Dizziness can cause much turmoil in your life. It can begin without warning, accompanied by nausea and unsteadiness or loss of balance when you walk. Vertigo is the sensation when a room feels like it’s spinning around you. There are many reasons for sudden onset of dizziness:
- infections of the inner ear (which controls our sense of balance) can cause dizziness;
- medications can have a side effect of dizziness;
- common substances such as caffeine, alcohol and nicotine can lead to the feeling;
- viruses may affect your sense of balance.
Often, the exact cause of dizziness is unknown, and diagnosis such as Benign Paroxysmal Positional Vertigo (BPPV) is given. In this syndrome, vertigo is caused by sudden changes in your posture or position. Another common diagnosis involving dizziness is Meniere’s Disease. It also has unknown origins, and is usually associated with vertigo, hearing loss, sensation of fullness in the ear or a roaring, buzzing or ringing sound in the ear known as tinnitus. Rarely, a slow growing tumor affecting the inner ear, called Acoustic Neuroma, may cause these symptoms. It is very important that a person seek medical attention to rule out pathology. However, once these causes have been ruled out, manual physical therapy may prove very helpful.
Multiple studies show correlations between vertigo and musculoskeletal problems associated with the cervical spine, the head and jaw, and shoulder girdle. Postural alignment significantly affects the balance-sensitive structures. Postural alignment also plays a major role in determining the tension of muscles around the head, jaw and neck.
When we work with patients referred for vertigo, classic patterns of injury often emerge. Take, for example, the case of a 38-year-old woman who had a recent sudden onset of vertigo so severe that she was unable to get out of bed for several days. Her history included a mild scoliosis (curvature of the spine), intermittent tinnitus, off-and-on low back pain, neck tightness and headaches. The tinnitus started when she was 19 years old, 3 years after a field hockey ball hit her on the side of her right jaw. She also had whiplash from a car accident and had a hard time finding a comfortable sleeping position for her neck. She had been doing relatively well with these symptoms until recently.
Upon further questioning, she remembered that for the past several months she had been taking a “spin class” and found that the position of the stationary bike aggravated her neck and back. Then 2 days prior to the onset of vertigo she went to the movies and had to sit at the front of the theater. So in order to see well, she sat with her head tipped back. Although this was uncomfortable, she didn’t feel any immediate problems. Earlier that same day she carried her 25-pound son on her shoulders for a short distance, and felt her neck snap, but didn’t think much of it since it didn’t seem to hurt.
This series of events usually adds up to the straw that broke the camel’s back, but is often overlooked in the traditional medical model. And other seemingly unrelated symptoms were also present. Although an MRI was negative for tumor or infection, this patient had persistent numbness of the cheekbone, always had problems with a particular tooth (although dental intervention had been exhausted) and had recurring vision problems on the same side.
In this particular case, examining the postural and musculoskeletal systems clearly linked all these different symptoms together. Because our standing posture is determined by where our center of gravity falls, it is easy to track compensations that must be made at the rib cage, spine, shoulders, head, jaw and neck and analyze how everything is connected. Looked at in isolation, it might appear that all these symptoms were separate and must be stress related. However, seen in terms of biomechanical alignment, the symptoms not only made sense, they were also predicable and often treatable.