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

Vertigo is a feeling that your head or your surrounding is spinning. It is an illusion of movement. People with vertigo cannot bend down to pick up stuff, as they may feel the spinning sensation.
There are two types i.e. objective and subjective. Vertigo is said to objective when the surrounding seems to be spinning; subjective is when the person feels their head is spinning. Vertigo can be slightly mysterious to diagnose. There are, however, some causes which can help you understand it better. There are two main types of vertigo: Central and Peripheral. Central vertigo is when there is an issue in the brain that is causing vertigo. Middle ear problems leading to vertigo is known as peripheral vertigo.

Central vertigo:

Paroxysmal positional vertigo (BPPV): Also known as, Benign paroxysmal positional vertigo (BPPV). These episodes are benign and occur in paroxysms or spurts. The person will feel the attack with simple actions like turning over in bed. They do not last long, often about 20 to 30 seconds.
Migraine: Known for the severe headaches, migraine can also cause vertigo.
Head trauma: This type of vertigo usually subsides with time as the person recovers from trauma.
Neck injuries: Injury to nerves and blood vessels in the neck can also lead to vertigo.
Health conditions: General health issues like arteriosclerosis, multiple sclerosis, and diabetes lead to vertigo.
Stroke or blood flow blockage: When blood does not reach the base of the brain, it can result in vertigo.
Peripheral vertigo:

Middle ear infections: Labyrinthitis (either bacterial or viral) a middle ear infection can cause vertigo. Common viruses include herpes, influenza, measles, rubella, hepatitis, and EBV.
Meniere s disease: Another ear problem causing vertigo is Meniere s disease. This is known for its 3 symptoms   vertigo, ringing in the ears (tinnitus) and hearing loss. This can be caused by various factors, some of which can include ear infections, head injuries, or heredity. The exact cause of the condition is not established clearly.
Acoustic neuroma: A tumor of the nerve tissue in the inner ear may cause vertigo. The person can also have hearing loss and ringing sensation.
Other causes of vertigo include:

Pregnancy: During the first trimester, in particular, the various hormonal changes can cause vertigo. The expanding uterus puts pressure on the blood vessels, leading to reduced blood supply to the brain, which can also induce vertigo. As the baby continues to grow, lying on the back can put pressure on the blood vessels to the heart, causing vertigo.
Stress: It is known to worsen vertigo, which a person may already have. Anxiety and panic attacks are known to worsen vertigo.
Travelers: Be it ship, air, or train, some people experience a spinning sensation with any form of travel.


Vertigo In Adults - Why It Happens?

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

BPPV or Benign paroxysmal positional vertigo is a major cause of vertigo. This is a condition that gives a sensation of head spin all of a sudden. It also results in dizziness in brief episodes. The severity level can vary from intense to mild. BPPV is triggered with certain changes of the head position. Although BPPV is bothersome, it isn t serious unless there is a chance of a person falling abruptly because of the head spin. There are ample treatment options available to address this problem.

Symptoms of BPPV
BPPV includes some of the following symptoms:
a. Loss of balance
b. Dizziness
c. Feeling of the surrounding spinning
d. Vomiting and nausea
e. Rhythmic movement of the eye

When to seek medical attention?
If dizziness is accompanied with one of the below-mentioned symptoms, it is time to urgently seek medical attention and get vertigo addressed for good:

Hear loss
Tingling or numbness
Fever accompanies with severe headache
Arm or leg weakness
Problems with vision
Difficulty in walking
Becoming unconscious
Causes of BPPV:
If there is on known cause associated with BPPV, the condition is termed as idiopathic BPPV. In most of the cases, though, BPPV is associated with a severe to minor blow to the head. Other causes include an injury to the inner ear, prolonged sitting position in a fixed posture, even migraine pain is at times associated with BPPV.

What are the risk factors?
Benign paroxysmal positional vertigo is likely to occur in the age group of 50 and above, this being said it can happen at any age in case of any injuries. Statistically, it is found that the likelihood of BPPV is more in women than men. Head injury of any sort is by far the most likely reason of BPPV.

What are the tests and diagnosis involved?
A doctor is likely to perform a physical examination followed by a series of tests. Some typical signs that a doctor looks for include the following:
Ability to control eye movement- especially side to side movement

Symptoms of dizziness
In case it is difficult to spot the symptoms, a doctor might suggest video- nystagmography or electronystagmography. It helps to track irregular eye movement. An MRI can also be prescribed to study the cross-sectional images of the body and the head.

Treatments associated with BPPV:
BPPV mostly go away within months or weeks on its own. If however, it still persists, a doctor can suggest Canalith Repositioning- series of small movements that helps to counter BPPV. For extreme cases, a doctor might advise a surgery for blocking the portion of the inner ear that might be causing the problem. It guarantees close to a 100 percent fix to BPPV.

Vertigo / Dizziness - When To Seek Medical Attention?

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, 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?

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