainstem. Anyway, all you need to know is this. Mechanoreceptors in your neck interacts with vestibular nucleus of the inner ear and specialized Group X nuclei in the brainstem for sensing and maintaining balance and equilibrium. And if your mechanoreceptors are not providing proper sensory feedbacks including spatial position, joint angle and movement to the vestibular nucleus and Group X nuclei, you’ll have problem with disequilibrium or vertigo.
If you feel like you’re about to fall over or have sensation of head spinning and vertigo with sudden turning of your head or moving your head side to side during daily activities, consider consulting with a chiropractor. A knowledgeable chiropractor can provide tests that can differentiate between cervical disequilibrium, BPPV, Meniere’s disease and cervicogenic vertigo.
Cervicogenic vertigo and cervical disequilibrium are treatable with chiropractic care. I’ve great success treating vertigo and disequilibrium with specific chiropractic adjustments and soft tissue treatments. There’s no reason why you shouldn’t be able to turn, bend or tilt your head and neck without experiencing any head spinning or feel like you’re about to fall over.