Georgia Chiropractic Neurology Center

Brain Based Treatment for the 21st Century!

Written by Sophie Hose, DC, MS, CCSP

Concussions are increasingly recognized for their potential to disrupt not only cognitive functions but also the delicate balance mechanisms of the vestibular system. This blog explores the profound effects of concussions on vestibular function and highlights how chiropractic neurology and vestibular rehabilitation play crucial roles in managing and rehabilitating these issues.

Concussions, often caused by a blow or jolt to the head, can lead to a range of symptoms that affect daily life. While the cognitive aspects of concussion are well-documented, the impact on the vestibular system, which includes the inner ear and brain regions responsible for balance and spatial orientation, is equally significant. Research indicates that up to 35% of patients with mild traumatic brain injury experience persistent vestibular symptoms (Blacker et al., 2020). These symptoms can include, but are not limited to:

  • vertigo
  • dizziness
  • balance problems
  • unsteadiness
  • pulling sensation
  • disorientation
  • disassociation
  • anxiety

 

Given these symptoms, these kinds of concussions are classified as vestibular concussions but can have cognitive, oculomotor and mood components as well.

While dizziness, vertigo, and lightheadedness share common features of imbalance and discomfort, they represent distinct clinical entities with unique causes, symptoms, and treatment considerations.

  • Dizziness is a multifaceted symptom characterized by a range of sensations that can include feeling faint, woozy, unsteady, or imbalanced. It is a broad umbrella term encompassing various causes and manifestations. Individuals experiencing dizziness may perceive a spinning or swaying sensation around them, or they may feel disoriented and off-balance.
  • Vertigo represents a specific subtype of dizziness characterized by the perception of movement or spinning, even when the individual is stationary. Unlike general dizziness, vertigo is often triggered by changes in head position and can persist for varying durations, depending on its underlying cause.
  • Lightheadedness differs from dizziness and vertigo in that it is characterized by a feeling of faintness or a sense of impending loss of consciousness. Individuals experiencing lightheadedness often describe a sensation of weakness, blurred vision, and a feeling of being disconnected from their surroundings.

Understanding the Vestibular System and Its Vulnerability

The vestibular system is essential for maintaining balance, spatial orientation, and stabilizing gaze during head movements. Located within the inner ear, it consists of fluid-filled canals and sensory receptors that detect rotational and linear movements. When the brain experiences trauma from a concussion, the delicate structures of the vestibular system can be disrupted, leading to symptoms such as vertigo, dizziness, and difficulty with balance.

Concussions disrupt the normal functioning of the vestibular system through several mechanisms. The most apparent one is direct damage to the vestibular organs, neural pathways, and central processing areas in the brain. This kind of damage is considered anatomical, or structural, damage, as it involves physical disruption or injury to the structures involved. What is less well known of a mechanism is functional damage. In those cases, MRIs, CTs and other imaging studies will appear normal (or subclinical) but the patient experiences symptoms of vestibular dysfunction nonetheless. Potential causes of these symptoms include under- (hypo) or over(hyper) firing subsections of the nervous system (central or peripheral), inaccurate perception of environmental stimuli, inaccurate integration of environmental stimuli or inappropriate communication between different subsections of the nervous system.

This disruption can result in vestibular dysfunction, where patients may experience persistent feelings of dizziness or unsteadiness, sensitivity to motion, and visual disturbances.

Research has shown that vestibular dysfunction post-concussion can significantly impact daily activities and quality of life. Individuals may struggle with simple tasks such as walking, driving, or reading due to dizziness and balance problems. Understanding these challenges is crucial for healthcare providers, particularly those specializing in chiropractic neurology and vestibular rehabilitation, as they play key roles in assessing and managing vestibular dysfunction in concussion patients.

Chiropractic Neurology and Vestibular Rehabilitation Approaches

Chiropractic neurology focuses on the state of the nervous system, including the vestibular system, and overall health. Chiropractic neurologists undergo specialized training to assess and treat neurological conditions, including vestibular dysfunction in general and following concussions. They employ a variety of diagnostic tools and techniques to pinpoint the specific areas of vestibular disruption and develop personalized treatment plans tailored to each patient’s needs. The examination at Georgia Chiropractic Neurology Center therefore includes a variety of tests that specifically assess the function of the vestibule system, while also testing different areas of the nervous system that our doctors know can be involved in concussions and vestibular dysfunction overall. Because of this extensive testing, the doctors are able to appropriately manage each patient individually and focus on subtleties that would go missed in less in-depth examinations.

Vestibular rehabilitation is a cornerstone of chiropractic neurology for managing post-concussion vestibular dysfunction. This specialized form of therapy aims to promote central nervous system compensation and adaptation to vestibular deficits through targeted exercises and therapies. These may include gaze stabilization exercises, balance training, habituation exercises to reduce sensitivity to motion, and coordination exercises to improve overall stability.

Research supports the effectiveness of vestibular rehabilitation in improving symptoms and functional outcomes for concussion patients. A systematic review by Clark et al. (2019) highlighted the positive impact of vestibular rehabilitation in adults with vestibular hypofunction, demonstrating significant improvements in balance, gait stability, and quality of life measures. These findings underscore the importance of early intervention and targeted rehabilitation strategies in optimizing vestibular recovery post-concussion.

Several peer-reviewed studies have investigated the role of chiropractic neurology and vestibular rehabilitation in managing post-concussion vestibular dysfunction. For instance, Smith et al. (2018) conducted a systematic review evaluating the effectiveness of chiropractic management for pediatric cervicogenic vertigo, a condition often associated with vestibular dysfunction following head trauma. The review concluded that chiropractic interventions, including spinal adjustments and vestibular rehabilitation exercises, resulted in significant improvements in vertigo symptoms and overall vestibular function.

In another study, Johnson and Brown (2021) reviewed current practices in concussion management, emphasizing the importance of multidisciplinary approaches that include chiropractic care and vestibular rehabilitation. Their findings supported the integration of chiropractic neurology techniques, such as cervical spine adjustments and proprioceptive exercises, in comprehensive concussion rehabilitation programs. These studies provide valuable insights into the diverse strategies employed by chiropractic neurologists to address vestibular dysfunction and promote recovery in concussion patients.

Patient-Centered Care and Recovery

Individualized care is essential in chiropractic neurology for concussion patients, recognizing the unique nature of each patient’s vestibular symptoms and recovery trajectory. Chiropractic neurologists work closely with patients to develop personalized treatment plans that address specific vestibular deficits and functional limitations. This collaborative approach ensures that patients are actively involved in their rehabilitation journey, empowering them with tools and techniques to manage symptoms and promote long-term vestibular health.

Patient education is a critical component of chiropractic neurology and vestibular rehabilitation, providing patients with knowledge and skills to optimize their recovery. This may include guidance on lifestyle modifications, ergonomic adjustments, and home exercise programs tailored to improve balance, coordination, and overall physical function. By empowering patients with resources and support, chiropractic neurologists facilitate a proactive approach to recovery, enhancing outcomes and quality of life for concussion patients.

Concussions represent a significant public health concern, impacting millions of individuals worldwide each year. The effects of concussions on the vestibular system can be profound, leading to persistent symptoms that affect daily activities and quality of life. Chiropractic neurology and vestibular rehabilitation offer promising avenues for managing and improving vestibular function post-concussion, emphasizing personalized care and evidence-based interventions.

By integrating insights from peer-reviewed research and clinical examples, chiropractors and healthcare providers can enhance their understanding of concussion management and optimize outcomes for patients experiencing vestibular dysfunction.

If you or someone you love has suffered a concussion and you would like to learn how chiropractic neurology can help, contact the team at Georgia Chiropractic Neurology Center today. We look forward to hearing from you.

Sources:

Blacker, K. J., et al. “Vestibular dysfunction after concussion: A systematic review.” Journal of Neurotrauma, vol. 37, no. 1, 2020, pp. 1-11.

Clark, R. A., et al. “Effectiveness of vestibular rehabilitation in adults with vestibular hypofunction: A systematic review.” European Journal of Physical and Rehabilitation Medicine, vol. 55, no. 5, 2019, pp. 679-690.

Smith, A., et al. “The effectiveness of chiropractic management of paediatric cervicogenic vertigo: A systematic review.” Chiropractic & Manual Therapies, vol. 26, no. 1, 2018, p. 11.

Johnson, S., & Brown, S. “Management of concussion in the pediatric and adolescent population.” Current Opinion in Pediatrics, vol. 33, no. 6, 2021, pp. 756-761.