Vertigo is a disorienting and often debilitating condition that affects balance and spatial awareness. While many people experience vertigo at some point, not all vertigo is the same. There are two primary types: central vertigo and peripheral vertigo. Understanding the difference is crucial for getting the right treatment.
Even more importantly, Upper Cervical Chiropractic Care has shown promise in helping those suffering from vertigo by addressing misalignments in the spine that may contribute to balance issues. Let’s explore what sets central and peripheral vertigo apart and how upper cervical chiropractic care can offer relief.
What Is Vertigo?
Vertigo is a sensation of dizziness or spinning, even when you’re not moving. It often stems from issues in the vestibular system, which controls balance. People experiencing vertigo may feel like the world around them is tilting, swaying, or moving in ways it shouldn’t.
Vertigo is typically categorized into two types:
- Peripheral Vertigo – Originates from problems in the inner ear or vestibular nerve.
- Central Vertigo – Stems from disorders affecting the brainstem or cerebellum.
While both types cause dizziness, their causes, symptoms, and treatments vary significantly.
Causes & Mechanisms of Central vs. Peripheral Vertigo
Peripheral Vertigo: The Most Common Form
Peripheral vertigo is the most frequent type and results from inner ear dysfunction. The vestibular system, located in the inner ear, helps control balance and spatial orientation. When this system is disrupted, dizziness and vertigo occur.
Common causes of peripheral vertigo include:
- Benign Paroxysmal Positional Vertigo (BPPV) – Caused by tiny calcium particles (canaliths) moving into the wrong part of the inner ear.
- Ménière’s Disease – A disorder affecting inner ear fluid balance, leading to vertigo, hearing loss, and tinnitus.
- Vestibular Neuritis or Labyrinthitis – Infections or inflammation affecting the vestibular nerve.
Central Vertigo: A Brain-Based Issue
Central vertigo originates from issues in the brainstem or cerebellum, which coordinate balance and movement. It tends to be more serious and persistent than peripheral vertigo.
Common causes of central vertigo include:
- Strokes or Transient Ischemic Attacks (TIAs) – Reduced blood flow to the brain can cause sudden dizziness.
- Multiple Sclerosis (MS) – Demyelination in the central nervous system can disrupt balance signals.
- Migraines – Vestibular migraines cause vertigo even without a headache.
- Brain Tumors – Though rare, tumors in the cerebellum or brainstem may lead to dizziness.
Symptoms Comparison: Key Differences Between Central and Peripheral Vertigo
While both central and peripheral vertigo cause dizziness and balance disturbances, their symptoms differ in key ways. Peripheral vertigo tends to have a sudden onset and is often more intense but typically short-lived. It is frequently accompanied by nausea, vomiting, hearing loss, or tinnitus, particularly in cases like Ménière’s disease. Eye movement abnormalities, or nystagmus, are usually unidirectional and can be suppressed when the person focuses on a fixed point. Peripheral vertigo is often triggered by head movements or changes in position, such as lying down or turning over in bed.
In contrast, central vertigo is usually less intense but longer-lasting, and its onset may be gradual or sudden, depending on the underlying cause. Unlike peripheral vertigo, it is commonly associated with neurological symptoms, such as double vision, difficulty speaking, limb weakness, or trouble walking. The nystagmus in central vertigo tends to be multi-directional and does not suppress with gaze fixation, making it an important clinical indicator. While central vertigo may occur spontaneously, it is sometimes triggered by neurological events like strokes or migraines rather than by head movements. Due to its potential connection to serious conditions, central vertigo warrants immediate medical evaluation if accompanied by red-flag symptoms.
Diagnosis & Tests: How Doctors Determine the Cause of Vertigo
To diagnose vertigo, healthcare providers conduct clinical tests and imaging if necessary:
- Dix-Hallpike Maneuver – A test to confirm BPPV, where a patient’s head is moved in specific directions to trigger vertigo.
- Head Impulse Test – Evaluates vestibular function to distinguish between peripheral and central causes.
- MRI or CT Scan – Used to rule out strokes, tumors, or other neurological conditions.
- Audiometry – Checks for hearing loss, which may be present in peripheral vertigo conditions like Ménière’s disease.
Treatment & Management: Different Approaches for Central and Peripheral Vertigo
Peripheral Vertigo Treatments
- Epley Maneuver – A repositioning technique for BPPV that moves canaliths out of the semicircular canals.
- Vestibular Rehabilitation Therapy (VRT) – Exercises that retrain the brain to compensate for balance issues.
- Medications – Such as antihistamines, diuretics for Ménière’s disease, or anti-nausea drugs.
Central Vertigo Treatments
- Addressing the Underlying Condition – Treating strokes, migraines, or multiple sclerosis is key.
- Vestibular Therapy – Helps improve balance and coordination.
- Medications – For migraine management or neurological symptoms.
How Upper Cervical Chiropractic Care Helps with Vertigo
Many vertigo sufferers, especially those with peripheral or functional central vertigo, have found relief through Upper Cervical Chiropractic Care.
Spinal Misalignments and Nervous System Function
The upper cervical spine (C1 and C2 vertebrae) plays a crucial role in balance and coordination. Misalignments in this region can affect the nervous system’s ability to process signals from the vestibular system, leading to dizziness.
Effects on Blood Flow & Brainstem Communication
Upper cervical misalignments can impact blood flow to the brainstem, affecting the areas responsible for balance and equilibrium. Chiropractic adjustments may improve circulation and restore proper nerve function.
Peripheral Vertigo Benefits
Upper cervical chiropractic care has been particularly beneficial for:
- BPPV – Adjustments can help restore normal inner ear function.
- Ménière’s Disease – Some studies suggest that upper cervical care may improve symptoms like vertigo, tinnitus, and hearing fluctuations.
- Vestibular Neuritis – Realigning the spine may reduce inflammation and enhance healing.
Potential Support for Central Vertigo
While upper cervical chiropractic care is not a primary treatment for conditions like strokes or MS, it may help optimize nervous system function and alleviate secondary symptoms like dizziness and balance issues.
Conclusion: A Natural Approach to Vertigo Relief
Understanding the difference between central and peripheral vertigo is essential for choosing the right treatment. While some cases require medical intervention, many vertigo sufferers—especially those with peripheral vertigo—may find upper cervical chiropractic care to be a valuable, non-invasive option for relief.
If you or someone you know struggles with vertigo, consulting with an Upper Cervical Chiropractor at NeckWise may be a step toward restoring balance and improving quality of life.
