Being ‘giddy’ with love or reaching ‘dizzying heights’ in your career can be milestones in one’s life, but for those who live with Vertigo, these phrases have a different meaning altogether. Vertigo is the sensation of spinning while one is stationery. Often associated with nausea and vomiting, it can lead to imbalance, impaired vision and affect the quality of the life of the person suffering from it. More often than not, this condition is a symptom of other disorders and diseases. There are two types of Vertigo: Central and Peripheral. Central vertigo is caused by either injury to the balance centres of the central nervous system or brain-related syndromes. Treatment for central vertigo requires medication and is out of the purview of this blog. We shall concentrate on Peripheral Vertigo, which can be treated by physical therapy and rehab Pilates.
Peripheral vertigo is caused by problems in the inner ear which controls our balance. As mentioned in the blog on Balance, three mechanisms help our body maintain balance viz. vision, proprioception at ankle and foot, and vestibular system (the semi-circular canals of the inner ear). The vestibular system can be affected by various diseases ranging from common cold, influenza and bacterial infection which can cause transient vertigo to Meniere’s Disease, vestibular neuritis and BPPV which can cause severe vertigo over a prolonged period of time.
BPPV or Benign Paroxysmal Positional Vertigo is the most common cause of vertigo. Tiny calcium particles clump up in the semi-circular canals of the inner ear and hamper the signal being sent from the ear to the brain regarding the position of the head. There is no known reason for BPPV to set in, it is usually associated with ageing. Meniere’s disease, on the other hand, is due to build-up of endolymphatic fluid and changing pressure in the ear. This is accompanied by a feeling of fullness and ringing in the ears. Another cause is labyrinthitis or vestibular neuritis. It is related to an inner ear viral infection which causes inflammation.
All these conditions affect the signals being sent from the semi-circular canal to the brain and make one feel disoriented in space. It is usually triggered by a change in position of the head, leading to a swaying or spinning sensation which can last for around 45 seconds.
Cervical Vertigo or Cervicogenic Dizziness
Another cause of vertigo is cervical spondylosis which is basically medical jargon for age-related degeneration of the vertebral column of the cervical spine. There is some debate in the medical community about the association of the cervical spine to vertigo. Some medical professionals refuse to acknowledge the dizziness in patients with neck pain to vertigo. However, most physical therapists and medical researchers have found a link between vertigo and cervical spondylosis.
Cervical spondylosis is basically osteoarthritis of the cervical spine. The drying up of the cartilage between the vertebrae causes increased mechanical stress on the discs leading to spurs and narrowing of the disc space. It is associated with stiffness of the neck, pain radiating to the shoulders and upper back, and headaches.
Cervical vertigo can be caused by irritation in the nerves of the spinal cord or by disturbance of the flow of blood in the vertebral arteries of the cervical spine by the altered vertebral column. It is again triggered by a change in position of the head and might cause blacking-out or dizziness. It can also cause tingling sensation and numbness in fingers.
So how does one determine if the vertigo is peripheral or cervical?
Watch the video at the end of the blog where Dr. Persis Elavia explains a simple method to self-diagnose. She also suggests a simple trick to steady oneself when dizziness hits.
Disclaimer: Please always consult a medical professional if you are going through a bout of vertigo. Certain tests, investigations and manoeuvres have to be done under the guidance of the medical professional.
BPPV and cervical vertigo can both be treated with physical therapy and rehabilitation. Retraining the balance mechanism of the body, especially the proprioceptive feedback can really build the confidence of someone suffering from vertigo.
At Moushu’s Pilates, we have worked with various clients who have had different types of vertigo. Majority of these clients were even afraid of lying down on the reformer, our star equipment. Karishma Samtani is one such client. Having had severe neck pain and regular phases where she couldn’t turn her neck around, Karishma also used to feel giddy by sudden movements of her head. Crossing the road or even simply getting up from the bed to a standing position used to make her dizzy.
When she joined Moushu’s Pilates, with the aim of improving her general fitness levels, Dr. Moushumi Kuvawala designed a special programme to treat her vertigo as well. The gradual progress from mat exercises to open chain and weight-bearing exercises helped strengthen the muscles around her neck and shoulders. This compensated for the cervical spondylosis of her spine and helped her with not only the mobility of her neck but also reduced her dizziness. Within a few weeks, she was balancing on unstable surfaces like the wobble board and gym ball. And as her neck pain reduced, her confidence grew and she can now move on the reformer too.
Challenging the balance of the body in a controlled environment can train the mind by creating new neural pathways for proprioceptive feedback. Exercises for vertigo and balance training not only help with symptoms of vertigo but also help overcome the fear of falling which is the biggest concern for those suffering from it. So please go and get yourself checked if you feel dizzy constantly. Under the supervision of a doctor and physical therapist, most forms of vertigo can be dealt with easily.
Do you experience dizziness in daily activities? Physiotherapist and Pilates expert, Dr. Moushumi Kuvawala is seeing patients at her studio. Book an appointment now.