What is vertigo?

Vertigo is a sensation of spinning or dizziness that occurs even when you are not moving or moving. It is often described as feeling like you or the environment around you is moving or spinning. Vertigo can be caused by various underlying issues which includes:

●     Inner ear problems:

○     Benign paroxysmal positional vertigo (BPPV): This occurs when tiny calcium particles (canaliths) clump up in the canals of the inner ear.

○     Meniere's disease: An inner ear disorder thought to be caused by a buildup of fluid and changing pressure in the ear.

○     Vestibular neuritis or labyrinthitis: An inner ear infection, usually viral, that causes inflammation around nerves important for balance.

●     Head or neck injury: Such injuries can affect the vestibular system in the inner ear, leading to vertigo.

●     Medications: Certain drugs can cause vertigo as a side effect.

●     Migraines: Some people experience vertigo or dizziness as a symptom of migraines.

●     Other neurological conditions: Conditions such as multiple sclerosis or tumors may cause vertigo.

Vertigo can be accompanied by other symptoms such as nausea, vomiting, sweating, abnormal eye movements (nystagmus), and difficulty walking.

How is vertigo diagnosed?

Diagnosing vertigo involves a combination of medical history, physical examination, and specific tests to determine the underlying cause. Here are some common methods and procedures used in diagnosing vertigo:

●     Medical History:

○     The doctor will ask about your symptoms, their duration, and any factors that trigger or alleviate them.

○     They will inquire about your medical history, including any recent illnesses, head injuries, medications, and any family history of vertigo or related conditions.

●     Physical Examination:

○     The doctor will perform a physical exam, focusing on the nervous system and ear function.

○     They may observe your eye movements for signs of abnormal movement (nystagmus), which can indicate inner ear problems.

●     Hearing Tests:

○     Audiometry and other hearing tests can help determine if there is any hearing loss associated with vertigo, which may indicate a problem with the inner ear.

●     Balance Tests:

○     The doctor may perform balance tests, such as the Romberg test, the head impulse test, or the Fukuda-Unterberger test, to evaluate your balance and coordination.

●     Dix-Hallpike Maneuver:

○     This specific test is used to diagnose benign paroxysmal positional vertigo (BPPV). The doctor will guide you through a series of head movements to see if they trigger vertigo and nystagmus.

●     Imaging Tests:

○     In some cases, imaging tests like MRI or CT scans may be ordered to rule out other potential causes of vertigo, such as tumors, stroke, or structural abnormalities.

●     Blood Tests:

○     Blood tests may be performed to check for underlying conditions such as infections, inflammation, or metabolic disorders that could be causing vertigo.

●     Electronystagmography (ENG) or Videonystagmography (VNG):

○     These tests measure involuntary eye movements while you undergo certain head and body position changes, helping to identify issues with the inner ear or the brain's balance centers.

●     Vestibular Evoked Myogenic Potentials (VEMP):

○     This test measures the response of certain muscles to sound stimulation, providing information about the function of the inner ear and the vestibular nerve.

The specific tests and procedures used will depend on the suspected cause of vertigo and the patient's symptoms. A thorough and accurate diagnosis is essential for determining the appropriate treatment plan.

What are the symptoms of vertigo?

The primary symptom of vertigo is a sensation of spinning or dizziness, but it can be accompanied by a range of other symptoms, including:

●     Sensation of Spinning or Swaying: Feeling like you or your surroundings are moving or spinning, even when you are still.

●     Nausea and Vomiting: The spinning sensation can cause feelings of nausea, and in severe cases, vomiting.

●     Balance Problems: Difficulty maintaining balance, which can lead to unsteady walking or standing.

●     Abnormal Eye Movements (Nystagmus): Involuntary, jerky eye movements that may be horizontal, vertical, or rotary.

●     Headaches: Some individuals may experience headaches, especially if vertigo is associated with migraines.

●     Sweating: Profuse sweating can occur due to the stress and discomfort caused by vertigo.

●     Ringing in the Ears (Tinnitus): A ringing, buzzing, or hissing noise in one or both ears.

●     Hearing Loss: Partial or complete hearing loss, particularly if the vertigo is caused by an inner ear disorder like Meniere's disease.

●     Feeling of Fullness in the Ear: A sensation of pressure or fullness in the affected ear.

●     Difficulty Focusing: Problems with vision, such as trouble focusing or double vision.

●     Feeling Lightheaded or Faint: A sensation of being about to faint, although this is less common with true vertigo.

In some cases, vertigo can last for only a few seconds or minutes, while in others, it can persist for hours or even days. The symptoms may also be intermittent, coming and going at different times.

What are the normal treatments for vertigo?

Treatment for vertigo depends on the underlying cause and the severity of the symptoms. Here are some common treatments and interventions:

●     Medications:

○     Vestibular suppressants: These include medications like meclizine, dimenhydrinate, or diazepam, which can help reduce the spinning sensation and nausea.

○     Antiemetics: Medications such as promethazine or ondansetron can help control nausea and vomiting.

○     Antibiotics or Antivirals: If an infection is causing the vertigo, such as vestibular neuritis, appropriate antibiotics or antiviral drugs may be prescribed.

○     Diuretics: For Meniere's disease, diuretics can help reduce fluid buildup in the inner ear.

●     Physical Therapy:

○     Vestibular rehabilitation therapy (VRT): This is a type of physical therapy designed to help strengthen the vestibular system. It involves specific exercises that improve balance and reduce dizziness.

○     Canalith repositioning maneuvers: For benign paroxysmal positional vertigo (BPPV), techniques such as the Epley maneuver or Semont maneuver can help move dislodged calcium particles out of the semicircular canals in the inner ear.

●     Lifestyle and Home Remedies:

○     Avoiding triggers: Identifying and avoiding movements or positions that trigger vertigo can help manage symptoms.

○     Staying hydrated: Dehydration can worsen vertigo, so it's important to drink plenty of fluids.

○     Stress management: Stress can exacerbate vertigo symptoms, so relaxation techniques such as deep breathing, meditation, or yoga can be beneficial.

○     Adequate rest: Ensuring sufficient sleep and rest can help reduce the severity and frequency of vertigo episodes.

●     Surgical Options:

○     In rare cases where vertigo is caused by structural problems in the inner ear or other medical conditions, surgical intervention may be necessary. Examples include vestibular nerve section or labyrinthectomy.

●     Dietary Changes:

○     For conditions like Meniere's disease, reducing salt intake can help prevent fluid buildup in the inner ear. Some patients may also benefit from avoiding caffeine and alcohol.

●     Treatment for Underlying Conditions:

○     Addressing the root cause of vertigo is crucial. For example, if migraines are causing vertigo, managing and preventing migraines through medications and lifestyle changes can help.

●     Education and Support:

○     Educating patients about their condition and providing support can help them cope with the symptoms and manage their daily activities more effectively.

How can acupuncture help patients with vertigo?

Acupuncture can help patients with vertigo in several ways:

●     Restoring Balance: Acupuncture is thought to restore the balance of energy, or Qi, in the body. In Chinese medicine, vertigo is often seen as a result of imbalanced Qi flow, particularly in the liver, spleen, and kidneys.

●     Reducing Inflammation and Improving Circulation: Acupuncture may help reduce inflammation and improve blood flow, which can alleviate symptoms of vertigo. Enhanced circulation can ensure better delivery of oxygen and nutrients to the inner ear and brain.

●     Regulating the Nervous System: Acupuncture can stimulate the nervous system, potentially reducing symptoms of vertigo by calming the vestibular system and modulating the signals that contribute to dizziness.

●     Reducing Stress and Anxiety: Since stress and anxiety can exacerbate vertigo symptoms, acupuncture's calming effect can help manage these factors, leading to a reduction in the frequency and severity of vertigo episodes.

●     Relieving Associated Symptoms: Acupuncture can also address symptoms associated with vertigo, such as nausea, headaches, and neck tension. By relieving these symptoms, patients may experience overall improvement in their condition.

Scientific Evidence and Studies:

●     Some studies suggest that acupuncture can be effective in reducing the frequency and severity of vertigo symptoms. For example, a systematic review and meta-analysis published in the Journal of Alternative and Complementary Medicine found that acupuncture might have a positive effect on vertigo, particularly in cases of benign paroxysmal positional vertigo (BPPV).

●     Other research indicates that acupuncture may be beneficial as part of a comprehensive treatment plan, especially when combined with other therapies such as vestibular rehabilitation exercises.

Points Commonly Used in Acupuncture for Vertigo:

●     GB20 (Fengchi): Located at the base of the skull, this point is used to treat dizziness and headaches.

●     PC6 (Neiguan): Located on the inner forearm, this point helps relieve nausea and vomiting.

●     LI4 (Hegu): Located on the hand, this point is used to alleviate headaches and improve overall energy balance.

●     LV3 (Taichong): Located on the foot, this point is believed to help regulate liver Qi and improve balance.