Q&A on understanding vertigo


A room that seems to spin while you remain still can be a fun attraction at the county fair. It’s not as entertaining, however, when you get that same feeling standing at the counter in your kitchen. If you’re not on the Tilt-a-Whirl when your world starts spinning, it could be vertigo.

More than 35 percent of all adults will experience some form of balance disorder (vestibular disorder) in their lifetime, according to the Vestibular Disorders Association. For many of them, vertigo is the culprit.

Last month we shared an infographic with a brief overview from Swedish audiologist, Dr. Mary Henry, AuD, FAAA about the different types of vertigo. This month, in honor of Balance Awareness Week on September 15 – 21, Dr. Henry answers our questions about vertigo and helps take a closer look at this disorienting—but treatable—condition.

What is vertigo?

“Vertigo is the sensation of movement when the world isn’t moving,” said Dr. Henry. “With true spinning vertigo, you can actually see the room spin.” 

Vertigo is not a disease on its own. It is a symptom of a medical condition that is causing you to feel dizzy and off-balance. “Vertigo is a kind of dizziness,” said Dr. Henry.

What conditions cause vertigo?

Some of the most common conditions that can cause vertigo include:

  • Benign paroxysmal positional vertigo (BPPV) is the “most common and most treatable” form of vertigo, according to Dr. Henry. It occurs when small calcium crystals in your ear break loose and free-float in your ear canal. Your brain receives confusing signals, which causes you to become unbalanced and dizzy. The vertigo usually lasts less than 30 seconds but can last up to 60 seconds in rare cases.
  • Meniere’s disease is a disorder in your inner ear that affects your hearing and balance. It occurs when your inner ear cannot regulate fluid pressure. This is different than “popping” your ears, for example, when flying. The exact cause of Meniere’s disease is unknown. In addition to severe, spinning vertigo, the symptoms of Meniere’s disease include hearing loss, ear pressure, and ringing in your ears.
  • Labyrinthitis is swelling, inflammation and infection in your inner ear that causes vertigo. A virus, bacteria, or even the common cold or a bad case of the flu can bring on the condition, which can result in hearing loss, balance issues, and uncontrolled eye movements.

What causes vertigo?

Your body uses information from your eyes, muscles, and inner ear to maintain its balance and interpret sensory information. If there is a glitch in any of those systems, it can cause vertigo and prompt balance issues.

Some causes of vertigo include:

What are the symptoms of vertigo?

The symptoms of vertigo vary according to their underlying condition, according to Dr. Henry. Regardless of the type, all forms of vertigo include a spinning feeling that starts and stops without warning. The feeling can last anywhere from under 30 seconds to several days.

Possible associated symptoms include:

  • Loss of balance and unsteadiness
  • Temporary hearing loss
  • Ringing, roaring, or hissing sound in your ear (tinnitus)
  • Uncontrolled eye movements (nystagmus)
  • Unexplained nausea

How is vertigo diagnosed?

An accurate vertigo diagnosis starts with a long conversation with your doctor that outlines your medical history and symptoms.

“A thorough case history is the most important thing for diagnosing vertigo,” said Dr. Henry. “I spend a fair amount of time asking about the details.”

Some of the questions Dr. Henry asks are:

  • How often do your symptoms occur?
  • How long do your symptoms last with each episode?
  • When did you start having balance issues?
  • What triggers your episodes?
  • Do you have any other symptoms like hearing loss, headaches or ringing in your ears?

Testing may include:

  • Dix-Hallpike maneuver to detect involuntary eye movements when you change your head’s position
  • Advanced imaging like an MRI or CT scan
  • Neurological tests
  • Hearing test
  • Electrocochleography to detect inner ear abnormality
  • Balance tests

How is vertigo treated?

As with most conditions, treatment for vertigo depends on the specifics of your condition. According to Dr. Henry, treatment may include:

  • Epley maneuver which uses a series of head movements to reposition crystals in your ear
  • Physical therapy
  • Medication
  • Diet and lifestyle changes
  • Surgery

Find a doctor

If vertigo has you feeling like your world is spinning out of control, the doctors and audiology team at Swedish can help you achieve the balance you’re looking for. Find a doctor you can trust in our provider directory.

Related resources

Swedish Balance Center

Swedish Neuroscience Institute

Infographic: Types of Vertigo

What to expect from a vestibular balance assessment

Dizziness from loose crystals in your head

This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.


About the Author

Our philosophy for well being is looking at the holistic human experience. As such, the Swedish Wellness & Lifestyle Team is committed to shining a light on health-related topics that help you live your healthiest life. From nutrition to mindfulness to annual screenings, our team offers clinically-backed advice and tips to help you and your loved ones live life to the fullest.

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