Vertigo

Katy Waterman | Published 26 March 2024 | Updated 09 April 2024 | 6 mins read

What is vertigo?

Vertigo is the sensation of you or the environment around you spinning. It can come on in spells or last for long periods of time with varying severity – some people only experience a slight unsteady feeling while others feel as though the room is spinning around them and can lose their balance.

It’s different to dizziness in that dizziness is a broader feeling of lightheadedness or disorientation. Additionally, dizziness tends to be related to factors like a drop in blood pressure, whereas vertigo is usually (but not exclusively) a condition caused by issues within the inner ear.

Types of vertigo

There are two different types of vertigo – central and peripheral.

Peripheral vertigo

Peripheral vertigo is the most common type of vertigo and is usually caused by inner ear problems. However, it can also be a result of moving your head in a specific way (known as benign paroxysmal positional vertigo or BPPV), a head injury or even some types of medication. Peripheral vertigo can also be accompanied by associated auditory findings such as hearing loss or tinnitus. While central vertigo is not.

Central vertigo

Central vertigo is a result of problems in your brain – most likely at the back of your head and near your spinal cord. The triggers for central vertigo tend to be migraines, strokes, multiple sclerosis, brain tumours (including benign ones) and certain types of medication.

Causes

In most cases, your vertigo will be tied to inner ears issues. But it’s not the only cause. There are many underlying conditions that can also cause vertigo including infections, migraines, and something called BPPV.

Common causes of vertigo include:

Benign paroxysmal positional vertigo (BPPV) – The most common cause of vertigo. It creates a brief, intense sense of spinning of movement even when you’re sitting still. Episodes are triggered by a rapid change in head movement such as a blow to the head.
Infection – A viral infection of the vestibular nerve (called vestibular neuritis) or the organ responsible for hearing and balance – the labyrinth (called labyrinthitis) can cause intense, constant vertigo.
Meniere’s disease – A condition caused by a build-up of excessive fluid in the inner ear resulting in sudden cases of vertigo that can last for several hours.
Migraine – vertigo induced by a migraine can last between a few minutes and hours.
Head or neck injury – Vertigo is a common symptom after a traumatic injury to the head or neck, especially if the vestibular system is affected or damaged.
Medications – some medications can cause bouts of vertigo, dizziness, hearing loss, or tinnitus.
Neurological conditions – multiple sclerosis, skull fractures, tumours (especially those that develop at or near the base of the brain), or strokes can all be causes of vertigo.

Woman Wearing a Pajama Holding Her Head.

Can stress cause vertigo?

Stress is known to increase the levels of the hormone cortisone. Increased levels of cortisone can cause unpleasant side effects such as dizziness and vertigo. However, once these levels dissipate and your stress lessens, your vertigo should improve. Additionally, if you are already prone to experiencing vertigo, you may find that it becomes worse during periods of stress.

Symptoms

The most common symptom of vertigo is the sensation of movement when there is none. This can feel like the world is spinning around you, as if the ground is shifting beneath you, or as if your body is moving even when you are sitting still. It can be the only symptom you experience or it can be accompanied by a variety of other symptoms.

Other symptoms you may experience include:

Nausea
Vomiting
Sweating
Headache
Hearing loss
Ringing in the ears (tinnitus)
Loss of balance

Diagnosis

If your vertigo is causing you problems, your first point of call should be your GP. They will be able to help determine the cause of your issues and may perform a series of tests and determine what might be causing it based on your symptoms and medical history.

It’s likely that they will perform a head movement test and look in your eyes to see if they try to track the spinning. They may also test your balance to see if it triggers a vertigo attack.

If your vertigo is caused by a hearing problem, further examinations can be done by an audiologist or ear, nose and throat (ENT) specialist. They can then perform a hearing test and request further tests and scans to determine the root cause of the vertigo.

Treatment

How you treat your vertigo will depend on the cause. To improve symptoms, vestibular rehabilitation therapy as well as some medications have been found to be effective.

Young doctor writing on a clipboard while a patient holds medication.

Common treatments include:

Epley manoeuvre – A series of head manoeuvres that can help to relieve vertigo associated with BPPV. This treatment helps to displace canalith crystals (small particles that can cause vertigo) from the canals of the inner ear.
Medication – some medications have found to be an effective treatment for vertigo.
Antibiotics – If your vertigo is caused by an ear infection, you’ll be given antibiotics to treat the infection, which may help to relieve the vertigo.
Staying hydrated – dehydration can worsen vertigo symptoms, so it’s important to drink plenty of water.
Avoid vertigo-related triggers – these include caffeine, alcohol, excessive salt intake, and stress.
Surgery – Some underlying conditions that cause vertigo such as brain tumours, or head injury may require surgery to treat.

Takeaway

Vertigo is a fairly common but frustrating symptom of other conditions that can impact quality of life when more severe. It can be caused by many factors including infections, migraines, injuries or BPPV.

Treating the underlying cause of your vertigo is the most effective way to relieve discomfort and offer you relief. There are many methods to treat vertigo depending on the cause, including exercises, medications, and ensuring you stay hydrated.

If you’re experiencing vertigo, it’s important to speak to a doctor to find out the cause and find a treatment that works for you.

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FAQs

This can vary depending on the person – it can come on in quick spells that go as fast as they come on or it can last hours and leave you feeling nauseous and disoriented.

Your doctor can work out which ear is causing your vertigo issues using a simple test.

To start, they will move your head to one side before laying you down on the table and tracking your eye movement. Then they’ll repeat on your other side. Whichever side causes the spinning to increase is most likely to be the one that is causing the issue.

Vertigo can be triggered by a variety of triggers, including:

Movement of head /sudden movement in certain directions
Infection
Some medicines
Other underlying conditions

Vertigo itself is not hereditary, however, some conditions of which vertigo is a symptom, such as Meniere’s disease, are.

This will depend on several factors and the severity of your vertigo. It’s best to check the DVLA criteria to make sure.

This depends on the cause. Untreated underlying conditions can gradually get worse with time which can mean the vertigo also gets worse over time. It’s important to treat the cause in order to cure the symptoms of your vertigo.