Ask The Doctor: Positional Ve... Health Article
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David Vernick, M.D. is assistant clinical professor of otology and laryngology at Harvard Medical School and interim chief of the Division of Otology and Laryngology at Beth Israel Deaconess Medical Center.
Question:
Can arthritis in neck and shoulders be the cause of "positional vertigo?" In the past, when I've experienced vertigo symptoms, I've visited my chiropractor for an adjustment that would successfully relieve my misalignment, which was pinching a nerve in my neck and causing the dizziness. My last episode was not as successful, though.
Answer:
Positional vertigo is typically a shortened name for "benign postural positional vertigo," or BPPV. This condition is caused by the migration of balance crystals in the inner ear (otoconia), which move from their usual position into one of the semicircular canals — usually the posterior canal.
This results in dizziness when you roll over in bed, bend over, look up or turn your head quickly. The dizziness usually lasts less than a minute. If the motion is repeated the dizziness is not as severe. If there is no motion, there is no dizziness. The dizziness usually resolves over weeks to months.
There are several other causes for dizziness that have a positional component. Postural vertigo occurs when you get up too quickly. This is from a relative lack of circulation to the head. Anyone can experience this, but it is more often seen in those that are elderly or on blood pressure medication. Getting up slowly usually avoids the problem.
Cervical vertigo can occur with problems in the neck. Symptoms are usually worse when the neck is bad and get better when the neck problem improves. Symptoms are related to motion of the neck and head. The feelings can be that of true spinning vertigo or imbalance. Treatment for the neck problems usually is the best option for treatment of this form of dizziness.
Many times it is not clear what the cause of the dizziness is without a thorough medical evaluation. If treatment is not successful, it is possible that there is an alternative or additional cause that has not yet been diagnosed.