Vertigo is the sensation that you or your surroundings are spinning, even when you are standing still
Vertigo is not dizziness in the everyday sense—it is a specific type of spinning sensation that comes from a problem with your balance system. When you have vertigo, the world feels like it is rotating around you, or you feel like you are rotating in space. This happens because your inner ear, your eyes, or your brain are sending mixed signals about where your body is and how it is moving.
The spinning sensation can be mild or severe enough to make you fall. It may last for seconds, hours, or days depending on what is causing it. Vertigo is not a disease itself—it is a symptom that something in your balance system is not working correctly.
Key Takeaways
- Vertigo is a spinning sensation caused by problems in your inner ear, eyes, or brain's balance system, not by everyday dizziness.
- The two main types are peripheral vertigo (inner ear problems) and central vertigo (brain or nervous system problems).
- Common causes include benign paroxysmal positional vertigo (BPPV), inner ear infections, and Meniere's disease.
- A doctor can usually identify the cause through physical tests, imaging, or hearing tests.
- Treatment depends on the cause and may include head movements, medication, or addressing an underlying condition.
How your balance system works
Your body keeps you balanced using three main sources of information: your inner ear, your eyes, and sensors in your muscles and joints. Your inner ear contains fluid-filled canals that detect movement and position. Your eyes tell your brain where you are in space. Your muscles and joints send signals about your body's position.
Your brain combines all this information to keep you upright and oriented. When one of these systems breaks down or sends the wrong signal, your brain gets confused. That confusion creates the spinning sensation of vertigo.
Peripheral vertigo versus central vertigo
Peripheral vertigo comes from a problem in your inner ear or the nerve that connects it to your brain. This is the most common type. It usually causes severe spinning, nausea, and vomiting, but it is rarely dangerous. The spinning often gets worse when you move your head in certain directions.
Central vertigo comes from a problem in your brain or brainstem. This type is less common but more serious. It may be caused by a stroke, multiple sclerosis, or a brain tumor. Central vertigo often comes with other symptoms like weakness, slurred speech, or difficulty walking.
Common causes of vertigo
Benign paroxysmal positional vertigo (BPPV) is the most frequent cause. Tiny crystals in your inner ear become loose and move into the wrong part of the canal. When you move your head—especially when lying down or rolling over in bed—these crystals shift and trigger the spinning sensation. BPPV is not dangerous, though it can be very uncomfortable.
Inner ear infections can cause vertigo that develops over hours or days. Labyrinthitis and vestibulitis are infections of the inner ear or the nerve that controls balance. They often follow a cold or flu and usually improve on their own over weeks.
Meniere's disease causes a buildup of fluid in the inner ear. It brings on sudden, severe spinning attacks that can last hours, along with hearing loss, ringing in the ears, and a feeling of fullness in the affected ear. The cause is not fully understood.
Other causes include head injury, migraine, certain medications, low blood pressure, and problems with blood flow to the brain. Some people develop vertigo after a stroke or with conditions like multiple sclerosis.
How doctors identify the cause
Your doctor will start by asking when the spinning started, how long it lasts, and what movements trigger it. They will ask about other symptoms like hearing loss, tinnitus (ringing in the ears), nausea, or weakness.
The doctor will perform physical tests to see how your eyes move and how you balance. One common test is the Dix-Hallpike maneuver, where the doctor moves your head into specific positions to see if it triggers vertigo. This helps identify BPPV.
Depending on what the physical exam shows, your doctor may order imaging tests like an MRI or CT scan to rule out brain problems. They may also perform hearing tests or a test called videonystagmography, which tracks your eye movements to measure how your balance system is working.
What happens after diagnosis
Treatment depends on what is causing your vertigo. For BPPV, your doctor may teach you specific head movements called the Epley maneuver or Brandt-Daroff exercises. These movements reposition the loose crystals in your inner ear so they stop triggering the spinning sensation. Many people feel better after one or two sessions.
For inner ear infections, treatment usually involves rest, fluids, and medication to reduce nausea. Most infections clear up on their own. For Meniere's disease, doctors may recommend dietary changes, water pills, or injections into the inner ear to reduce fluid buildup.
If vertigo is caused by a more serious condition like a stroke or tumor, your doctor will refer you to a specialist and discuss treatment options for that underlying problem. In some cases, physical therapy can help your brain adjust to the balance problem and reduce symptoms over time.
When to see a doctor
See a doctor if you experience spinning sensations, especially if they are new or severe. Seek immediate medical attention if vertigo comes with chest pain, shortness of breath, severe headache, weakness on one side of your body, slurred speech, or difficulty walking. These can be signs of a stroke or other serious condition.
If you have had vertigo before and it returns in the same way, you may not need emergency care, but you should still contact your doctor. They can confirm it is the same condition and discuss whether your treatment plan needs to change.
Frequently Asked Questions
Is vertigo the same as being dizzy?
No. Dizziness is a general feeling of lightheadedness or unsteadiness. Vertigo is a specific sensation that the room is spinning or you are spinning, caused by a problem with your balance system. You can be dizzy without having vertigo, and you can have vertigo without feeling generally dizzy.
Can vertigo go away on its own?
Yes, depending on the cause. Inner ear infections often improve within weeks without treatment. BPPV may resolve on its own, though the Epley maneuver speeds recovery. Other causes like Meniere's disease or central vertigo may require ongoing treatment or may improve slowly over time.
What should I do if I feel vertigo coming on?
Sit or lie down immediately to prevent falling. Keep your eyes focused on a fixed point if possible. Avoid sudden head movements. If the spinning is severe or you have other symptoms like weakness or difficulty speaking, call for emergency help.
Can medication stop vertigo?
Medication can reduce nausea and help you feel more comfortable, but it does not usually treat the underlying cause. For BPPV, head movements work better than medication. For other causes, treating the underlying problem—like an infection or fluid buildup—is more effective than medication alone.
Will vertigo come back?
That depends on the cause. BPPV can return, sometimes years later. Inner ear infections typically do not recur. Meniere's disease often comes and goes in episodes. If vertigo is caused by a chronic condition like migraine, it may return periodically. Your doctor can discuss the likelihood of recurrence based on your specific diagnosis.