Vertigo – the feeling of being off-balance – is a common problem in society. In fact, the Vestibular Disorders Association (which deals with problems of the inner ear, the main source of vertigo) notes that nearly a third of Americans have experienced some problem in this area. Here are the things you need to know about this sensation.
Vertigo: Symptom Or Problem?
Unlike most conditions, vertigo is primarily a symptom of problems rather than being a separate problem all by itself. There’s no physical component to vertigo. Instead, it’s best to understand the answer to “What is Vertigo?” as your brain receiving bad information from another part of your body.
As such, while the symptoms of vertigo can be debilitating, most treatments involve finding the source of the problem and treating that. Medication (to reduce dizziness) may be used to control this symptom, but treating vertigo is usually a secondary consideration.
Treatments may require several weeks (or, rarely, several months) to go into effect. You may need to adjust your lifestyle until the problem is resolved, such as by having someone else drive you to your destination. Causes of vertigo are often not covered by insurance, but you may be able to get financial assistance if your situation is bad enough to interfere with your normal routine. Talk to your insurance provider for more information on this subject.
What Causes Vertigo?
Many conditions can cause vertigo. Here are some of the most common:
Benign Paroxysmal Positional Vertigo (BPPV)
This is a condition that occurs when small bits of calcium gather in the inner ear. This is the part of the body associated with balance, and the presence of these particles can disrupt the way signals are normally transmitted to the brain.
Attacks of BPPV usually last for one minute or less and can be caused by particular movements. For example, some people trigger attacks when they sit up in bed or tilt their head in a specific direction.
This condition often resolves itself over a few weeks or months. To hasten this process, your doctor may have you perform canalith repositioning, a series of maneuvers designed to get the calcium particles away from your semicircular canals. This is effective on most patients and, once learned, can be performed at home.
If canalith repositioning fails, you may need to undergo surgery. That said, your doctor will likely suggest waiting several weeks to see if the problem resolves itself – in most cases, surgery is not necessary for resolving BPPV.
Meniere’s disease is a condition caused by an increase of fluid in the inner ear. This condition is characterized by tinnitus (ringing noises), a sensation of the ear being plugged, and short-term bouts of extreme vertigo.
This condition usually requires treatment ranging from medicine to the use of pressure-control devices. In some cases, surgery is necessary to stop it, though this often results in a permanent decrease in balance.
Meniere’s disease is more dangerous than most causes of vertigo since symptoms can be bad enough to trigger sudden falls. If you’ve developed (or think you’ve developed) this condition, you should avoid driving, stairs, and other danger spots until the issue has been resolved.
This is a condition caused by inflammation of the inner ear. Other symptoms include nausea, dizziness, and general loss of healing. From the outside, labyrinthitis looks similar to Meniere’s disease, so your doctor may need to perform several tests to determine which condition you have.
In most cases, this condition is caused by viral infections. There is no effective way of preventing it, and it can happen to anyone.
The good news is that this condition is temporary and easily controlled with medication. The majority of people will achieve a full recovery within two months and may see symptoms significantly reduced as early as one week.
This type of vertigo is caused by differences in pressure, typically between the middle ear cavities. The most common cause is blockage (partial or total) of the eustachian tube, which connects cavities and helps to regulate pressure in the inner ears. The common cold is a major source of blockage.
This type of vertigo is typically found in environments with significant pressure differences, such as while flying or diving into deeper waters. Incidents usually last from 10-60 seconds, but despite the short duration, this is enough to be dangerous.
In most cases, alternobaric vertigo resolves on its own within a few days. However, if you experience frequent cases while flying or diving, you may have a more serious condition. Treatment beyond medicine is rare, and usually takes the form of a surgically-inserted ear tube that helps to ensure balance between the middle ear’s cavities.
Vestibular Decompression Sickness
This cause of vertigo results from tissues absorbing gases at different rates, especially when ascending from a deep dive in the ocean. Most deep dives include a mix of oxygen, nitrogen, and helium, each of which has different rates of absorption within the body.
Switching between gas mixes too quickly can lead to the body “stocking up” on a gas and shifting enough to trigger decompression sickness. Vertigo is one of the symptoms of this.
Most cases of vertigo from decompression sickness are quickly resolved, but the main sickness may require oxygen therapy sometime after returning to the surface.
Can Anything Else Cause Vertigo?
Yes. Many other conditions can cause vertigo, including:
- Injury (especially to the head or neck areas)
- Disturbance of the vestibulocochlear nerve
- Medications (especially those that cause ear damage, such as some injections)
The severity of symptoms can vary. For example, a patient with cholesteatoma (a tumor-like destructive growth in the middle ear) may experience mild vertigo as their only sign that something is wrong. For this reason, you should always seek a medical examination if you experience unexplained vertigo.
How Quickly Does Vertigo Go Away?
Vertigo stops when the source of the problem stops. Depending on the cause, this could take anywhere from a few minutes to a few hours. In the majority of cases, vertigo disappears on its own (at least for a time) because your body can adjust to the changes.
For example, if you fix your gaze on an object that isn’t moving, that can ‘interrupt’ information from your inner ear that says you are moving around. Your brain constantly takes things like this into account. Unfortunately, fresh information can overwrite past information – this is why vertigo usually doesn’t stop until the source stops acting up.
How Is Vertigo Treated?
Treatment for vertigo happens in several different ways. The most common treatment, aside from simply waiting for it to subside, is using anti-dizziness medication to lessen its effects or antibiotics to treat a viral infection.
Alternatively, your doctor may suggest vestibular rehabilitation. This is a type of physical therapy used to strengthen your vestibular system and teach your brain more about how your body and head movements interact with gravity. Most people who go through this therapy will only need to do it for 8 weeks at most, but in rare cases, it may take several months of physical therapy to see results.
Additionally, chiropractors that specialize in restoring balance to the craniocervical junction frequently can help in cases of BPPV, Meniere’s, and other unexplained vertigo.
Aside from these techniques, vertigo is almost never treated directly. As a symptom, it goes away naturally if you deal with the cause, and that’s what most doctors focus on.
How Dangerous Is Vertigo?
This depends entirely on its severity. Mild cases of vertigo symptoms may result in slight feelings of nausea or dizziness, but this is no more than an inconvenience and has a minimal impact on everyday life.
Severe cases, on the other hand, can lead to falls, injuries, or death. Vertigo often strikes with little or no warning, so people who experience regular attacks have to be especially careful about how they move and where they go.
As with many conditions, vertigo is more dangerous in the elderly, the injured, and people who are otherwise at elevated risk of harm.
When Should I See My Doctor?
If you’re experiencing mild vertigo, schedule an appointment with your doctor even if the symptom doesn’t stick around. It may have been caused by something that resolved itself, but at the same time, it may be a warning sign of a more serious condition. Catching a problem early typically makes it easier to resolve, and it’s always better to be sure.
If you experience severe vertigo, have someone take you to your doctor or the emergency room immediately. Make sure to request a focused neurologic examination, which can help to locate the source of the vertigo and serve as a detector for other serious conditions. Failure to get a neurologic examination can lead to preventable deaths.
Vertigo can be frightening the first time you experience it, but remember: Most causes of vertigo are treatable. As long as you’re careful, vertigo is not likely to become a long-term problem for you.