If you have ever experienced vertigo, you know that it can put a damper on life. Feeling off-balance or like the “room is spinning” puts you at danger for falls and prevents you from doing things you need to do. Vertigo is very problematic for the elderly. Vertigo can put the brakes on for younger people.
Vertigo affects over 8 million people in the United States and one-third of them are over the age of 65. Another 35 percent of sufferers are age 40 and older. At least 2.4 million people who suffer from vertigo have the condition chronically and need to have treatment. If you suffer from vertigo or know someone that does, this article will help you understand why this happens and how to manage it.
Vertigo is a type of dizzy feeling that makes you feel like the “room is spinning.” It can make you feel off-balance or lose your balance easily. You may feel like you are “whirling around” and this often happens then you change head positions or look down from high up.
Vertigo is classified into two sub-categories; Peripheral, and Central. The description of these are:
Peripheral Vertigo. This type stems from an issue deep inside the ear. This includes either the; vestibular labyrinth inside the inner ear or the nerve that works with the brain to process sounds. Peripheral vertigo is very treatable and usually not serious.
Central Vertigo. This type of vertigo is associated with the nervous system most often the brain or brain stem. Central vertigo may be a sign of something serious and needs immediate evaluation.
Symptoms of Vertigo include:
Nausea and Vomiting
Off balance or tendency to lose your balance easily
Unsteady when walking
Eye movements (nystagmus)
The causes of vertigo depend on the type. Here are the causes of both peripheral and central vertigo:
Peripheral Vertigo Causes
The cause of peripheral vertigo almost always has to do with a problem in the inner ear. Some of these issues include:
Acoustic Neuroma. A small tumor can form and put pressure on the vestibular nerve. This is most often benign, but can cause; hearing loss, vertigo, and ringing in the ears.
Meniere’s Disease. Vertigo from this is caused by a collection of too much fluid inside the inner ear.
Labyrinthitis. This is and infection and/or inflammation deep inside the inner ear.
Neuronitis. Inflammation of the vestibular never can cause vertigo.
Medications. Some medications can affect the inner ear and cause vertigo. These include; sedatives, anti-nausea medications, and certain antibiotics.
Benign Positional Vertigo. Calcium crystals can build up inside the inner ear. When these crystals shift, vertigo attacks come on. They are usually short-lived, but tend to recur.
Central Vertigo Causes
The causes of central vertigo are centered in the brain and include:
Injury to the head
Illness and infections that affect the brain
TIA (transient ischemic attack or “mini strokes”)
If you have a sudden onset of “spinning or whirling” sensation, you should see a doctor right away to make sure it is nothing serious. If you have chronic episodes of this sensation, see your doctor as soon as possible. The following tests can help diagnose the cause of vertigo and help your doctor find the best treatment:
Eye Movement Test. In this test your doctor can look for abnormal eye movements (nystagmus) and how well your eyes can track back and forth. They may also check your eye reactions by placing water into your ears.
Balance Testing. The doctor will have you stand barefoot on a flat surface and have you make different movements. You will be watched for balance issues along with the movements.
Head Tilt Test. The doctor will have you sit in a chair and move your head in different positions. This will check for inner ear fluid problems.
Magnetic Resonance Imaging. The doctor can order an MRI study to see into the inside ear areas or even a problem in the brain. This is considered “gold standard” for diagnosing vertigo if positional causes cannot be found.
Treatments for vertigo largely depend on the type and cause. For central vertigo, the treatment would be resolving the underlying cause, i.e. surgery, blood thinners for TIA and Stroke, head injury management, and treatment of migraine headaches.
For peripheral vertigo associated with the inner ear, the treatments are:
Medication. This includes; sedatives, antihistamines, anti-nausea medications, and anticholinergic medications. Your doctor may also prescribe; steroids to reduce inflammation in the inner ear, antibiotics for ear infection, or an antiviral drug. These medications are only used short-term during an acute episode.
Balance Exercises. You can be taught exercises that help your brains response to shifts in the vestibular canal. You will teach your eyes how to compensate for changes in both the canal and pressure on the nerve. A trained therapist will teach you the exercises such as; focus on a single object and moving your head in different positions. If you have a risk of falls, you will be taught home safety tips and may need a cane or walker for safety.
Canalith Therapy. If you have benign positional vertigo, you can be taught a technique to help reposition any calcium crystals in your inner ear. The doctor will manipulate your head into certain positions (Epley maneuver) that you can do at home. Once the crystals are repositioned, often the body will reabsorb them and you may feel better quickly. If the condition returns, you can do the technique yourself anytime.
Vertigo Prevention & Lifestyle Changes
If you have chronic vertigo, there are certain things you can do at home to help reduce your symptoms and protect your safety. These include:
If you Have a Vertigo Attack, Sit Down Right Away! Turn down the lights, lower TV volume and stay quiet until the attack passes.
Watch out for Hazards. Be aware at home or especially in unfamiliar places of hazards that might cause an injury if you become dizzy. Use caution on stairs and use handrails. Use nightlights at home, and use a cane if you need to.
Do NOT Drive During an Attack. If you are in the car driving, pull over right away and rest until the attack subsides.
Eat Regular Meals. Low blood sugar can make you lightheaded and bring on vertigo. Make sure you don’t skip any meals and eat at regular times.
Lower Caffeine Intake. Try to avoid or drink less caffeine which can increase vertigo symptoms.
Lower Alcohol Intake. Too much alcohol will cause the “room to spin” and if you pair that with vertigo you can be more prone to falls and injury. Keep alcoholic beverages to one or two per day.
Treat any Allergies. Allergies can cause excess fluid build-up in the inner ear. Treat allergies promptly and keep your sinuses clear.
Alternative Medicine for Vertigo
Always have vertigo evaluated by your doctor to rule out anything serious. Also, check with your doctor if you can use alternative medicine as a form of treatment. There could be serious side-effects and drug interactions. Here are some ideas of things you can do at home:
The Epley Maneuver
1. Sit on your bed and place a pillow about where your shoulders would land when you lie down.
2. Turn your head to a 45 degree angle to the left or right side.
3. Lie back quickly keeping your head at the 45 degree angle with the pillow under your shoulders.
4. Stay in this position 30 seconds.
5. Turn your head 90 degrees to the other side and stay in that position for 30 seconds.
6. Sit back up slowly and stay there to allow anything to settle.
Ginger is a popular remedy for many ailments and has been around for centuries. It can help relieve the symptoms of; nausea, vertigo, and dizzy spells. It is known to help improve circulation and possibly help increase the blood supply to the brain and inner ear.
The capsaicin in cayenne pepper can also help improve blood flow to the inner ear and your brain. It has anti-platelet properties that reduce the incidence of blood clotting, so use caution if you are taking blood thinners.
This herb is a vasodilator and can increase blood flow to your inner ear and brain. This herb contains neorucogenin and ruscogenin that both help improve circulation in many conditions.
Gingko helps reduce the stickiness of your platelets and increases blood flow to the brain and the inner ear. It can also improve the health of your blood vessels. Numerous people use Gingko in both the U.S. and European countries.
Carson, T. (2013, August 16). Herbs for Vertido. Retrieved from Livestrong: https://www.livestrong.com/article/339384-herbs-vertigo/
Mayo Clinic. (2012, September 6). Dizziness: Tests and Diagnosis. Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/dizziness/basics/tests-diagnosis/con-20023004
National Library of Medicine. (2013, October 29). Vertigo. Retrieved from MedLine Plus: https://www.nlm.nih.gov/medlineplus/ency/article/001432.htm
UC Irvine Department of Otolaryngology: Head and Neck Surgery. (2015, July 24). Vertigo. Retrieved from Department of Otolaryngology: Head and Neck Surgery: https://www.ent.uci.edu/clinical-specialties/ear-surgery/vertigo
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