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Is there anything worse than feeling dizzy, off-balance and nauseous? For many people, this unsettling sensation can last for minutes — or even longer — making everyday activities difficult or impossible.
If this sounds familiar, you may be experiencing vertigo, a symptom that can arise from problems in the inner ear or brain. Vertigo can feel like the room is spinning around you, even though everything is still. This can make walking, driving or even standing safely a challenge.
Noe Nava, a physical therapist with Sharp Rees-Stealy Medical Group who specializes in treating vertigo, shares five key things everyone should know about this often-misunderstood condition:
1
Vertigo is a symptom, not a diagnosis.
People often use the term "vertigo" as if it’s a disease, but it's a symptom — the feeling that you or your surroundings are spinning or moving when they’re not.
True vertigo often includes a specific eye movement called nystagmus, characterized by the eyes making rapid, involuntary motions. If you only feel dizzy inside your head without the sensation that the world is spinning, it may be a different type of dizziness.
2
There are many causes of vertigo.
Vertigo can be triggered by several conditions, including:
Inner ear issues
Meniere’s disease (a disorder of the inner ear)
Vestibular neuritis (inner ear inflammation)
Vestibular tumors (like acoustic neuroma)
Strokes or other vascular events
However, the most common cause of vertigo is a condition called benign paroxysmal positional vertigo, or BPPV.
3
Your balance system is impacted by BPPV.
To understand BPPV, it helps to know how the vestibular system (your balance system) works.
Your sense of balance comes from signals your brain receives from your eyes, muscles, joints and the inner ear. The inner ear has two main parts related to balance, the otolith organs and the semicircular canals.
The otolith organs contain tiny calcium carbonate crystals (also called “ear rocks” or otoconia). These crystals help detect motion and gravity.
In BPPV, these crystals become dislodged from their normal place and move into the semicircular canals. This confuses the brain with false signals, making it think your head is moving even when it’s not.
4
BPPV causes confusing signals in the brain.
When the crystals end up in the semicircular canals, they can trigger nystagmus and cause your brain to receive mixed messages. While the rest of your body and one part of your inner ear say you are still, the displaced crystals signal movement.
This “sensory mismatch” causes symptoms like:
Dizziness or spinning
Nausea or vomiting
Trouble with balance
Lightheadedness
Anxiety
5
BPPV is highly treatable.
If your vertigo is caused by BPPV alone, there’s a good chance of full recovery. In some cases, the body may naturally reabsorb or settle the crystals. But more commonly, a physical therapist can treat BPPV quickly and effectively.
One of the most common treatments is the canalith repositioning maneuver (CRM), a simple, guided sequence of head and body movements. This helps move the loose crystals back to their original position. Most patients feel relief in just one to three sessions.
Not all dizziness or balance problems are related to BPPV or inner ear disorders. Other causes may include heart conditions, changes in blood pressure, medication side effects or neurological issues.
If you're feeling dizzy or off-balance, talk to your doctor. The right diagnosis is the first step to effective treatment.
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Noe Nava
Contributor
Noe Nava is a physical therapist with Sharp Rees-Stealy Medical Group.
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