Vertigo

What Is Vertigo?

Imagine stepping off a spinning ride at an amusement park—that dizzy, spinning sensation is vertigo. The key difference is that vertigo is that spinning feeling even when you’re standing still. It’s not just dizziness. It’s the sensation that you or the world around you is moving when it’s not.

The good news? Vertigo is highly treatable. Most people with vertigo recover completely with proper diagnosis and care. Understanding what’s causing your vertigo is the first step toward getting relief.

Vertigo vs. Dizziness: Know the Difference

These terms get mixed up, but they’re not the same thing. Knowing the difference helps your doctor diagnose you better.

All vertigo is dizziness, but not all dizziness is vertigo. Understanding which you have helps treatment.

Types of Vertigo

Peripheral Vertigo (Most Common)

What it is: Problem in your inner ear affecting your balance system

Most common cause:
→ BPPV (Benign Paroxysmal Positional Vertigo)

Other inner ear causes of vertigo:

• Vestibular Neuronitis – Sudden severe vertigo lasting days to weeks; often after a viral infection; causes dizziness but usually not hearing loss

• Meniere’s Disease – Spinning episodes (20+ minutes), hearing loss, ear fullness, ringing in ears; exact cause unknown

• Labyrinthitis – Inflammation of inner ear from viral or bacterial infection; causes vertigo and hearing loss

Central Vertigo (Less Common)

What it is: Problem in your brain or nervous system

Causes:

• Stroke or TIA (mini-stroke)

• Brain tumor or lesion

• Vestibular migraine (migraine causing dizziness)

• Multiple sclerosis

• Brain inflammation

Why it matters: Central vertigo needs more urgent evaluation than peripheral vertigo

When Do You Actually Have Vertigo?

What You’ll Experience

During a Vertigo Attack:

• ✓ Strong sensation of spinning or tilting

• ✓ Nausea or vomiting

• ✓ Difficulty with balance and walking

• ✓ Sensitivity to head movement

• ✓ Sweating or feeling unwell

What You Won’t Experience:

• ✗ Loss of consciousness

• ✗ Numbness or tingling in arms/legs

• ✗ Slurred speech (unless BPPV is very severe)

• ✗ Severe headache (unless it’s vestibular migraine)

Red Flags – See a Doctor Now

Call your doctor immediately if you have vertigo WITH any of these:

🚨 Seek Emergency Care if:

• Sudden severe vertigo with weakness or numbness

• Trouble speaking or vision changes

• Sudden severe headache

• Difficulty breathing or chest pain

• Loss of consciousness

⚠️ See Your Doctor Soon (not emergency) if:

• First time experiencing vertigo

• Vertigo lasting more than a few days

• Multiple spinning episodes

• Vertigo affecting your daily life

What Causes Vertigo?

Inner Ear Problem (Most Common — 80% of Cases)

Your inner ear contains: Tiny fluid-filled canals that tell your brain which way is up

When something goes wrong: Your brain gets confused signals about movement and position

Brain Problem (Less Common — 20% of Cases)

Your brain controls balance through multiple systems. When one goes wrong, vertigo happens.

Brain-related causes:

• Stroke or mini-stroke

• Vestibular migraine

• Brain tumor (rare)

• Multiple sclerosis

• Head injury

Getting Diagnosed

Good news: Most vertigo diagnoses are simple and don’t require many tests.

Your Doctor Will Ask:

✓ When did it start?
✓ What does the spinning feel like?
✓ What triggers it? (head movement, specific position, certain activities)
✓ How long do episodes last?
✓ Do you have hearing loss or ringing in ears?
✓ Any nausea or balance problems?

Tests Your Doctor Might Do:

Most people don’t need brain scans. Your doctor decides based on your symptoms.

Getting Relief

Quick Relief During an Attack

Stop what you’re doing:

• Sit or lie down immediately

• Don’t try to “push through” it

• Stay still until the spinning stops

Create a safe environment:

• Keep lights dim

• Avoid bright screens

• Close your eyes if it helps

• Lie flat with head elevated on 2-3 pillows

Avoid triggers:

• No sudden head movements

• Don’t change positions quickly

• Avoid looking side-to-side rapidly

• Don’t focus on moving objects

Give it time:

• Most BPPV attacks last less than 1 minute

• Vestibular neuronitis takes days to weeks

• Your brain adapts and symptoms improve

Home Treatments That Work

The Epley Maneuver (For BPPV)

This simple repositioning technique works for most BPPV cases:

1. Start: Sit on edge of bed, turn head 45° to left

2. Lie back: Quickly lie down with head hanging off bed (maintain 45° angle)

3. Hold: Keep position for 30 seconds

4. Turn head: Rotate head 90° to right (without raising it)

5. Hold: 30 seconds

6. Roll your body: Roll entire body to right side, facing down

7. Hold: 30 seconds

8. Sit up: Slowly sit up, stay sitting for a few minutes

Repeat: This maneuver should be done 1-3 times daily until symptoms resolve (usually 1-3 days)

Important: Do this carefully. If you feel worse, stop and consult your doctor.

Vestibular Exercises (Retraining Your Brain)

These help your brain adapt to dizziness and improve balance:

How they work: Your brain learns to ignore confusing balance signals and rely on other cues

Natural Remedies

Medical Treatments

Medications:

• Anti-nausea medicines (help with queasiness)

• Vestibular suppressants (reduce spinning sensation)

• Taken short-term (a few days) while your brain adjusts

Physical Therapy:

• Vestibular rehabilitation (exercises to retrain balance)

• 4-6 weeks of regular sessions

• Success rate: 80-90% for BPPV

• Improves balance and reduces vertigo frequency

When Surgery Is Needed (Rare):

• Only for specific severe cases

• Meniere’s disease that doesn’t respond to other treatments

• Usually very effective when indicated

Life With Vertigo: What You Need to Know

Safety Precautions

Around the House:

• Remove tripping hazards

• Use handrails on stairs

• Wear non-slip shoes

• Keep nightlight on if episodes happen at night

• Have someone nearby during episodes

At Work:

• Tell your supervisor if you have vertigo (helps them understand)

• Avoid heights or machinery if vertigo is severe

• Take frequent breaks

• Stay hydrated and eat regularly

Driving:

• Don’t drive during or immediately after an episode

• Wait until completely symptom-free

• Tell your doctor about driving safety concerns

• Some states require reporting if vertigo affects driving

Lifestyle Changes That Help

Sleep Position:

• Sleep on your unaffected ear

• Use 2-3 pillows to elevate your head

• Keeps inner ear fluid balanced

Dietary Changes:

• Drink 8-10 glasses of water daily

• Limit salt (affects inner ear fluid)

• Reduce caffeine and alcohol

• Regular meals (low blood sugar worsens dizziness)

Stress Management:

• Stress and anxiety trigger vertigo

• Practice deep breathing or meditation

• Regular gentle exercise

• Yoga or tai chi (great for balance too)

Head Positioning:

• Move your head slowly

• Avoid sudden movements

• When looking down, bend at hips (not just neck)

• Support your neck when turning in bed