Condition Center: Vertigo

Photo Illustration by Aly Lim
Photo Illustration by Aly Lim

This informational guide, part of POPSUGAR's Condition Center, lays out the realities of this health concern: what it is, what it can look like, and strategies that medical experts say are proven to help. You should always consult your doctor regarding matters pertaining to your health and before starting any course of medical treatment.

As a kid, did you ever just spin in circles until you were dizzy? Well, vertigo can feel a lot like that. It's not a disease but rather a symptom of a variety of conditions, according to the Cleveland Clinic. It's more common in people over 65, according to research in the journal Aging and Disease. But it's possible for anyone to experience vertigo, so it's worth understanding the condition and knowing how to treat it.

Understanding Vertigo

Vertigo is the sensation of feeling like the environment around you is moving or spinning in circles when it's not, according to the Cleveland Clinic. These attacks can last anywhere from minutes to months in severe cases and are often compared to motion sickness. But according to Penn Medicine, it can also cause problems focusing the eyes, dizziness, hearing loss in one or both ears, loss of balance (may cause falls), ringing in the ears, and nausea and vomiting.

There are two main types of vertigo, per Penn Medicine:

  • Peripheral vertigo: This occurs when there are problems in the part of the inner ear that controls balance (e.g., vestibular labyrinth or semicircular canals, both part of the vestibular system). "The vestibular system's job is to tell your brain which way gravity is pulling us and how to move against gravity to reach our movement goals," says Bill Daniels, a personal trainer who specializes in vertigo and other vestibular disorders. "When this isn't working properly, we begin to feel dizzy or ungrounded." Research shows peripheral vertigo accounts for more than 90 percent of all causes of vertigo.
  • Central vertigo: Central vertigo most commonly occurs as a result of brain problems such as infection, tumors, injury, and stroke, especially in the elderly with vascular risk factors. This type of vertigo in particular can cause issues including difficulty swallowing, double vision, eye movement problems, facial paralysis, slurred speech, and weakness of the limbs, in addition to dizziness.

Causes of Vertigo

"Trips to the dentist cause the majority of vertigo cases I see in my clinic," says Lalitha McSorley, vestibular specialist and physiotherapist at Brentwood Physio. Lying down for a long dentist appointment, like a root canal, requires individuals to have their head back for an extended period of time, which can allow crystals of calcium — that live in the vestibular system and make you sensitive to gravity — move into the inner ear canal, where they displace fluid, according to the Mayo Clinic. This leads to inaccurate reporting from the inner ear to the brain about how you are moving and can result in vertigo. Typically, the vertigo will pass on its own after a few seconds to minutes. If you're going in for a long dental procedure, "ask your dentist if you can sit up every 15 minutes or have them change the position of the head rest so your head is not in a declined position," McSorley suggests.

According to Penn Medicine, other causes of peripheral vertigo, which is due to problems in the inner ear, include:

  • Benign paroxysmal positional vertigo (BPPV), a common inner-ear issue caused by loose particles ("crystals") of calcium in the inner ear.
  • Certain medications, including some diuretics or salicylates.
  • Injuries to the head or neck, which may damage the inner ear or other structures in the head and neck.
  • Damage to the vestibular nerve. Inflammation of the vestibular nerve, referred to as vestibular neuritis, can cause vertigo.
  • Repeated ear infections. They can lead to a condition called cholesteatoma, which causes skin growth to develop in the middle ear, leading to vertigo.
  • Ménière's disease, which occurs when fluid builds up in the ear. In this case, vertigo may be accompanied by tinnitus (ringing in the ears) and hearing loss.

Central vertigo, triggered by brain problems, can result from the below, per Penn Medicine:

  • Blood-vessel disease, otherwise known as vascular disease (vasculopathy), affects the blood vessels that carry oxygen and nutrients throughout your body, which can cause reduced blood flow to the inner-ear vestibular system, per the Mayo Clinic.
  • Multiple sclerosis, a condition that impacts the brain and spinal cord, can cause symptoms of central vertigo due to the location of the disease.
  • Seizures, or head trauma, can cause bleeding in areas of the brain, according to the Mayo Clinic.
  • Stroke is when part of the blood supply to the brain is cut off, therefore impacting the blood flow to the inner ear.
  • Tumors (cancerous or noncancerous) in the cerebellum, located at the bottom of the brain. Specifically, acoustic neuroma — a rare, benign brain tumor — can grow on the acoustic nerve, which helps to control hearing and balance, per the Mayo Clinic.
  • Vestibular migraine, a type of migraine headache usually felt as a throbbing pain at the front or on one side of your head. It typically impacts younger people, according to the NHS.
  • Certain drugs, such as anticonvulsants, aspirin, and alcohol, can have side effects that impact the brain, causing central vertigo.

The Most Effective Vertigo Treatments

Vertigo attacks can last several seconds to several minutes, according to the Cleveland Clinic. And in more severe cases, the sensation can last for hours, days, weeks or even months. Fortunately, can go away on its own. But there are things you can do to manage your symptoms. First try lying in a quiet, dark room to ease symptoms of nausea and reduce the sensation of spinning. It's also best to avoid stressful situations, as anxiety can worsen symptoms. But depending on the cause and severity of your symptoms, you might not want to wait. Below are effective ways to treat it, depending on the type, per McSorley.

Treating Peripheral Vertigo

  • Vestibular rehabilitation. This is a type of physical therapy specifically designed to help improve balance and walking ability in people with vertigo and can often cure most cases of vertigo after just one or two visits. "I will perform certain repositioning maneuvers with the patient," McSorley says. The maneuvers alleviate symptoms by strengthening your other senses to compensate for vertigo attacks.
  • Medication. Medications can often help to treat vertigo caused by inner-ear problems or other underlying conditions like antibiotics to treat an infection.
  • Surgery. In some cases, surgery may be needed to treat the underlying cause of vertigo. This may include surgery to repair damage to the inner ear or other structures in the head and neck.
  • Time. Many causes of vertigo resolve spontaneously, according to the University of Iowa Healthcare, meaning it involves waiting until it goes away on its own.

Treating Central Vertigo

  • Finding the source. Central vertigo is caused by problems in part of your brain, such as the cerebellum (which is located at the bottom of the brain) or the brainstem (the lower part of the brain that's connected to the spinal cord). Therefore, your doctor may suggest a brain scan or refer you to a neurologist.
  • Treating the migraine should relieve the vertigo if the migraine is what's causing it.

Ultimately, if you're concerned that you may be experiencing symptoms of vertigo, talk to your healthcare provider so they can determine the treatment option that's best for you.