Understanding Vertigo: Causes, Symptoms, and Treatment Options
Vertigo is a common problem that many people misunderstand. It can be mistaken for lightheadedness or general dizziness, but it often feels very different. Living with vertigo can be tough. It’s not only the physical feeling of unsteadiness, but also the stress and worry it causes. Many people feel frustrated because their symptoms are invisible. They may look healthy but struggle with balance or simple daily tasks. Friends and family might not see the challenges, making support even harder to find.
Feeling unsteady or dizzy can make everyday life difficult. Ordinary things like walking, working, or relaxing at home can become a struggle. Vertigo is more than just a spinning feeling. It can take away your confidence and leave you searching for answers.
Most people don’t realise vertigo often starts in the inner ear, but blood pressure, blood sugar, stress, and changes in vision can also play a part. The reasons behind vertigo can be complex. By learning more about vertigo, you can start to regain control and take steps towards feeling better.
What Is Vertigo?
Vertigo is not just a vague feeling of dizziness. It gives a strong sensation that you or your surroundings are moving or spinning, even when everything is still. Many people describe it as stepping off a merry-go-round while the room keeps whirling, or as if they’re spinning. This movement is usually invisible to others, but it can be overwhelming.
It can happen while you are standing, sitting, or lying down. Some notice their eyes flicker or move side to side (this is called nystagmus), which others may also see.
How Balance Works in Your Body
The body keeps its balance using three main systems: your eyes, your inner ears, and your body’s sense of position (proprioception). These systems work together. If one is not working right, vertigo can happen. According to Cleveland Clinic, problems in the balance part of the inner ear cause most vertigo, but issues in the brain or nerves can also play a role.
If your inner ear is not the main cause, the other balance systems should be checked. Audiologists who are additionally trained in and equipped with balance assessment techniques and technology often start with a detailed health history.
They look into your general health, mental wellbeing, sleep quality, diet, medications, and any past injuries. These details help us find possible triggers and also helps us select the appropriate test for the concerns raised.
The Hidden Impact of Vertigo
One of the most frustrating aspects of vertigo is that you "look so normal" on the outside. This invisible nature often leads to misunderstanding from family and friends, creating additional stress and arguments about whether the discomfort is "just in your head".
Vertigo vs. General Dizziness
Not all dizziness is vertigo. Dizziness can mean anything from feeling that you are going to faint to feeling off-balance or unstable. Vertigo is different. Its hallmark feature is the sensation of spinning or movement.
Vertigo: You feel yourself or the room spinning or moving. There is usually an episode, or an event, and it can be persistent and triggered by certain head movements, or body movements.
Other dizziness: You feel light-headed, about to faint, or just unsteady, but without spinning.
Describing your symptoms helps your healthcare team find the cause. They may ask about when and how vertigo begins, how long it lasts, and what triggers it. Sharing these details helps your audiologist and other specialists, such as your ENT doctor or neurologist, direct you toward the most suitable treatment.
Vertigo has several key symptoms. You may not have all of them at once, but certain signs are common.
Spinning or moving sensation: The classic sign. It can feel like the room is turning or you are moving in circles.
Loss of balance: Simple activities, like getting up or turning your head, can make you feel wobbly, or you have lost balance and experienced a fall
Nausea or vomiting: The false sense of motion can make you feel sick.
Abnormal eye movements (nystagmus): Your eyes might jerk or flicker during an episode.
Headache or tinnitus: Some people get headaches or ringing in their ears, sometimes with a feeling of fullness or blockage. Some people experience all the same symptoms as one would experience with a migraine, only there is not always a headache but there is an aura and light or sound sensitivity
Sweating and anxiety: Episodes can make your heart race or trigger panic. Alternatively, having cardiac problems may cause heart palpitations which may trigger a dizzy episode
Most vertigo episodes last a few seconds to a few hours, but sometimes they can go on for days.
Track Your Vertigo Symptoms
Keeping a simple diary of your symptoms helps spot patterns and triggers. At Hoffman Audiology, we offer our patients a journal called “My Vestibular Pathway” where they journal things that appear to trigger their symptoms. Record things like:
⮚ Does turning in bed trigger the episode?
⮚ How long does it last?
⮚ Does it happen when bending down and picking something up?
⮚ Did you have a poor night’s sleep the night before the attack?
⮚ Were you feverish or did you have flu-like symptoms before the episode?
⮚ Are you stressed, anxious or depressed because of how you are feeling?
⮚ Do you have a high-sodium diet?
⮚ Do you ingest stimulants during the day, such as caffeine, nicotine?
⮚ Do you have any spinal or neck problems?
⮚ Do you hear your heartbeat?
⮚ Can you hear any internal sounds that are unusual, such as your eyes blinking?
Main Causes of Vertigo
BPPV (Benign Paroxysmal Positional Vertigo)
BPPV is the leading cause of sudden, brief spells of vertigo. It happens when tiny crystals in your inner ear (called otoconia) become loose and move into the ear’s balance canals. Moving your head or rolling over in bed can trigger vertigo as these crystals shift and confuse your brain.
BPPV characteristics:
Symptoms often start suddenly, with spinning lasting seconds to a minute.
Episodes are triggered by specific head movements.
Nausea and imbalance are common; vomiting is less so.
Typically, BPPV does not cause hearing loss or tinnitus.
BPPV can be checked and treated by a trained audiologist. With the right maneuver, most people feel better after one or two sessions.
If your symptoms last for days, you can’t walk on your own, or you are vomiting for an extended period, the cause is probably not BPPV. Other inner ear or health problems may need to be considered, which might require additional tests and support from your medical team.
Other Causes: Migraines and Neurological Problems
Not all vertigo starts in the ear. Some causes involve the brain, nerves, heart, vision, or muscles.
Vestibular migraines: These can cause dizzy spells and sensitivity to light or sound, sometimes without a headache. Triggers include stress, hormones, diet, and some medications.
Multiple sclerosis (MS): MS can interrupt how your brain reads balance signals. Vertigo may come and go or last longer than with ear-related causes.
Parkinson’s disease: Many people with Parkinson’s report dizziness or vertigo, especially in later stages. Balance problems may occur even without clear vertigo episodes.
Stroke: A stroke in the balance areas of the brain can leave lasting vertigo.
Tumours or lesions: Pressure on nerves or balance centres in the brain can trigger vertigo and other symptoms.
Orthostatic hypotension: This is a drop in blood pressure when standing up. It can happen due to medication, dehydration, or heart conditions and often causes dizziness or fainting.
These causes might also bring blurred vision, loss of coordination, or numbness. Always take new, severe, or unusual symptoms seriously and seek help as soon as possible. Getting the correct diagnosis is the first step to feeling steady again.
Steps to Manage Vertigo
Keep a detailed journal of your symptoms and possible triggers.
Reach out to our team for a thorough assessment.
Follow recommended lifestyle changes, such as optimising sleep and managing stress.
If diagnosed with BPPV, complete the recommended repositioning manoeuvres.
Stay connected with our team for ongoing support.
Look at whether you have neck stiffness, blurry vision, or numbness in your feet or other extremities
Find Relief from Vertigo Today
If vertigo is severe, lasts for days, or is accompanied by vomiting, difficulty walking, vision changes, or numbness, seek medical attention right away. Diagnosis and treatment from a healthcare team—such as an audiologist, ENT specialist, GP, or neurologist—are recommended.
Don't let vertigo control your life. Understanding the root causes of your vertigo is like peeling back layers of an onion - we work together to identify triggers and find effective treatments that restore your confidence and balance.