Acupuncture and Oriental Medcine for Dizziness and Vertigo
by Jacob Godwin, EAMP
There are some very serious causes of vertigo. If your symptoms are sudden and severe, especially if accompanied by loss of control or function in any part of your body, call 911 and get emergency care.
The first step in understanding your condition is to know what is causing your symptoms. For vertigo, you made need a visit to your primary care physician to rule out serious problems. We will start by clearly understanding what you are experiencing. Different diseases can cause slightly different sensations. You can feel dizzy, light headed, faint, like the room is spinning, like you are spinning, etc. Most of the most common diseases that cause vertigo are not serious and respond very well to acupuncture and Oriental medicine treatments.
How We Treat Dizziness and Vertigo
After a thorough diagnostic interview and exam, I will begin your acupuncture treatment. Your diagnostic exam will focus on the specifics of your dizziness or vertigo, what makes it better, what aggravates it, when it began, determining triggers and associated symptoms. I will also take your pulse and look at your tongue to determine the internal disorders causing your problem. Dizziness and vertigo don't just appear out of nowhere. OM has many differential diagnoses for these symptoms. Identifying the correct pattern causing them is key, as always, to their successful treatment. AOM can be used to treat most of the causes of dizziness and vertigo, but not all. We will be able to determine whether or not you are a good candidate for AOM treatments at your initial visit.
I practice a very traditional 'style' of acupuncture. In the treatment of dizziness and vertigo, I will select nodes (acupoints) on your head mostly near the ear and back of your head. Distal nodes on your upper and lower extremeties will also be selected for treatment. The nodes on your head affect the nerves and blood vessels involved in the dizziness or vertigo - directly effecting your inner ear and brain - while the distal points are used to address system problems contributing to the headaches.
Herbal medicine is required in the treatment of most causes of vertigo and dizziness. Most of the causes of vertigo, after benign paroxysmal positional vertigo and other causes are ruled out, are types of inflammation in the inner ear. Acupuncture is used to address the neurological aspects of the disease while herbal prescriptions directly treat the inflammation. Oriental medicine diagnoses several causes of inner ear inflammation - all of them require herbal medicine. Many of these natural medicines have proven anti-inflammatory and antibiotic properties to reduce the inflammation in your ear.
I use auricular acupuncture in dizziness and vertigo cases. Auricular (on your ear) acupuncture points can be used in lieu of or in support of standard acupuncture treatments. For auricular acupuncture, I use special ear needles that are on adhesive tabs. These needles stay in your ear for up to a week. You will be instructed to reach up and squeeze them in order to stimulate them 10-12 times a day. Acupuncture is a stimulation therapy. It works by stimulating your central nervous system in particular ways. The idea is that certain signals get weak over time causing the brain to lose track of the problem - acupuncture boosts these signals, allowing the CNS to engage your body's inherent healing abilities. Auricular acupuncture has a distinct clinical advantage in cases of dizziness and vertigo in that the same cranial nerve innervates the outer ear and the inner ear, so the signal is even more effective. Another advantage of auricular acupuncture is that the needles stay in for a matter of days rather than minutes. This boosts the CNS signals for a longer period - usually with great effect.
ACUPUNCTURE TREATMENT SCHEDULE
The treatment schedule depends on the severity of the dizziness in dizziness cases. Also whether the symptoms are caused by what we call an empty condition or a full one. Dizziness responds very well and very quickly to AOM treatment when compared to vertigo. Vertigo is much more severe and has more complex causes. Vertigo cases require treatment 2 times per week for 6-8 weeks. If your vertigo is Benign Positional Vertigo, the Eply or Semont maneuver is indicated - acupuncture may not be used in cases of BPV other than to reduce the symptoms as much as possible to facilitate your doing the liberatory maneuvers.
HERBAL MEDICINE PRESCRIPTION
Prescribed herbal medicine is absolutely indespensable to the treatment of dizziness and vertigo caused by inflammation. You will likely take herbal medicine for several months, even after your acupuncture treatments are over. Herbal medicines make lasting changes to your physiology. They are not as fast-acting as pharmaceuticals, nor are they as dangerous. Natural medicine takes time, but its effects last. Again, in the case of BPV, you will need the liberatory maneuvers.
BPV has a very good prognosis when liberatory maneuvers are used. Dizziness responds very well and very quickly to both acupuncture and Oriental medicine treatments. In these cases, relief can be immediate with lasting effects seen in a matter of 2-4 weeks. In the case of vertigo not caused by BPV, serious causes need to be ruled out by your primary care physician. Having ruled these out, you are likely left with some form of inflammatory pathology in your inner ear. This can be Meniere's disease, vestibular neuritis, labrynthitis, etc. These causes of vertigo respond well to treatment, but usually take more time than cases of dizziness to see significant and lasting results - 6-8 weeks.
Understanding Dizziness and Vertigo
AOM has a very long history of diagnosing and treating dizziness and vertigo. There are several differential diagnoses that can explain your symptoms. Dizziness and vertigo are also fairly well-understood from a modern medical standpoint. Here are the main causes of dizziness and vertigo:
Vertigo usually results from a problem with the nerves and the structures of the balance mechanism in your inner ear (vestibular system), which sense movement and changes in your head position. Sitting up or moving around may make it worse. Sometimes vertigo is severe enough to cause nausea, vomiting and imbalance.
Causes of vertigo:
- Benign paroxysmal positional vertigo (BPPV). BPPV causes intense, brief episodes of vertigo immediately following a change in the position of your head, often when you turn over in bed or sit up in the morning. BPPV is the most common cause of vertigo.
- Inflammation in the inner ear. Signs and symptoms of inflammation of your inner ear (acute vestibular neuritis) include the spontaneous onset of intense, constant vertigo that may persist for several days, along with nausea, vomiting and imbalance. It can be incapacitating, requiring bed rest. When associated with sudden hearing loss, this condition is referred to as labyrinthitis. Fortunately, vestibular neuritis generally subsides and clears up on its own.
- Meniere's disease. This disease involves the excessive buildup of fluid in your inner ear. It is an uncommon condition that may affect adults at any age and is characterized by sudden episodes of vertigo lasting 30 minutes to several hours.
- Migrainous vertigo. Migraine is more than a headache disorder. Just as some people experience a visual "aura" with their migraines, others can get vertigo episodes and have other types of dizziness between migraines.
- Acoustic neuroma. An acoustic neuroma (vestibular schwannoma) is a noncancerous (benign) growth on the vestibular nerve, which connects the inner ear to your brain. Symptoms of an acoustic neuroma generally include progressive hearing loss and tinnitus on one side accompanied by dizziness or imbalance.
- Other causes. Rarely, vertigo can be a symptom of a more serious neurological problem such as a stroke, brain hemorrhage or multiple sclerosis. In such cases, other neurological symptoms are usually present, such as double vision, slurred speech, facial weakness or numbness, limb coordination, or severe balance problems.
Feeling of faintness (presyncope)
Presyncope is the medical term for feeling faint and lightheaded without losing consciousness. Sometimes nausea, pale skin and clamminess accompany a feeling of faintness. Causes of presyncope include:
- Drop in blood pressure (orthostatic hypotension). A dramatic drop in your systolic blood pressure — the higher number in your blood pressure reading — may result in lightheadedness or a feeling of faintness. It can occur after sitting up or standing too quickly.
- Inadequate output of blood from the heart. Conditions such as any of the various diseases of the heart muscle (cardiomyopathy), an abnormal heart rhythm (arrhythmia) or a decrease in blood volume may cause inadequate blood flow from your heart.
Loss of balance (disequilibrium)
Disequilibrium is the loss of balance or the feeling of unsteadiness when you walk. Causes may include:
- Inner ear (vestibular) problems. Abnormalities with your inner ear can cause you to feel like you are unsteady while walking, especially in the dark.
- Sensory disorders. Failing vision and nerve damage in your legs (peripheral neuropathy) are common in older adults and may result in difficulty maintaining your balance.
- Joint and muscle problems. Muscle weakness and osteoarthritis — the type of arthritis that involves wear and tear of your joints — can contribute to loss of balance when it involves your weight-bearing joints.
- Neurological conditions. Various neurological disorders can lead to progressive loss of balance, including Parkinson's disease, cerebellar ataxia, normal pressure hydrocephalus and spinal cord disorders.
- Medications. Loss of balance can be a side effect of certain medications, such as anti-seizure drugs, sedatives and tranquilizers.
Other dizzy sensations such as floating, swimming or heavy-headedness
Other "dizzy" sensations that are more difficult to describe may include feeling "spaced out" or having the sensation of spinning inside your head. Some causes include:
- Medications. Blood pressure lowering medications may cause faintness if they lower your blood pressure too much. Many other medications can cause nonspecific feelings of dizziness that resolve when you stop the medication.
- Inner ear disorders. Some inner ear abnormalities can cause persistent, non-vertigo-type dizziness.
- Anxiety disorders. Certain anxiety disorders, such as panic attacks and a fear of leaving home or being in large, open spaces (agoraphobia), may cause dizziness. Sometimes one cause — such as a vestibular disorder — may produce symptoms, but then anxiety causes your dizziness to persist even after your inner ear problem has resolved.