A Guide on How to Treat Vertigo After a Head Injury
Living with vertigo after a head injury can feel like navigating through a maze blindfolded. When it hits, it hits hard, and you often fear when the next episode will strike. At the same time, it can feel like a debilitating roller coaster ride (which, from experience, it 100% does); diagnosis and treatment of where the vertigo is coming from have come a long way.
If you’re reading this and you’re getting vertigo after a head injury, the challenge is going to be figuring out what combination of things is contributing to your vertigo.
Vertigo is very commonly a simple condition known as BPPV. When crystals get kicked loose, they fall into the inner ear cavity and make you dizzy. Fixing it is as simple as an Epley maneuver and some basic exercises.
Vertigo after a head/brain injury can often involve vertigo stemming from areas other than the inner ear. Things like moving your head wrong or walking through the grocery store can trigger vertigo attacks in ways BPPV doesn’t.
This article aims to help you distinguish where your vertigo is coming from and what to do about it. I hope it helps you find the right care as soon as possible. Let’s dive in.
Types of Post-Concussion Vertigo
Dizziness after hitting your head can manifest in various ways and timelines. Sometimes, it’s immediate and aggressive, and other times, it’s gradual. The nature of the symptom onset is a huge clue that gives providers like me great information as to what’s causing it.
Peripheral Vertigo
If you hit your head and suddenly get raging dizziness whenever you put your head a certain way, it’s probably something called BPPV. This is the most common form of post-traumatic dizziness and happens when crystals called otoconia get kicked into the vestibular organ and create a false sense of movement.
BPPV is a double-edged sword, meaning the treatment is pretty straightforward and effective, but treating it is extremely uncomfortable. You’ll likely perform an “epley maneuver” designed to put the crystals back into their proper place.
During the maneuver, you’ll likely feel terrible, the most dizzy you’ve ever been, and might throw up if it’s bad enough (I’ve thrown up several times). The good news is you’ll feel mostly better after this is done.
When this happens, you’ll usually get sent to a vestibular physical therapist qualified to treat peripheral vestibular disorders. They’ll give you some exercises to speed up recovery, and you’ll be able to go.
Central Vertigo
This type of vertigo is very different from peripheral vertigo. Central vertigo is either damage to an area called the cerebellum or a miscommunication between different sensory inputs.
You’ve likely experienced central vertigo at some point in your life. A relatable example is when you’re parked at a stop light, and another car or bus pulls up next to you. Sometimes, they start to move, and if you’re looking over, you may not know if it’s your car moving or theirs. This triggers a sense of disorientation and an immediate check-in to see whether or not you’re moving them.
This moment of disorientation is central vertigo. Following a head injury, multiple systems can sustain damage, which leads to an ongoing feeling similar to seeing the car move.
The challenge with concussion rehab is that there are different specialists for different sensory systems. For example, eye doctors treat eye conditions, vestibular PT typically treats dizziness, chiropractors and massage therapists treat a lot of neck pain, and so on. This leads to having multiple doctors and even more opinions about what’s right.
The easy way around this is to see a good functional neurologist. They are trained to assess a little bit of everything so you can know where to start. They won’t always be able to fix everything, but they can help you identify all the variables in your central vertigo, which will help you find effective care faster.
Tips to manage vertigo after a head injury
1: Seek a Compassionate Evaluation
First, it’s essential to consult a healthcare professional who can guide you with understanding and care. They can pinpoint the exact cause of your vertigo through various assessments.
If the first appointment doesn’t give you any useful info, look into someone to evaluate your neck and eyes. Cervicogenic vertigo and visually induced vertigo are common causes of dizziness, especially after hitting your head.
2: Pick the Right Therapy
If your dizziness happens when you move your head a certain way, see a vestibular PT. Examples are looking up or turning over in bed.
If you get terribly dizzy and overwhelmed in busy visual environments, go see an ophthalmologist or optometrist. They can examine your eyes and see what’s not working. Treatment involves prism lenses that act as a crutch and vision therapy to retrain the eyes.
If you wake up dizzy, have a lot of neck pain when you’re dizzy, or can push on a specific place on the neck that produces dizziness, see a chiropractor, massage therapist, or acupuncture.
If you have more than 1 of these happening, consult with a functional neurologist. Click here to speak with one.
3: Use your feet
A quick tip for relief is to vibrate the bottoms of your feet when you’re dizzy. Your vestibular system is responsible for your balance, and it makes sense that your balance centers communicate with your feet to stay upright. Feeding input through your feet is a great way to stabilize the balance system if it’s on the fritz.
Exercising them can also be beneficial as a more long-term relief strategy. Working on intrinsic muscle strength and calf strength is a good way to improve feedback into the vestibular system.
4: Nourish Yourself with Lifestyle Changes
Never underestimate the power of good nutrition and hydration. These simple yet vital elements support your recovery. Keep a diary of what triggers your symptoms—it’s a fantastic tool for avoiding flare-ups. Avoid alcohol, caffeine, MSG, and foods high in sodium. Alcohol and caffeine dehydrate you, and MSG/sodium changes how nerves communicate, especially in the inner ear.
5: Support Your Vagal System
Dealing with vertigo can strain your well-being. Relaxation techniques such as deep breathing, meditation, and vagal nerve stimulation can activate the body’s recovery response. Over the years, many have shared that these practices help ease the condition and offer a sense of calm amidst the chaos.
6: Love Your Neck
Head injuries often disrupt the neck tissues. These sensitive areas can be tricky to rehab correctly, especially at home. The clock drill is one easy way to identify weakness and strengthen muscles.
Think of your head as a clock, with noon between your eyebrows and six on the back. Press for 3-5 seconds on every number, and don’t let your head move. You’ll likely notice a few spots where your head shakes, you feel dizzy, or there is pain. Spend some extra time lightly pressing into those to begin the stretching process.
Conclusion
Vertigo after a head injury can be a daunting journey through terrible days that seem like they won’t get better. I promise they can. All you need is a dedicated provider that will walk you through the ups and downs of care.
Do your homework and identify if your vertigo is peripheral or central. Take your time and allow yourself to have bad days. They don’t mean you’re moving backward and are a necessary part of integrating the exercises into real life.
Lastly, know you are not alone if you’re reading this and experiencing vertigo. Embrace the journey, and may you find steadiness and peace along the way.
If you have questions about whiplash recovery, click here to schedule a complimentary consultation with one of our doctors. We’ve treated hundreds of complex neurologic cases and can help piece together the missing pieces in your recovery.
*Note: The information provided in this article is for educational purposes only and does not constitute a doctor-patient relationship. Patients should consult their medical provider or primary care physician before trying any remedies or therapies at home.
