How to treat long Covid dizziness in 4 steps

How to treat long Covid dizziness in 4 steps

Research on COVID 19 has shown a variety of symptoms, with one study showing 19% of people report dizziness or vertigo as a symptom. This blog post discusses long covid dizziness and 4 steps to get your dizziness addressed. (1) Learn the latest research on long covid dizziness and steps to take to address covid related dizziness including common providers and treatments.

Research last updated August 2023 for this article. Ongoing research is occurring in this area so information discussed may be out of date depending on the time you read this article.

What is considered long Covid

The acute phase of covid is when symptoms first appear, and testing shows a positive result until your body has cleared the active virus. The acute phase by the CDC has recommendations ranging 5-10 days during this acute phase based on different scenarios you can find here.

Long covid is defined as  symptoms that are present 4 weeks after the acute phase is over (2). About 10% of people with covid get long covid. There appears to be a link with increasing likelihood of long covid with each reinfection.

Dizziness and Covid

During infeciton, our body releases cytokines as part of the normal immune response. A cytokine storm is when the body release too many cytokines into the blood too quickly. This can be a result of infection, autoimmune condition or other disease. This can occur during covid 19 infection and is believed to be a contributor to long covid symptoms.

Meniere’s disease, vascular vertigo and BPPV have also been linked to elevated cytokines.

Covid related dizziness can appear in a variety of ways. Typical testing used by audiology for assessing for vestibular disorders shows abnormal findings in those with dizziness after covid (3). A variety of findings came from this study on testing, talking to your doctor about comprehensive testing with audiology or ENT could be a helpful step in determining best course of action.

How Covid or long Covid dizziness occurs

During infection, there are a few ways that the body can be involved that result in dizziness. Some are:

1. It can trigger VM
2. It can cut off blood flow to inner ear, presenting like a vestibular neuritis
3. Trigger BPPV
4. Disrupt neural pathways involved in balance
5. Attack Schwann cells on vestibular nerve
6. Attack hair cells in vestibular system

Long Covid dizziness and migraine

Other considerations with covid related dizziness is how this impacts others based on a variety of factors. For example, those with a prior history of migraine report intensified symptoms of their migraine attacks. If no previous history of migraine, the onset of headache or migraine disorder may become known. This is thought of a genetic link to a person with a higher susceptibility to migraine or dormant and infection activated the headache or migraine disorder.

Treatment: Treat like a migraine disorder. Get a headache specialist and/or neurologist involved. Work on breaking the cycle of migraine attacks and then focus on prevention and management.

Long Covid dizziness: Hypofunction

If your presentation after covid is like a neuritis or hypofunction, the same treatment principles apply. It appears that compensation for this can take longer than a traditional hypofunction/neuritis. Keep this in mind as you’re working on VRT, exercise, mindset etc. Progress can be made and good recovery, but it may take longer and that’s normal.

Treatment: Vestibular Rehab Therapy. ENT or PT are common providers to identify and manage this condition

Long COVID dizziness and POTs

POTs stands for Postural Orthostatic Tachycardia Syndrome.  POTS symptoms can vary widely with more information from Cleveland clinic here.

79% of those with long covid meet criteria for Treatment regime generally consists of:  graded exercise (recumbent/supine) , fluids and electrolytes, compression garments, smalls meals throughout the day, certain medications. Cardiology is an important provider role to have on your team for identifying and managing POTS.

Other treatment considerations for long Covid dizziness

1. Determine what covid caused for you. (hypofunction, migraine, PPPD, BPPV etc.)
2. Treat condition if there is one
3. Manage the dizziness (Remember Vestibular Group Fit principles here: Movement, Mindset, Education, Medical support)
4. Get moving! Not sure where to start? Consider being a vestibular group fit member for guidance, support and access for scaling movement content.

This is treatable and manageable. Getting the right providers to help manage and monitor your care with you is important!

Common medical providers for dizziness

Typical providers that are involved in this type of care are:

• post covid care centers
• internal medicine physician
• neurology
• ENT
• Cardiology (POTS)

Disclaimer

Want to learn more about long covid dizziness and other vestibular tools from the experts and be a part of a supportive community to get back to your daily life?  Find out more at this link: https://tvd.flywheelstaging.com/about-group/

Disclaimer:

Remember: this post is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here.

Sources

1. 1. Caronna E, Ballve A, Llaurado, et al. Headache: A striking prodromal and persistent symptoms, predictive of COVID 19 clinical evolution. Cephalalgia. 2020; 40(13):1410-1421. doi: 10.1177/0333102410965157
2.  Tana, C, Bentivegna, E., Cho, SJ. et al. Long COVID headache. J Headache Pain 23, 93 (2022). https://doi.org/10.1186/s10196-022-01450-8
3. Pazdro-Zastaweny K, Dorobisz K, Misiak P, Kruk-Krzemien A, Zatonski T. Vestibular disorders in patients after COVID 19 infection. Front Neurol. 2022 Sep 20;13:956515. doi:10.3389/fneur.2022.956515. PMID: 36203969; PMCID: PMC9531925