Why Do People Get Vertigo? Understanding the Causes and Treatments

Vertigo, a sensation of spinning or dizziness, can significantly impact daily life; however, relief is available, and you don’t have to live with it. At WHY.EDU.VN, we provide expert insights into understanding the various causes of this symptom, ranging from inner ear issues to migraines, and offer a clear understanding of treatment options and management strategies. Explore with us the connection between positional vertigo, vestibular disorders, and potential neurological causes.

1. What is Vertigo?

Vertigo is a symptom, not a disease, characterized by the false sensation that you or your surroundings are spinning or moving. This can manifest as a feeling of tilting, swaying, or being off-balance. Understanding that vertigo is a symptom is the first step in diagnosing and treating the underlying cause, whether it’s related to inner ear problems or neurological conditions.

According to Dr. Man-Kit Leung, an otolaryngologist in San Francisco, it’s crucial to identify the root cause of vertigo rather than simply accepting it as a condition to live with.

Person holding their head, indicating dizziness and vertigo

2. How Does Vertigo Feel?

Vertigo is more than just feeling dizzy; it’s a specific type of dizziness that creates a false sense of movement. You might feel like you are spinning or that the world around you is turning. This sensation can range from mild rocking to intense spinning, significantly affecting your balance and coordination.

Dr. Benjamin Wycherly describes vertigo as “a feeling like you’re in motion. Things are moving or you’re moving when you’re really not.” This sensation can be disorienting and frightening, especially when it occurs unexpectedly.

3. What Are the Main Causes of Vertigo?

The causes of vertigo are diverse, but most often stem from issues within the inner ear. However, central causes related to the brain should also be considered.

• Peripheral Causes (Ear-Related):

  • Benign Paroxysmal Positional Vertigo (BPPV): This is the most common cause, where calcium crystals in the inner ear become dislodged.
  • Meniere’s Disease: A chronic inner ear disorder that affects balance and hearing.
  • Vestibular Neuritis or Labyrinthitis: Inflammation of the vestibular nerve, often due to a viral infection.

• Central Causes (Brain-Related):

  • Migraines: Vestibular migraines can cause episodes of vertigo, even without a headache.
  • Stroke or Transient Ischemic Attack (TIA): Disruption of blood flow to the brain can lead to vertigo.
  • Multiple Sclerosis (MS): A neurological disease that can affect balance and coordination.
  • Brain Tumors: In rare cases, tumors in the brainstem or cerebellum can cause vertigo.

4. What is Benign Paroxysmal Positional Vertigo (BPPV)?

BPPV is a common cause of vertigo, triggered by specific changes in head position. It occurs when small calcium crystals, known as otoconia, become dislodged from their normal location in the inner ear and move into the semicircular canals.

These crystals interfere with the normal fluid movement in the canals, sending incorrect signals to the brain about the body’s position, resulting in a brief but intense sensation of spinning.

5. How Long Do Vertigo Episodes Last?

The duration of vertigo episodes can vary widely depending on the underlying cause. Episodes can last from a few seconds to several hours, or even days.

• BPPV: Typically lasts less than a minute, often triggered by head movements.
• Meniere’s Disease: Episodes can last from 20 minutes to several hours.
• Vestibular Neuritis: Can cause persistent vertigo lasting for several days.
• Migraines: Vertigo episodes can last from a few minutes to several hours.

Dr. Deema Fattal notes that while some vertigo episodes may be short-lived, individuals may experience a residual sense of imbalance that can last much longer.

6. How is Vertigo Diagnosed?

Diagnosing vertigo involves a comprehensive evaluation, including a review of your medical history, a physical examination, and specific diagnostic tests. Your doctor will ask detailed questions about your symptoms, triggers, and the duration of your episodes.

Key diagnostic procedures include:

• Medical History: Discussing the onset, duration, and triggers of your vertigo.
• Physical Examination: Assessing your balance, coordination, and neurological function.
• Dix-Hallpike Maneuver: A test to diagnose BPPV by observing eye movements (nystagmus) in response to specific head movements.
• Balance Tests: Such as the Romberg test and the Fukuda-Unterberger test.
• Hearing Tests (Audiometry): To assess for hearing loss, which can indicate Meniere’s disease.
• Imaging Studies (MRI or CT Scan): To rule out central causes of vertigo, such as stroke or brain tumors.

7. What Role Does Medical History Play in Vertigo Diagnosis?

A detailed medical history is crucial in diagnosing vertigo. The specifics of when the vertigo started, how it has changed over time, the length of each episode, triggers, and any associated symptoms provide valuable clues to the underlying cause.

According to Dr. Fattal, “The key is the history—when it started, how it is changing over time, how long each episode lasts, what are the triggers, and any associated symptoms.”

For instance, vertigo that started recently may indicate a stroke, while recurrent vertigo over many years is less likely to be stroke-related.

8. How Does a Physical Exam Help in Diagnosing Vertigo?

A physical exam can provide crucial insights into the cause of vertigo. Techniques like the Dix-Hallpike maneuver help doctors identify peripheral causes, while observing for other neurological signs can point to central issues.

Dr. Leung explains, “If their eyes do spin in a certain position and it stops, then it is more likely a peripheral cause. But if they keep spinning and it doesn’t stop, then I worry about a brain issue.”

Additionally, symptoms such as slurred speech or weakness on one side of the body are red flags for potential stroke.

9. How Does Positioning Affect Vertigo?

Body and head positioning significantly impact certain types of vertigo, particularly BPPV. Changes in head position can trigger episodes of vertigo when the dislodged crystals move within the semicircular canals.

“What can happen is you are lying in bed, and you roll over to your side to look at the alarm clock and you get a sudden burst of spinning vertigo,” explains Dr. Wycherly.

This is because the movement of the stones in the inner ear induces a false sense of spinning. Identifying these positional triggers is crucial for diagnosing and managing BPPV.

10. Can Migraines Cause Vertigo?

Yes, migraines are a common cause of vertigo. About one in three migraine sufferers experience vertigo, which can occur with or without a headache. This condition is known as vestibular migraine.

Dr. Wycherly notes, “Migraines are so common and that just means that vertigo from migraine tends to be common too.”

The exact mechanisms by which migraines cause vertigo are not fully understood, but it is believed to involve the interaction between the brain’s pain centers and balance centers.

11. What is Meniere’s Disease?

Meniere’s disease is a chronic inner ear disorder that affects balance and hearing. It is characterized by episodes of vertigo, hearing loss, tinnitus (ringing in the ear), and a feeling of fullness in the ear.

According to Dr. Wycherly, Meniere’s disease is “not nearly as common as BPPV or migraine,” but it is still a significant cause of vertigo.

The exact cause of Meniere’s disease is unknown, but it is thought to involve an imbalance of fluid in the inner ear.

12. What Treatments Are Available for Vertigo?

The treatment for vertigo depends on the underlying cause. Some common treatments include:

• Epley Maneuver: A physical therapy maneuver used to treat BPPV by repositioning the calcium crystals in the inner ear.
• Medications: Such as antihistamines, antiemetics, and benzodiazepines, to relieve symptoms of vertigo and nausea.
• Vestibular Rehabilitation Therapy (VRT): A specialized form of physical therapy that helps improve balance and reduce vertigo.
• Dietary Changes: Such as reducing salt intake for Meniere’s disease.
• Migraine Treatments: Medications and lifestyle changes to manage migraines and associated vertigo.
• Surgery: In rare cases, surgery may be necessary for severe cases of Meniere’s disease or other inner ear disorders.

13. How Does the Epley Maneuver Help with Vertigo?

The Epley maneuver is a series of head movements designed to reposition the dislodged calcium crystals in the inner ear, thereby relieving the symptoms of BPPV. The maneuver involves specific head rotations performed by a trained healthcare professional.

Dr. Fattal explains that the Epley maneuver is a “simple physical therapy maneuver” that can effectively treat BPPV.

By moving the crystals to a part of the inner ear where they don’t cause symptoms, the Epley maneuver can provide immediate relief from vertigo.

14. When is Vertigo Considered a Medical Emergency?

Vertigo can be a symptom of serious underlying conditions, and it is essential to know when to seek immediate medical attention.

Seek emergency care if vertigo is:

• Sudden in Onset: Especially if it is accompanied by other neurological symptoms.
• Severe: Causing an inability to walk or function.
• Associated with Neurological Symptoms: Such as clumsiness, weakness, numbness, facial drooping, slurred speech, or vision changes.
• Accompanied by Hearing Loss: Sudden hearing loss with vertigo can indicate a serious condition requiring urgent treatment.
• Occurring with Other Symptoms: Such as severe headache, neck pain, or swallowing difficulties.

Dr. Fattal advises, “go to the emergency department if the vertigo is a sudden onset and is associated with … the person literally crawling or cannot walk.”

15. What Over-the-Counter Medications Can Help with Vertigo?

Several over-the-counter (OTC) medications can help manage the symptoms of vertigo, particularly nausea and dizziness.

Common OTC medications include:

• Meclizine (Antivert, Bonine): An antihistamine that reduces dizziness and nausea.
• Dimenhydrinate (Dramamine): Another antihistamine commonly used for motion sickness and vertigo.

Dr. Leung recommends meclizine, noting that it “helps with dizziness and nausea as well. Many times, nausea accompanies vertigo and dizziness.”

These medications can provide temporary relief, but it is essential to consult a healthcare professional for a proper diagnosis and treatment plan.

16. How Do Lifestyle Factors Affect Vertigo?

Lifestyle factors such as diet, exercise, sleep, and stress can significantly impact vertigo. Dehydration, high salt intake, poor nutrition, lack of exercise, inadequate sleep, and high stress levels can all trigger or worsen vertigo symptoms.

Dr. Fattal emphasizes the importance of “nutrition, exercise, sleep and stress (NESS)” in managing vertigo.

Maintaining a healthy lifestyle can help reduce the frequency and severity of vertigo episodes.

17. What is the Role of Vitamin D in Vertigo?

Vitamin D plays a crucial role in calcium absorption and bone health, and low levels of vitamin D have been linked to an increased risk of BPPV.

According to Dr. Wycherly, “patients with osteopenia and osteoporosis and low vitamin D have higher risk for BPPV.”

Ensuring adequate vitamin D levels through diet or supplementation may help prevent or manage BPPV.

18. How Does Salt Intake Affect Vertigo?

High salt intake can exacerbate vertigo, especially in individuals with Meniere’s disease. Sodium can affect the fluid balance in the inner ear, potentially triggering vertigo episodes.

Dr. Wycherly recommends that patients “track their sodium intake for a period of time” to ensure they are not consuming excessive amounts.

The American Heart Association recommends limiting sodium intake to no more than 2,300 milligrams per day, with an ideal amount of no more than 1,500 milligrams per day for most adults.

19. Why Should You Not Ignore Vertigo?

Vertigo is not something you should simply “put up with.” It can often be diagnosed and treated effectively, leading to significant improvements in quality of life. Ignoring vertigo can lead to prolonged suffering and potential misdiagnosis of underlying conditions.

Dr. Fattal shares a particularly poignant observation: “The longest I’ve seen is 20 years of undiagnosed vertigo, which is really sad.”

Seeking timely medical attention can help identify the cause of vertigo and implement appropriate treatments to alleviate symptoms and prevent future episodes.

20. Should I See an ENT for Vertigo?

Yes, seeing an ear, nose, and throat (ENT) specialist, also known as an otolaryngologist, is a good first step if you are experiencing vertigo. ENT specialists are trained to diagnose and treat conditions affecting the inner ear, which is often the source of vertigo.

Dr. Wycherly advises, “patients should be pursuing vertigo with an ear, nose and throat specialist or start with their primary care physician.”

An ENT can perform a thorough examination, conduct necessary tests, and recommend appropriate treatments or referrals to other specialists, such as neurologists, if needed.

21. Can Anxiety Cause Vertigo?

While anxiety itself may not directly cause vertigo, it can exacerbate the symptoms or trigger episodes in individuals who are already prone to vertigo. The relationship between anxiety and vertigo is complex and often involves the interplay of physical and psychological factors.

Anxiety can lead to hyperventilation, muscle tension, and increased sensitivity to bodily sensations, which can all contribute to feelings of dizziness and imbalance. Additionally, anxiety disorders such as panic disorder and agoraphobia are often associated with vestibular symptoms, including vertigo.

Managing anxiety through therapy, medication, and relaxation techniques may help reduce the frequency and severity of vertigo episodes.

22. What is Cervicogenic Dizziness?

Cervicogenic dizziness is a type of dizziness that originates from the neck, often due to problems with the cervical spine, muscles, or nerves. It is characterized by a feeling of unsteadiness, imbalance, or disorientation, rather than a true spinning sensation.

Cervicogenic dizziness is typically triggered or worsened by neck movements, such as turning the head or looking up. It may also be associated with neck pain, stiffness, headaches, and limited range of motion in the neck.

Treatment for cervicogenic dizziness typically involves physical therapy, manual therapy, and exercises to improve neck mobility, posture, and muscle strength.

23. What is Persistent Postural-Perceptual Dizziness (3PD)?

Persistent Postural-Perceptual Dizziness (3PD) is a chronic vestibular disorder characterized by persistent dizziness, unsteadiness, and a heightened awareness of one’s body position in space. The symptoms are often exacerbated by upright posture, active or passive movement, and exposure to complex visual stimuli.

3PD typically develops after an acute vestibular event, such as BPPV, vestibular neuritis, or a concussion. However, the symptoms persist long after the initial event has resolved. Psychological factors, such as anxiety and depression, may also play a role in the development and maintenance of 3PD.

Treatment for 3PD typically involves a combination of vestibular rehabilitation therapy, cognitive-behavioral therapy, and medication to manage anxiety and depression.

24. What is Mal de Debarquement Syndrome (MdDS)?

Mal de Debarquement Syndrome (MdDS) is a rare neurological disorder characterized by a persistent sensation of rocking, swaying, or bobbing, typically after a sea voyage, air travel, or other forms of passive motion. The symptoms can last for months or even years, significantly impacting quality of life.

The exact cause of MdDS is unknown, but it is thought to involve a maladaptation of the brain’s balance and spatial orientation systems. Symptoms are often temporarily relieved by renewed exposure to passive motion, but they return once the motion stops.

Treatment for MdDS is challenging and may involve medication, vestibular rehabilitation therapy, and transcranial magnetic stimulation.

25. How Can Vestibular Rehabilitation Therapy (VRT) Help with Vertigo?

Vestibular Rehabilitation Therapy (VRT) is a specialized form of physical therapy designed to improve balance, reduce dizziness, and enhance overall function in individuals with vestibular disorders. VRT involves a customized exercise program that targets specific areas of the vestibular system, such as the inner ear and brain.

VRT exercises may include:

• Gaze Stabilization Exercises: To improve visual clarity during head movements.
• Balance Training Exercises: To enhance stability and reduce the risk of falls.
• Habituation Exercises: To reduce sensitivity to specific movements or visual stimuli that trigger dizziness.
• Canalith Repositioning Maneuvers: Such as the Epley maneuver, to treat BPPV.

VRT is often an effective treatment option for various types of vertigo and can help individuals regain their independence and quality of life.

26. What Are Some Self-Care Tips for Managing Vertigo at Home?

In addition to medical treatments, there are several self-care strategies that can help manage vertigo symptoms at home:

• Get Adequate Rest: Fatigue can worsen vertigo symptoms, so aim for 7-8 hours of sleep per night.
• Stay Hydrated: Dehydration can contribute to dizziness, so drink plenty of water throughout the day.
• Avoid Triggers: Identify and avoid specific movements, foods, or situations that trigger your vertigo.
• Use Assistive Devices: If you have difficulty with balance, use a cane or walker to prevent falls.
• Create a Safe Environment: Remove hazards from your home, such as loose rugs and clutter, to reduce the risk of falls.
• Practice Relaxation Techniques: Stress can worsen vertigo symptoms, so practice relaxation techniques such as deep breathing, meditation, or yoga.
• Limit Caffeine and Alcohol: These substances can interfere with balance and worsen vertigo symptoms.

27. How Can Diet Help Manage Vertigo?

Diet plays a significant role in managing vertigo, particularly for conditions like Meniere’s disease and migraines. Making specific dietary changes can help reduce the frequency and severity of vertigo episodes.

Key dietary recommendations include:

• Limit Sodium Intake: High sodium intake can worsen vertigo symptoms, especially in individuals with Meniere’s disease. Aim for a low-sodium diet by avoiding processed foods, salty snacks, and excessive use of table salt.
• Stay Hydrated: Dehydration can contribute to dizziness, so drink plenty of water throughout the day.
• Eat Regular Meals: Skipping meals can lead to low blood sugar, which can trigger dizziness. Eat regular, balanced meals to maintain stable blood sugar levels.
• Limit Caffeine and Alcohol: These substances can interfere with balance and worsen vertigo symptoms.
• Identify and Avoid Trigger Foods: Certain foods, such as chocolate, aged cheese, and processed meats, can trigger migraines and associated vertigo. Keep a food diary to identify and avoid your personal trigger foods.

28. What Are Some Common Misconceptions About Vertigo?

There are several common misconceptions about vertigo that can lead to confusion and delays in seeking appropriate treatment.

Some of these misconceptions include:

• Vertigo is “all in your head”: Vertigo is a real physical symptom that can have various underlying causes, including inner ear disorders, neurological conditions, and psychological factors.
• Vertigo is just a minor inconvenience: Vertigo can significantly impact quality of life, interfering with daily activities, work, and social interactions.
• There is no treatment for vertigo: Many effective treatments are available for vertigo, including medication, physical therapy, and lifestyle changes.
• Vertigo is always caused by BPPV: BPPV is a common cause of vertigo, but other conditions, such as Meniere’s disease, migraines, and vestibular neuritis, can also cause vertigo.
• Vertigo will go away on its own: While some cases of vertigo may resolve spontaneously, it is essential to seek medical attention to identify the underlying cause and receive appropriate treatment.

29. How to find support from WHY.EDU.VN for Vertigo?

At WHY.EDU.VN, we understand the challenges and frustrations that come with experiencing vertigo. Our platform is dedicated to providing reliable, expert-backed information to help you understand the causes, treatments, and management strategies for vertigo. Whether you’re looking for detailed explanations of inner ear disorders, practical tips for managing symptoms at home, or guidance on when to seek emergency care, WHY.EDU.VN is here to support you.

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30. FAQ about Vertigo

Here are some frequently asked questions about vertigo, along with their answers:

1. What is the difference between dizziness and vertigo?
   Dizziness is a general term for feeling unsteady or lightheaded, while vertigo is a specific type of dizziness that creates a false sense of spinning or movement.

2. What are the most common causes of vertigo?
   The most common causes of vertigo include BPPV, Meniere’s disease, vestibular neuritis, and migraines.

3. How is vertigo diagnosed?
   Vertigo is diagnosed through a comprehensive evaluation, including a medical history, physical examination, and specific diagnostic tests, such as the Dix-Hallpike maneuver and balance tests.

4. Can stress cause vertigo?
   Stress itself may not directly cause vertigo, but it can exacerbate the symptoms or trigger episodes in individuals who are already prone to vertigo.

5. Is there a cure for vertigo?
   There is no one-size-fits-all cure for vertigo, as the treatment depends on the underlying cause. However, many effective treatments are available to manage symptoms and improve quality of life.

6. What medications can help with vertigo?
   Medications that can help with vertigo include antihistamines, antiemetics, and benzodiazepines.

7. Can diet affect vertigo?
   Diet plays a significant role in managing vertigo, particularly for conditions like Meniere’s disease and migraines. Limiting sodium intake, staying hydrated, and avoiding trigger foods can help reduce the frequency and severity of vertigo episodes.

8. When should I see a doctor for vertigo?
   You should see a doctor for vertigo if the symptoms are severe, persistent, or accompanied by other neurological symptoms, such as weakness, numbness, or slurred speech.

9. What is vestibular rehabilitation therapy?
   Vestibular rehabilitation therapy (VRT) is a specialized form of physical therapy designed to improve balance, reduce dizziness, and enhance overall function in individuals with vestibular disorders.

10. What is BPPV and how is it treated?
    BPPV (Benign Paroxysmal Positional Vertigo) is a common cause of vertigo triggered by specific changes in head position. It is treated with canalith repositioning maneuvers, such as the Epley maneuver.

Experiencing vertigo can be unsettling, but you don’t have to navigate it alone. At WHY.EDU.VN, we provide the information and support you need to understand and manage your symptoms effectively.

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