Vertigo is a common presentation in Chiropractic practice and has a variety of causes.
Chiropractors are well positioned to help differentially diagnosis vertigo which is especially important as particular causes can be dangerous and require medical intervention.
The most common type of vertigo is BPPV, benign paroxysmal postural vertigo and this is most often associated with the inner ear.
Our inner ear houses important apparatus known as semi-circular canals. Fluid is contained within these canals and the movement of this fluid communicates to the brain vital information related to balance.
From time to time crystals form within this fluid. Think of that chemistry set you had as a kid where, with the help of the sun, you precipitated copper sulphate out of solution and created those stunning blue crystals.
For reasons unknown, most likely ageing, the composition of this fluid alters and crystals develop. These are known as otoliths, not dis-similar to uric acid crystals associated with gout or even kidney or gallstones.
From here, the crystals interfere with the normal fluid dynamics within the semi-circular canals and oftentimes get stuck! This then leads to balance issues which are very different to light headedness or dizziness. In the case of vertigo, the room spins. In the latter, you spin.
Let’s talk about how your Chiropractor diagnoses and tests for BPPV associated with inner ear. I recommend you search for these tests on YOUTUBE to see what’s involved rather than I describe them here.
The primary test is called the ‘Dix-Hall pike’ test. Your Chiropractor is looking for flickering of your eyes known as nystagmus. Whichever side your head is positioned determines the involved ear.
Once this is determined the Chiropractor will look for the direction of eye flicker. This will be then determine the appropriate test.
Rotational eye flicker or nystagmus means there is a problem with the rear or posterior semi-circular canal and this requires the ‘Epley’s manoeuvre’ to be performed.
Lateral or side to side eye flickering indicates a problem with the lateral or side-ways orientated canal which requires the ‘Lampert manoeuvre’.
And up and down eye flickering means the upper or superior canal has crystals lodged and requires the Deep Head Hanging manoeuvre’.
It is best to let your Chiropractor help you with any of these techniques particularly as they involve relatively extreme neck positioning not to mention, they usually provoke more vertigo.
That being said, if done properly these techniques are very effective and often only have to be performed once or maybe once per day for a few days at home.
If your Chiropractor suspects something other than your inner ear causing the problems he or she will refer you accordingly. This may mean a brain C.T. scan or MRI or referral to an ENT specialist via your GP.
Don’t let this go unattended. Vertigo, irrespective of the cause may lead to a fall which could be disastrous.
About the Author:
Dr. Andrew Arnold is the ‘Practice Leverage Expert’; Principal Chiropractor and owner, Cranbourne Family Chiropractic and Wellness Centre; Accredited Business Coach; Founder, Million Dollar Wellness Practice. Andrew is married to Dr. Linda Wilson, the Stress Specialist and has two children, Isaac and Bella. He lives in Melbourne, Australia.