Let’s begin by defining what dizziness is. As a disorder, dizziness falls into three categories:
- Vertigo: The feeling that you or your surroundings are spinning about -- similar to being on a ride at an amusement park.
- Syncope: A brief loss of consciousness, such as when one faints, or dimmed vision and feeling uncoordinated, lightheaded, and confused. You may experience this if you stand up too fast.
- Non-syncope, non-vertigo dizziness: You feel as if you cannot keep your balance, and it may worsen with movement.
Dizziness and vertigo rank alongside back pain and headaches as some of the most common reasons for visits to family physicians, clinics, and the emergency room. Falling is often a direct consequence, and this becomes even greater when one is elderly, due to other neurological problems and chronic medical problems.
Dizziness, imbalance, and vertigo affects 5 to 10 percent of the population until the age of 40. It then impacts 40% of the population. In those over the age of 65, the incidence of falling is 25 percent. In the year 2011, emergency room visits due to vertigo or dizziness were 3.9 million.
The Swedish National Study on Aging and Care reported that in those under the age of 80, falls were 16.5 percent and dizziness was 17.8 percent. In those over the age of 80, falls rose to 31.7 percent and dizziness was at 31 percent. Older people tend to have more general reasons why they fall, while younger people have a more definite reason why they fall.
Conditions Known for Dizziness
Mild hearing loss is the most common reason for disability worldwide. Around 25 percent of those younger than 25 years have hearing loss. After 40 years of age, around 40 percent of people experience it. Interestingly, vertigo, dizziness, and hearing loss are often associated with the onset of Meniere’s disease.
This is a disorder of the inner ear that negatively impacts the central nervous system. Migraines are another reason for dizziness and are more common than Meniere’s disease. Around 40 percent of those suffering from migraines have vertigo, mild hearing loss, and motion sickness. It can be a problem to predict which one of these is actually the reason for your dizziness. Some other causes of vertigo include:
- BPPV - benign paroxysmal positional vertigo
- Immune-mediated inner ear disease
- A vestibular migraine or migraine-associated vertigo
- Vestibular neuronitis
- Brainstem or cerebellar vascular lesions
- Acoustic tumors
How Doctors Determine Which Type of Dizziness You Have
When a patient complains of dizziness, doctors usually begin by taking a detailed patient history and complete a neurotologic examination. Patient history is vital and should include such things as what symptoms you experience, how long they last, and what seems to trigger or reduce them. You will also want to describe your ailment using words other than dizzy, as this is a blanket term including a number of different sensations.
Are you unsteady, feel like things are spinning, feel weakness all over, falling down often, passing out, or simply feel off balance? It is good to be as specific as possible when describing this condition to your doctor. Why is this so important? Dizziness can be due to a malfunction in the central nervous system, systemic or cardiovascular disease and can include such things as:
- Feeling light-headed
- Motion intolerance
- A floating or tilting sensation
Vertigo may have to do with a problem in the vestibular system and often has to do with an inner ear problem. Vertigo may include an illusion of movement or spinning. The time course of vertigo is vital when talking with your doctor.
- Episodic vertigo that only lasts a few seconds and happens when you move your head in a certain position is probably due to BPPV.
- Episodic vertigo that goes on for days and is accompanied by nausea may be the result of vestibular neuronitis, particularly if you have had a recent virus.
- Vertigo that is associated with ear symptoms, such as congestion and tinnitus, and lasts for a few hours is more than likely due to Meniere’s disease.
- Vertigo that comes on suddenly and only lasts a few minutes can be due to a migraine or brain or vascular disease.
Finding Relief for Dizziness and Vertigo
An interesting study was conducted in the private practice of an upper cervical chiropractor. She examined patients in an uncontrolled, nonrandomized environment for approximately an eight-year period. There were 60 patients included in her study, all of whom had been diagnosed with vertigo or dizziness of one type or another. Upon gathering their medical history, it was noted that 56 of them remembered having at least one head or neck trauma before being diagnosed with vertigo or dizziness.
These traumas included car accidents, sporting accidents (skiing, horseback riding, cycling), or falls down stairs or on icy pavement. When imaging and radiography were used to look closer at the upper cervical spine, it was discovered that all 60 had a misalignment or subluxation in the bones of the upper neck, particularly the C1 or C2 vertebra. Each patient was then given upper cervical care tailored to their specific needs during a 1- to 6-month period. The results were amazing!
As many as 48 of these saw the total resolution of their symptoms. The remaining 12 reported a major improvement in the severity and frequency of their vertigo episodes. Here at The Upper Cervical Spine Center in Charlotte, North Carolina, we use a similar technique to that used in the above study. It does not require us to pop or crack the spine to get results. Rather, we use a gentle technique that allows the bones of the neck to move back into place naturally and stay in place longer. This is often all that is needed to see positive results in dealing with dizziness.