I have suffered from positional vertigo so I know that there is a big difference between being dizzy (feeling light headed and off balance) to having your eyes spinning uncontrollably inside your head, where you feel like you are doing fast summersaults. You would not believe how often I have students show up in class and tell me that they are having a vertigo attack. I have learned that whether it is actually vertigo or dizziness, it is important to tell people to go at their own pace and stop if something feels wrong. I decided to ask Andrea Dewar, registered physiotherapist and friend, to come and talk to my virtual studio members about the difference between the two conditions and here are the important points from her lecture last week.

The first message I want to get across, was the last point that Andrea made. Staying in shape is your number one way to prevent these attacks from happening. We need to do both cardiorespiratory training and muscular conditioning and well as flexibility improvement exercises. Why? Because many cases of dizziness can be attributed to poor fitness and poor posture. If you never train your heart and lungs, you will not be able to nourish your body properly with oxygen, and if you also have weak postural muscles and carry a hunched back or vulture neck position all day long, your lungs are not able to expand fully. These two facts alone create a situation where you might become prone to breathing issues which can bring on dizziness issues. Stress management is also key because when we are tense, we tighten our neck muscles and cervical spine health becomes compromised. So Andrea suggested that we practice deep breathing techniques, yoga or meditation to keep our stress levels under control.

So how do you know the difference between simple dizziness and vertigo? Andrea explained the two as follows:

DIZZINESS: spatial orientation is off, usually characterized as a non specific sensation (floating feeling, light headedness, unstable, feeling on a boat, feeling drunk). This feeling can be brought on by lying to sitting or standing, coming back up from squatting low down, standing for long periods of time without moving. We can experience blurred vision, feel faint, feel pressure in the head and even see rings of light.

VERTIGO: defined by a sensation of rotatory movement, spinning or turning. Can be both a feeling that the environment around is turning or spinning (external) or that one feel themselves turning around 360 degrees. In my case, my eyes cannot focus and I feel as though I am physically doing fast summersaults.

The next important take away is that if you are experiencing any dizziness is to go and see your doctor because it could be a sign of something more serious.

For example, feeling faint could mean that there is something wrong with your heart. Feeling unstable or wobbly could mean that your muscles are deconditioned or that the natural degeneration of the inner ear has progressed to such a rate as to affect your balance. Medications can make us feel off balance too. Concussions can bring on dizziness as well as tightness in the neck muscles. Andrea also pointed out that anemia and hypoglycemia can also contribute to sensations of dizziness. The clear message here is you have to see a medical professional to rule out serious health problems. I always tell you to listen to your body. It is telling you something.

VERTIGO causes:

A. Benign Positional Paroxysmal vertigo (BPPV)
◦ Tiny crystals that are located in one area of your inner
ear (utricle) get dislodged and migrate into the
semicircular canals of the inner ear.

Incidence of BPPV increases after 55 years old
◦ Ratio of women: men, 2:1
◦ Idiopathic 60-80% of the time
* Can be related with Osteoporosis, Osteopenia,
auto-immune diseases, diabetes, anxiety
◦ 10-30% of BPPV are caused by trauma
◦ 5-25% of BPPVS caused by other illnesses (upper
respiratory tract—common)

BPPV Symptoms: Gives a feeling of intense VERTIGO that lasts
from seconds to usually maximum one
minute, related with quick changes in the
position of the head
* Usually dizziness, nausea and balance issues
follows the vertigo sensation and can last for
hours after.
* People end up avoiding the movement that
provoked the vertigo.

B. Labyrinthitis:
◦ Virus or a bacterial infection of the ear
◦ Temporary altered hearing of the ear affected
◦ If bacterial treated with antibiotics
◦ Acute vertigo typically lasts less than 24 hours
◦ Balance affected, eyes affected (Nystagmus),nausea,
symptoms can last up to 3 months
◦ Often treated with anti vertigo meds in acute cases
* Teva Beta Histine (SERC), Gravol

C. Vestibular Neuritis
– Viral Infection affecting Vestibular nerve
– Severe vertigo lasting typically less than 48 hours
– No auditory symptoms
– Treated with often Gravol in ER (IV)
– Symptoms can last up to 6 weeks

D. Serious head traumas
* Fractures of skull, concussions, scuba diving incidents.

E. Meniere’s disease
*Auto immune disease
* Women 30-40 years old
* Pressure build in ear
* Vertigo 20 minutes to a few hours
* Re-occurring episodes over a 10 year span, ENT
* Treated with medications (SERC, Gravol, limited salt intake,
diuretic), injections or surgery in serious cases.

F. Other potential causes of vertigo :Acoustic neuromas (Schwannoma)
◦ Tumors of the brain
◦ Meningitis
◦ Alcohol
◦ Vitamin B12 deficiency
◦ Vertebral basilar insufficiency
◦ Vestibular Migraines
◦ Strokes
◦ Multiple Sclerosis

If you are experiencing any of the above symptoms you would first go to your doctor and if referred to a physio, Andrea would do a complete Vestibular Physio Evaluation to determine if it is dizziness or vertigo. She then walked us through the steps she uses to determine this and left us with some good news. If it is indeed BPPV vertigo it is the most common type, and the easiest to fix. Andrea now sees 3 or 4 patients a day with this condition. This is the type of vertigo that I suffer from and thankfully Andrea has taught me how to manage it. You see BVVP is a mechanical problem and moving the head in the right sequence can put the ear crystals back into the right place. Once you know in which of the 6 canals the crystals are located, Andrea then has specific maneuvers that will stop the spinning sensation. The bad news is that there is an 80% chance of reoccurrence within the first year. I have had three attacks since my first in the spring of 2019.

Andrea explained that she suffered from an attack of viral vertigo which was far more serious. The spinning took place for 24 hours and she had to be hospitalized. So you need to see the doctor first to get the proper diagnosis. I do not recommend doing any of the maneuvers on your own without seeing a specialist first because you could make your situation worse. However, Andrea gave us detailed descriptions of the Epley and the Semont maneuvers. I am able to remedy my vertigo with the right Semont maneuver.

If you want to discuss your dizziness with Adrea Dewar, she can be found at the Action Sport Physio Clinic in either Vaudreuil or Pointe Claire and she also has an office in her home. I highly recommend booking an appointment today. Don’t suffer needlessly. Get informed and hopefully you will be moving normally once again with no dizzy feelings!

See you soon,

Beth