Vertigo refers to dizziness, or spells of dizziness, or rotational dizziness, which can be short term or long term. It is a general symptom for a variety of conditions of the brain, inner ear, sensory nerve pathway, and other sensitive organs. Vertigo has the capability of hampering the day to day functioning of the person. Furthermore, due to these reasons, it has the potential to cause anxiety and depression.

Types of Vertigo & Diagnosis:

Vertigo can be categorized into two major types based on the underlying cause:

1. Peripheral Vertigo: It is said to occur if it is related to the problems of the inner ear, such as its inflammation or an infection in its tiny parts or displacement of tiny particles present in the inner ears.

2. Central Vertigo: It is said to occur if it is related to the problems of the brain (the Central Nervous System) or the sensory nerve pathways.

Vertigo can be diagnosed by physical examination, assessing the medical history followed by undergoing a CT scan or an MRI, as required.

Treatment:

It is important to essentially understand the root cause of the condition and then treat that accordingly for best results.

1. A bacterial infection can be addressed through antibiotics.

2. Nausea and motion sickness can be reduced by using anti-emetics and antihistamines.

3. Sometimes, for patients with intractable Benign Paroxysmal Positional Vertigo (BPPV), surgery is performed to block the area triggering Vertigo.

4. Exercises can also help in managing the milder symptoms of Vertigo without visiting to the doctor for the same.

5. Most of the time, in case of BPPV, physiotherapy is the recommended treatment.

6. Certain lifestyle changes and precautions can be adopted to avoid conditions that trigger Vertigo.

7. Vestibular Rehabilitation Therapy goes a long way in managing Vertigo.

Vestibular Rehabilitation Therapy (VRT) for Managing Vertigo:

Vestibular Rehabilitation Therapy, abbreviated as VRT, is a program based on exercise that promotes the retraining of the Central Nervous System and repositioning of the free flowing particles in the fluid present in the inner ear. This helps in treating the condition of the inner ear for managing Vertigo. Its application is based on scientific research and evidence. The major goal of this type of treatment is to let the brain establish coordination again with the inner ear, with eye, and with the proprioceptive system for processing information.

The proprioceptive system consists of the sensory receptors which respond to pressure and stretch. Hence, VRT is effective in improving the diminishing quality of life due to Vestibular Disorders like Vertigo, by addressing both, the primary as well as secondary consequences of the condition. Over a period of time, when the patient becomes sufficiently trained under professional guidance, VRT can then be carried out at home at prescribed intervals based on the specific requirement.

Methods for VRT-

Depending on the clinical examination, the three major methods of exercise for Vestibular Rehabilitation Therapy can be prescribed, as described below:

1. Habituation exercises are prescribed for those patients who experience dizziness by movement and by visual stimulation.

2. Gaze Stabilization exercises are prescribed for those patients who experience uncontrolled eye movements leading to unclear vision.

3. Balance Training exercises are prescribed for improving steadfastness, to prevent falling, and to restore balance during performing activities like bending, standing and turning, reaching, walking, and running for helping patients return to their daily lives confidently.

Take Away:

Vertigo is the vestibular condition of dizziness that can be managed through methods like Vestibular Rehabilitation Therapy for re-training the brain to coordinate with the affected organs. It helps in restoring the quality of life. VRT is mainly practiced through habituation exercises, gaze stabilization exercises, and balance training exercises.

Managing Vertigo Through Physiotherapy And VRT!

Dizziness or vertigo is a feeling of being off centre, which makes a patient feel like there is lack of balance. This is especially apparent when one is at a height or while wearing footwear with high heels. It may be caused due to a variety of causes, and ear problems are one of the primary causes of this kind of dizziness. Let us take a look at the various ear problems and how they can cause dizziness or vertigo.


1. Infection: the bacteria or virus that causes cold and loose motions can also cause an ear infection. This can give rise to temporary vertigo which may last up to six weeks or more. Dizziness or vertigo happens in such cases because the viral effect spreads to the inner ear which causes a ringing and off balance sensation. The general physician or ent specialist will usually prescribe a round of medicines only if the condition becomes too severe to handle.


2. Benign paroxysmal positional vertigo: this kind of dizziness is also known as bppv and may be caused due to the motion of a calcium particle known as otolith, in the ear. This can cause a fluttering movement that gives the sensation of falling down or losing balance. This usually takes place in the part of the ear that catches the sensation of gravity. The movement of the otolith can make the patient feel as if his or her head is turning or swaying, while in reality the patient may be stationery. This problem can be fixed with the help of a two minute therapy known as epley manoeuvre, which can be conducted easily in the ent specialist's clinic.


3. Meniere's disease: there is actually a specific condition that is characterised primarily by dizzy spells and vertigo. The other symptoms of this ear bone condition include ringing of the ears, loss of hearing, and the feeling of fullness or pressure build up in the ears. This can be fixed with therapy and drugs as well as hearing loss aids.


4. Dandy's syndrome: this is an ear condition where the patient constantly feels like he or she is bouncing up and down. This condition hits patients who are on antibiotic medication for any kind of infection, and it subsides once the medication is done with. It occurs in such cases because certain kinds of antibiotics may be toxic for the ear. One may also see natural improvement in the condition over the passage of time.


5. Tumours: other reasons like tumours and strokes can also cause vertigo on a temporary or permanent basis.


Dizziness due to ear problems can be due to a number of mild to severe reasons. It is best to get these causes checked.

How Ear Problems Can Cause Dizziness

Vertigo is a medical condition where the affected person feels that the world or surrounding environment is spinning or moving. It is accompanied with nausea, vomiting, sweating and having problems in walking steadily. Moving your head worsens this condition. An illusion of movement is observed.

Vertigo arises from several conditions. There are mainly two types of Vertigo-

Peripheral Vertigo: This is the most common vertigo and is caused often due to a problem in the balance mechanism of the inner ear. The causes include:

Benign Paroxysmal Positional Vertigo: Being one of the common causes of vertigo, BPPV occurs due to certain head movements when standing up or bending over. The attacks are short, powerful and recurrent in nature. Nausea is also accompanied. A feeling of lightheadedness and despaired balance is observed after the attack. Fragments of calcium carbonate crystals are broken off from the channel linings present in the inner ear. These fragments cause the problem by getting into the ear fluid canals, and certain head movement sweeps them across the canal causing vertigo.

Head Injury: Vertigo develops due to head injuries, and the symptoms are similar to that of dizziness.
Labyrinthitis: It is an infection in the inner ear, which causes the labyrinth of the ear to get inflamed. The labyrinth controls our hearing and balance. An inflammation causes it to send different information than the other, normal ear. This conflict causes vertigo. Such vertigo can be accompanied by nausea, vomiting, loss of hearing and ear pain.

Vestibular Neuronitis: This is a condition pertaining to the inner ear, which causes inflammation of the nerve which connects the labyrinth to the brain. The condition arises from viral infections. Nausea and vomiting are observed, and this condition leads to vertigo.

Meniere's Disease: This rare condition in the inner ear causes severe vertigo along with hearing loss and aural fullness. Meniere's disease prompts sudden vertigo attacks with nausea and vomiting.
Central Vertigo: Central vertigo arises from problems in the cerebellum of the brain and brainstem. Causes include:

Migraines.
Sclerosis, a condition which affects the central nervous system.
Acoustic neuroma, a type of brain cancer growing on the acoustic nerve.
Brain tumors, stroke or transient ischemic attack.
Certain medications.
Treatment-
Treatment of vertigo depends on the cause and on the extent of symptoms. Labyrinthis and vestibular neuronitis are cured by vestibular rehabilitation and medication. BBVV is treated using a process called the Epley maneuver. Meniere's disease is cured by modes of dietary restriction, medication, treating tinnitus and treating hearing loss. Generally, curing the cause of vertigo helps in healing the disorder.

Vertigo is caused by different reasons and factors and rectification of these factors helps in the treatment of vertigo.

Vertigo: Causes and Treatment

Dizziness is usually described as variety of sensations, which comprise of a feeling of faintness, unsteady, weak, light headed, giddy or woozy. When dizziness causes a false feeling of spinning and the moving surroundings is known as vertigo.

Dizziness can be one of the most common reasons for a visit to the doctor. However, constant feeling of dizziness can affect a person's life drastically, but it is rarely life threatening. The treatment of dizzy sensation and dizziness mostly depends on the symptoms.

Causes of dizziness
The common causes of dizziness are medication, motion sickness and ear problems, especially disturbances of the inner ear. An injury, infection or poor blood circulation can also lead to dizziness. The triggers of dizziness and the sensations it provides are used to evaluate the cause. Also, the duration of the dizziness and the symptoms lead to a clue towards the cause of the same.

Dizziness caused by the inner ear problems
The balance of the body depends on the combined effort of many parts of the sensory system. These are:

1. Sensory nerves: these send messages to the brain in regard to the body positions and its movements
2. Inner ear: the inner ear has the organ of corti which are responsible for detecting the motions and thereby help in the balance of the body.

In vertigo a person might feel that the things around them are moving, thus creating a swaying or a spinning motion. Vertigo is usually caused by the problems of the inner ear. 

The common causes are:

1. Benign paroxysmal positional vertigo (bppv), this happens when the calcium particles accumulate in the inner ear canals. The inner ear is responsible for the body movements and balance.

2. Meniere's disease, a problem of the inner ear mainly caused by the build up of the fluids, thereby leading to a change in pressure. This causes vertigo along with hearing loss and tinnitus.

3. Vestibular neuritis is the problem of the inner ear and is largely due to infection. Infection leads to swelling of the nerves of the inner ear which affect the body movements.

Treatment of vertigo includes:
1. Rehabilitation of the vestibular system by physical therapy in order to strengthen it.
2. Canalith repositioning by suggesting some body and head movements basically for bppv. These movements help to move the calcium deposits from the inner ear canals to one of the chambers, which are further absorbed by the body. When the canaliths (calcium deposits) move, it might give rise to vertigo.
3. Medicines are given to relieve symptoms of motion sickness and nausea. Antibiotics can be taken in case of infection and swelling.
4. Surgery in some cases.

Dizziness and Ear Problems

Dizziness, vertigo and balance issues are common symptoms and most of us may have experienced momentary symptoms. It is a sensation of feeling a movement even after the movement has stopped. For example the sensation we feel when we get off a merry-go-round or feeling butterflies in the stomach when we are on a roller coaster ride. Imagine if these symptoms are constant and start affecting our day to day activities. Even a simple task of walking can be bothersome as we may feel like our body is drifted and we cannot balance properly. We may feel a severe spinning sensation when we change position from lying down to sitting or rolling over in bed. It can also cause fear, anxiety and make us limit our movements and activities. These may cause more complications such as neck pain, headaches, body pains and depression. It is therefore very important to find out the root cause of vertigo and treat it immediately.

Dizziness is a sensation of light-headedness or unsteadiness. It can be caused heart disease, brain related causes like stroke, prolong illness, psychological issues, side effect of certain medications, blood pressure fluctuations and many other conditions. Neck stiffness, pain and weakness can also cause dizziness called Cervicogenic dizziness or Cervical Vertigo.
Vertigo is a spinning sensation or a feeling of motion when we are not moving. Its a common symptom in inner ear disorders. Some of the conditions that cause vertigo are: BPPV or Positional Vertigo, Meniere's, Labrynthitis, Vestibular Migraines, Vestibular neuritis, mal de barquement syndrome, perilymph fistula, toxicity of ears due to certain antibiotics, acoustic neuroma etc.
Balance problems or Disequilibrium means unsteadiness, imbalance or loss of equilibrium. It can occur as a primary symptom or with vertigo and dizziness.
You need to consult a Vestibular Therapist or Vertigo specialist who can diagnose your problem correctly. If you have Positional Vertigo known as BPPV then specific tests and manevers can help cure it completely. If there is inner ear disease such as Menieres disease, ear infections, labrynthitis or vestibular neuritis then proper medications prescribed by ENT specilialist and Vestibular Therapy can help you get rid of vertigo. In case the symptoms are related to Central nervous system (Brain) then promt treatment from Neurologist and Vestibular Therapist can help decrease vertigo and improve daily activities. If the symptoms are related to the neck called Cervical Vertigo or Cervicogenic Dizzienss then proper treatment of neck by a Vestibular Physiotherapist can help. Also making sure the posture is good when working on computer/laptops for prolong periods can prevent strain and reduce dizziness related to neck and back muscle tightness.

Vertigo & Dizziness - How You Can Get Rid Of It With Physiotherapy?

Are you feeling lightheaded, unbalanced or woozy lately? Are you having strange sensations in the ears and eyes? These indicate that you are suffering from dizziness, a condition affecting the body s sensory organs. It can cause fainting at times as well. It is not a disease, but a symptom of several disorders. Dizziness is caused by inner ear disturbances, effects of medication, motion sickness and underlying health conditions, such as poor blood circulation, infections or injuries.

Test and diagnosis
If you feel dizzy for a prolonged period of time or if the dizziness occurs and reoccurs, a special treatment is required. This is because dizziness may make you prone to several risks in everyday life. Several tests are carried out to find out the cause of the dizziness. If a stroke is suspected, an MRI scan or CT scan is carried out. A physical examination is undertaken in which the way you walk and balance are observed and the nerves of the central nervous system are checked. Hearing and balance tests may also be required, which are as follows:

Eye movement testing in which the path of the eyes is observed while tracking an object in motion. An eye motion test may be given where cold and warm water is placed in the ear canal.
Head movement tests are carried out when benign paroxysmal positional vertigo is suspected.
Treatment
Treatment of dizziness includes medicines, therapies and balance exercises.

Medicines

Water pills are prescribed when a patient has Meniere s disease, which helps in reducing dizziness.
Antihistamines provide temporary relief from dizziness.
Therapy

Head position maneuvers: A technique known as canalith repositioning helps in resolving dizziness quickly. It can be performed by a doctor, therapist or audiologist. The position of the head is maneuvered in the process.
Balance therapy: Several exercises help in making the body s balance system lesser sensitive to motion. This technique, known as vestibular rehabilitation, is used for people suffering from dizziness due to inner ear conditions.
Psychotherapy: This therapy may be used for patients who experience dizziness because of anxiety disorders.
Use of antibiotics: An antibiotic by the name of gentamicin may be injected in the inner ear for disabling the balance function. The unaffected ear performs that function.
Other procedures: A procedure known as labyrinthectomy may be used for disabling the vestibular labyrinth in the affected ear.
If you experience dizziness continuously, it is important for you to visit an ENT specialist. An ENT specialist deals with problems related to the ear, nose and throat and will be able to provide you with the best diagnosis and treatment for dizziness.

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