If you feel a sudden sensation of things spinning when you stand up or move quickly, it could be vertigo. Sometimes you may feel as though you’re on a rocking boat or spinning when you move your head, even if you’re standing or lying still. Vertigo can be an unsettling and even scary feeling.
Vertigo is different from dizziness, which is more of a lightheaded feeling. Both cause some similar issues, such as feeling you’re off balance. If you feel things around you are moving when they aren’t, that’s vertigo.
Vertigo can happen to just about anyone at any age, but it tends to be more common in people over age 65. Almost 40 percent of people in the U.S. suffer from vertigo at some time in their lives.
And not everyone experiences it exactly the same. For some, vertigo can be triggered easily and often. And while one person may have very short bouts, vertigo may drag on for longer stretches in others.
Even if your vertigo symptoms are mild, it’s a good idea to take it seriously—especially if you’re older. Vertigo can bring on instability and may lead to a fall. For older adults, an unexpected fall can lead to a whole host of other problems.
The good news is that most cases of vertigo are mild and end on their own. But if vertigo doesn’t go away, call on your doctor or physical therapist (PT). There are exercises that can help. Your doctor can also give you medications for nausea, if that’s a problem for you.
Why is the world spinning?
It’s important to understand that vertigo is not a disease. It is a symptom that shows up as a result of something going on in the ears or the brain.
The 2 main types of vertigo are:
- Peripheral vertigo: This is caused by an issue with the inner ear.
- Central vertigo: This happens when there’s an issue with the brain or central nervous system. It could be due to:
- An infection
- A traumatic brain injury
- A tumor
- A stroke
- A sudden drop in blood pressure
- Being dehydrated
- Side effects of medicine
- Motion sickness
- A health issue such as Ménière's disease
The most common type of vertigo
The most common reason for vertigo is due to an issue within the inner ear. This peripheral vertigo condition is known as benign paroxysmal positional vertigo (BPPV). A closer look at BPPV will show how this common type of vertigo occurs.
In a normal ear, the canals in the ear house tiny calcium crystals. These crystals move slightly when you move your head. This causes nerves that then send messages to your brain about what direction your head is moving. It’s just one part of a complex system that helps your body keep balance and orientation.
But if your inner ear is harmed in some way—perhaps due to a car crash or a head wound—these crystals can get loose and move into other parts of the ear canal. When this happens, mixed signals go to your brain. You may feel one thing and see something else. For example, your brain might get a signal that you’re still moving even after you’ve stopped.
These mixed messages to your brain cause you to feel shaky. You may feel like the ground is moving or rushing toward you. This can be very disorienting. For some it can cause nausea.
How is vertigo triggered?
Once the crystals in the inner ear are dislodged, bouts of vertigo can be easily triggered.
It’s almost always brought on by a sudden change in head position. It can be set off by something as simple as standing up quickly. (You can see that rollercoasters and carnival rides are not a good idea for someone with vertigo!)
When to see a doctor
Most of the time vertigo is not dangerous or life-threatening. But that does not mean you should ignore it. If you’ve had bouts of vertigo, it’s a good idea to talk with your doctor to rule out anything serious. Even if you think you have peripheral vertigo, you will want to check with your doctor.
On rare occasions, vertigo falls into the central vertigo category, and you will need a doctor’s care.
Your doctor can work with you to figure out the source of your vertigo. Talk with your doctor about your symptoms and medical history. And your doctor will help you get started with treatments if needed.
Treating vertigo
Treatment for vertigo will depend on what your doctor thinks is the root cause.
If you’re diagnosed with BPPV, your doctor or a PT might be able to help with head-positioning exercises. These can relieve the symptoms of vertigo. The most common treatment is known as the Epley maneuver .
The Epley maneuver is a series of slow, specific head movements that help move dislodged inner ear crystals back where they belong. It doesn’t always resolve vertigo symptoms right away. But in most cases, vertigo clears up after a few attempts.
While this is an effective way to treat BPPV, it’s not unusual for vertigo to return—particularly in older adults. If so, your doctor or PT may teach you how to do these head movements on your own.
How to help yourself
If you’ve had bouts of vertigo but have not yet had the chance to see a doctor, keep these tips in mind for your safety:
- Sit down right away if you feel dizziness coming on.
- Move your head carefully and slowly during daily activities.
- If you get up at night, turn on the lights first.
- If you think you’re at risk of falling, carry a walking stick for balance if needed.
- Sleep with your head slightly raised on 2 or more pillows.
- When getting up from bed, do so slowly and sit on the edge of the bed for a while before standing up.
- Try to relax, as anxiety can trigger vertigo.
- Do not bend over to pick things up. Squat down to lower yourself instead.
- Do not stretch your neck to look straight up. For instance, be careful while reaching to grab something from a high shelf.
Bouts of vertigo can be scary. Fortunately, these spells of unsteadiness usually go away in a short time. Try to stay calm and safe if you feel it coming on. And remember to talk with your doctor about it. Your health care team can help you figure out what’s going on and allow you to get back to a more normal life.
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References
Cleveland Clinic. (2021). Vertigo.https://my.clevelandclinic.org/health/diseases/21769-vertigo
Davis, B. (2017). Peripheral vertigo vs. central vertigo: What is the difference? https://uppercervicalawareness.com/peripheral-vertigo-vs-central-vertigo-difference/
Farrell, L. (n.d.) Vestibular rehabilitation therapy (VRT). https://vestibular.org/article/diagnosis-treatment/treatments/vestibular-rehabilitation-therapy-vrt/
Johns Hopkins Medicine. (n.d.) Home Epley Maneuver. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/home-epley-maneuver
Kaiser Permanente. (2020). Benign Paroxysmal Positional Vertigo (BPPV). https://wa.kaiserpermanente.org/kbase/topic.jhtml?docId=hw263714#hw263717
Kaiser Permanente. (2020). Vertigo: Senses that help your balance and position.
https://wa.kaiserpermanente.org/kbase/topic.jhtml?docId=not24061
MedlinePlus. (2021). Dizziness and vertigo. https://medlineplus.gov/dizzinessandvertigo.html
Shepard, N. T. (2009). Signs and symptoms of central vestibular disorders. https://www.asha.org/articles/signs-and-symptoms-of-central-vestibular-disorders/
Torburg, L. (2015). Mayo Clinic Q and A: Number of disorders can trigger vertigo. https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-number-of-disorders-can-trigger-vertigo/
This article was written by Jason Nielsen, edited by Gail Olson, and clinically reviewed by Jossue Ortiz, DC.
