Vertigo, Dizziness and Chiropractic Care

Vertigo, Dizziness and Chiropractic Care

Vertigo is a symptom that presents in chiropractic patients, particularly after neck or head trauma. Dizziness and vertigo can be an extremely disabling complaint. It’s a sense of spinning or dizziness, sometimes associated with symptoms like sweating, vomiting and nausea.

Cause of Vertigo

Vertigo can have many causes; in most cases, it’s a treatable condition. The treatment that’s used depends on the cause. That’s why when you first visit your chiropractor for treatment they will have to do a thorough examination. In some cases, your chiropractor may have to refer you to a neurologist for additional assessments.

BPPV, also known as Benign Vertigo or sometimes Positional Vertigo, is one of the common causes of dizziness and vertigo.

BPPV or Benign Paroxysmal Positional Vertigo

BPPV is a disorder that causes you to experience brief recurrent periods of vertigo, triggered by particular head movements. The condition can affect people of all ages, although it’s most common in people who are aged 50 years and above.

If you’re experiencing symptoms of vertigo or dizziness, it’s vital that you rule out other causes including trauma, infection, blood pressure changes or a problem within your brain and/or your spinal cord.

BPPV Causes

This inner ear condition usually begins after:

• Use of ototoxic medications (for instance, gentamicin)
• A severe virus or cold
• Minor strokes
• Ageing
• A head injury

In the under 50s, the most common known cause is whiplash and head trauma. In people who are older, the most known common cause of this disorder is degeneration of their inner ear vestibular system, and Benign Paroxysmal Positional Vertigo becomes more common with advancing age. BPPV is called “idiopathic” in 50 per cent of the cases. This means the disorder occurs without any known reason.

BPPV Assessment

Since different BPPV types are often characterised by particular head positions triggering them, the examination of a specific BPPV type normally involves your chiropractor placing you in different positions and then monitoring the cause of your symptoms. At Neuroworks may also schedule a very thorough vestibular assessment including computerised video nystagmography where we place camera goggles on your eyes and run through a variety of head and eye movement tests and air caloric tests where the ear is warmed or cooled. This gives a much more information on your condition and a valuable means of monitoring recovery.

Also, nystagmus or characteristic, uncontrolled eye movements are an indicator. So, your chiropractor will observe these plus other signs and determine the type of Benign Paroxysmal Positional Vertigo you are suffering from. That’s very important because each type of BPPV needs a different treatment method.

BPPV Treatment

If free-floating calcium carbonate crystals within your ear are the cause, a series of repositioning manoeuvres can move them into the back of your ear canal and move these particles within a ‘pocket’ there. Here, they’re less likely to cause any problem triggered by movement. Your chiropractor will then tell you to remain still and upright as you possibly can to ensure the treatment is effective.

In some cases, VRT (Vestibular Rehabilitation Therapy) can also be effective; however, if you are a BPPV sufferer who is still experiencing symptoms, you may need a follow-up course of treatment. If you’re suffering from BPPV symptoms, conservative treatment methods that chiropractors offer may bring relief from the symptoms after only one treatment.

Don’t Put up with Vertigo – See a Chiropractor

vertigoVertigo affects about 40 percent of people who are over 40 years old at least once in their life. It can be debilitating and even stop you from enjoying life.

What Is Vertigo?

It’s a sensation that you feel when you move, spin in circles or stand very quickly. Typically, you feel like the space or room is spinning or swaying when in fact you’re sitting or standing still. You can experience this feeling of imbalance plus lack of control for several minutes or even several hours.

Causes of Vertigo

BPPV (Benign Paroxysmal Positional Vertigo), which is also known as Positional Vertigo or Benign Vertigo, is among the most common conditions that cause dizziness and vertigo.

Generally, approximately, 20 percent of all dizziness cases are due to Benign Paroxysmal Positional Vertigo and about 50 per cent of all dizziness cases in older patients is as a result of Benign Paroxysmal Positional Vertigo.

Other common causes of vertigo include labyrinthitis or vestibular neuronitis, which is the inflammation of your inner ear. Also, there are other causes of vertigo that are more serious like tumours, stroke and neurological diseases like MS (multiple sclerosis). With these conditions, other symptoms may also be present, and they’re often picked up during a chiropractic or neurological examination.

Causes of BPPV

BPPV usually begins after the following:

• Use of ototoxic medications such as gentamicin
• Due to an ageing process
• A virus or severe cold
• A head injury

In under 50-year-olds, whiplash and head trauma are the most common causes. The most common cause in older people is often the degeneration of the inner ear vestibular system. With advancing age, BPPV gets more common. In 50 per cent of all cases, Benign Paroxysmal Positional Vertigo is called “idiopathic”, meaning that it occurs without any reason.

BPPV Diagnosis

Chiropractors can diagnose this disorder after they have taken a full case history, then doing a physical as well as a neurological examination. At Neuroworks not only do we use tests like the Dix–Hallpike test or Nylen–Barany test/manoeuvre, are used in differentiating peripheral from central vertigo but we have a state of the art balance testing lab in which we have computerised video nystagmography including air calorics, head movement sensors and a computerised balance testing platform. We use this equipment not only to objectively make a more exact diagnosis than physical examination but also to monitor progress.

BPPV Treatment

BPPV is treated using certain repositioning manoeuvres. Chiropractors are trained to do the Semont or Epley manoeuvre, a simple technique that will cure your BPPV.

Your chiropractor is going to move you into certain positions, which depends on the previous assessment outcome, using gravity in moving the calcium carbonate (CaCO3) crystals away into a specific area of your inner ear where they’ll reduce your  symptoms.

That will be followed by home exercises (Vestibular rehabilitation exercises).

Otoconia (crystals) formation in your inner ear canals will reduce under these conditions, hence lessening the probability of future attacks. This treatment is effective and within 3 to 4 treatments, 80 percent of the patients are symptom-free. If you need a highly experienced Ealing chiropractor, feel free to contact Neuroworks Chiropractic Clinic.


BPPV Vertigo Treatment

bppvBPPV or Benign Paroxysmal Positional Vertigo is a condition that causes patients to experience recurrent attacks of vertigo often lasting for only a few moments and which are triggered by particular head movements. Although the problem can affect people of any age, it is most common in the over 50s.

If you are experiencing symptoms of dizziness or vertigo, it is important to rule out other causes that can include blood pressure changes, infection, trauma or a problem within the brain and/or spinal cord itself. BPPV is the most common cause of Vertigo seen by us at Neuroworks Chiropractic practice – and for most patients, is quite easy to remedy.

If the symptoms described sound familiar, please call to arrange an appointment on 020 8566 3757 and we can assess your problem. If it is BPPV, we can begin appropriate treatment, if it is something that we feel, requires further assessment, we can refer to you another health care professional.

The Causes Of BPPV

Ealing Chiropractor, Johan C Jeronimus, founder of the Neuroworks Chiropractic Clinic, explains that the distressing symptoms of BPPV, that can involve nausea and, less frequently, vomiting, are usually due to a build-up of tiny calcium carbonate crystals floating freely in the fluid of the inner ear. This type of BPPV is referred to as, Geotropic. Particular head movements or positions can result in crystals sending confusing, random messages to the brain as they brush against the sensory, hair-like filaments that, in normal circumstances help us to maintain balance.

Apogeotropic is the name for the type of BPPV where the tiny particles of calcium have attached themselves to a domed structure called the Cupula in the ear.

There are other causes of BPPV and these include an imbalance in the structure of the inner ear and changes in the Cupula that may include a decrease in density due to excess intake of alcohol.

How Do We Assess BPPV?

Because different types of BPPV are characterised by particular head positions that trigger them, the diagnosis of a specific type of BPPV will usually involve placing our patient in different positions and monitoring which cause symptoms. Characteristic, uncontrolled eye movements or nystagmus are also an indicator, so observing these and other signs enable us to determine the type of BPPV a patient is suffering from. This is important, as each type requires a different treatment method.


When the cause is free-floating calcium carbonate crystals within the inner ear, a series of positioning manoeuvres can move the particles into the back of the ear canal and deposit them within a ‘pocket’ there – where they are less likely to cause problems triggered by movement.

After repositioning, your Ealing Chiropractor will often suggest that patients remain as still and upright as possible to ensure that the treatment is as effective as possible.

In some cases, Vestibular Rehabilitation Therapy or VRT can be effective, although a follow-up course of treatment may be necessary for BPPV sufferers who are still experiencing symptoms.

We may also suggest that patients avoid salt and caffeinated drinks for a week after treatment and consider cutting down on both, thereafter as a reduction in the intake of these chemicals has been shown to reduce the formation of the calcium carbonate crystals within the inner ear that trigger BPPV – thus reducing the likelihood of further episodes.

If you are suffering from the symptoms of BPPV, the good news is that the conservative treatment methods offered by your Ealing Chiropractor can often bring relief from symptoms after a single treatment.