Understanding vertigo, the spinning sensation

Have you ever felt like the world around you is spinning, tilting and swaying, making it hard to keep your balance even when you're standing still? 

That sensation might be vertigo, a dizzying condition that affects millions worldwide. Whether it's a fleeting spin or a persistent swirl, vertigo can significantly impact your well-being. 

Vertigo isn't just feeling dizzy or light-headed; it's a specific type of dizziness where you feel like you or your surroundings are spinning or moving, even when you're not. This sensation can range from mild to severe. 

According to IOS Press, dizziness affects approximately 20-40 per cent of people at some point, with about 7.5-10 per cent experiencing vertigo. It's a common symptom, especially as we age, and it affects women about two to three times more often than men. 

Dr Catherine Njogu, a chiropractor, explains that vertigo often originates from issues within the inner ear. 

“Vertigo is caused by a disturbance of the vestibulocochlear nerve, which is responsible for hearing and balance. Problems in the ear canal can disrupt your equilibrium,” Dr Njogu explains. 

There are two main types of vertigo: peripheral and central. Peripheral vertigo, caused by inner ear problems, is more common. Central vertigo, stemming from issues in the central nervous system (the brain and spinal cord), tends to be less severe but longer lasting. 

Dr Njogu stresses the importance of thorough diagnostic procedures to differentiate between peripheral and central vertigo. 

“Various factors can trigger vertigo, including inner ear disorders like benign paroxysmal positional vertigo (BPPV), cervical vertigo, Meniere’s disease or labyrinthitis,” Dr Njogu adds.

Other causes are certain medications that can affect the inner ear’s function, leading to vertigo as a side effect and migraine. 

For example, BPPV occurs when tiny calcium crystals called otoconia dislodge and move into the semi-circular canals, which sense head movement. Moving your head or changing positions can trigger vertigo in these cases. 

Cervical vertigo, caused by a compressed or pinched nerve in the cervical spine that is the neck vertebrae, has symptoms that include neck pain, headache and nausea or vomiting. 

According to Dr Njogu, a comprehensive approach is key to treating vertigo. “We conduct detailed cranial nerve exams and assess cervical spine alignment to identify any structural issues contributing to vertigo symptoms,” she notes.

Joy Wanjiru Waihenya, a physiotherapist specializing in vestibular rehabilitation, describes how patients often liken vertigo to feeling on a merry-go-round.

“Each patient's journey starts with a thorough assessment. We address not only vertigo itself but also underlying neck tension and joint misalignments,” Waihenya explains.

Treatment options include muscle release techniques for BPPV, chiropractic adjustments for spinal alignment and canalith repositioning manoeuvres to relocate displaced inner ear crystals and alleviate symptoms.

Vestibular rehabilitation, a specialised exercise programme, helps improve balance and reduce vertigo symptoms through targeted head, eye, and body movements.

Dr Njogu emphasises lifestyle adjustments for preventing vertigo, such as avoiding triggers like excessive alcohol, managing stress, avoiding sudden head movements, regular exercise for balance and strength and maintaining a low-sodium diet for conditions like Meniere’s disease.

“Simple lifestyle changes, like using handrails on stairs or taking breaks during activities, can significantly help manage vertigo,” Waihenya advises.

Once symptoms are under control, both experts recommend empowering patients with exercises for continued improvement and self-care.