Vertigo and Dizziness

Although frequently used interchangeably, they are two separate and distinct entities. Dizziness usually refers to a sense of faintness, giddiness or lightheadedness, while vertigo is usually expressed as a "whirling" sense of movement. While we have all experienced dizziness, vertigo is often wrongly confused to be the same sensation. The best analogy to describe the sensation of vertigo is the following: Imagine yourself spinning on a merry-go-round and then you step off quickly. You continue to feel like your spinning around in circles. This is true vertigo. Both can be caused by many clinical conditions ranging from: cardiovascular, neurological or endocrine disorders to certain types of medications and adverse drug reactions. Most often, they are usually caused by problems in the inner ear or from the structures of the neck.

Coordination, Balance and Equilibrium

Your body coordinates three sources of sensory information to establish coordination, balance and equilibrium. Information from your eyes, your inner ears, and the joints of your body all supply information to the brain. A problem in any one of these three areas, can send "incorrect" information to your brain and give you symptoms of disequilibrium. As stated previously, there are many causes of dizziness and vertigo, but most often they involve the inner ear or the joints of the neck.

How Can Chiropractic Help Vertigo and Dizziness?

The body has special nerve sensors called proprioceptors that are richly invested in the structural tissues of the body. They function to send information to the brain about position and movement sense of the body. These receptors are most heavily concentrated in and around the joints of your body. When your joints are dysfunctional and not moving properly, altered sensory information is sent to your brain, which can create disequilibrium (vertigo and dizziness). This is often seen in the neck as cervicogenic vertigo (vertigo caused from the neck). Chiropractic is extremely effective at helping cervicogenic vertigo by addressing dysfunctional neck structures.

Clinically, the most common type of vertigo seen in this office is Benign Vertigo, or Benign Paroxysmal Positional Vertigo (BPPV). Benign vertigo is theorized to be caused by small densities (Canolith, litho=stone) that are formed inside the inner ear. Most often as a result of head trauma, recently or in the past. What usually initiates the episode of vertigo is that the head is placed in an awkward position for a prolonged period of time, either from an unusual sleeping position, or some other activity, for example: painting a ceiling with your head in prolonged extension. It is theorized that these "stones" migrate into areas of the inner ear and cause trouble with the vestibular apparatus or organ of balance. And thereby send false signals of movement, when the body is not moving.

Treatment for Benign Vertigo: The Canalith Repositioning Procedure...

The canolith repositioning procedure is not a chiropractic procedure, but a procedure first instituted and described by John M. Epley, M.D. The procedure is basically a manual head positioning procedure designed to move these densities out of sensitive areas of the inner ear, into areas that do not cause problems. Clinically, I have been very successful treating benign paroxysmal positional vertigo in the office. Most patients experience immediate results, while only a handful require one to two more visits. About half experience a relapse, usually around 3-6 months, that quickly goes away with further treatment. The procedure is painless. If you can lie on your back, rollover on your side, lie face down, while having your head supported in a variety of positions, you will do fine.


My interest in vestibular disorders first began in graduate school; my wife woke up one morning with severe vertigo for the very first time. After a trip to an otolaryngologist, (ears, nose, throat specialist, or E.N.T.) and further diagnostic testing, not much was done, only medication was prescribed such as Antivert, which was not very effective, and had side effects also. A Neurologist instructor of mine suggested I do further research into it so I traveled to the University of Iowa Medical Center Library, and researched articles on treatment. That is when I came across Dr. Epley's canolith repositioning procedure. As of 2006, I have treated approximately 300 people. I would estimate 80% have had immediate cessation of their vertigo on their first visit, while 15% required an additional two to five visits for complete resolution. Of the remaining patients, a few were unable to perform the required positioning (elderly) and received no benefit. Some had signs and symptoms that were not related to the inner ear. One patient had cervicogenic (caused by the neck) vertigo, and two were unresponsive to the Epley procedure. I have had only two patients that have gotten worse temporarily.

I have been most disappointed that most, if not all, doctors know nothing about treating this affliction with this relatively simple and effective manual method. Of all the E.E.N.T. specialists my patients have seen, they have never performed this procedure. One E.E.N.T. told my patient to hang her head off the edge of the bed, and that was it! I would think that something that is directly in their scope of practice would deserve a complete knowledge of all treatments available. She was most displeased and came to me and walked out free of vertigo. Most of the patients I have seen have been seen by their family doctor, then referred to E.E.N.T. specialists, and neurologists with no help. I have received many referrals from the physicians in my group office with excellent results. I am always looking for an E.E.N.T. specialist that I can refer to if I have a difficult case.

Medline Articles on Vertigo