Buzz
Vertigo strikes unexpectedly, causing a sensation of spinning, or perhaps making you feel as if the world is turning around you. Your stomach churns, and you instinctively grab onto something to prevent falling. This is vertigo—a distorted perception of motion, where the signals from your eyes, inner ears, and sense of touch are in conflict with reality. Vertigo is not a disease but a symptom that indicates an underlying issue with the body, and it occurs more often than you may think. Here’s what you should understand about this condition.
1. VERTIGO ISN'T SIMPLY DIZZINESS.
Dizziness is a broad term that refers to the feeling of lightheadedness or faintness. Many of us, as children, experienced (and even enjoyed) this basic type of dizziness while spinning on a merry-go-round. However, it can also be triggered by dehydration, motion sickness, or a sudden drop in blood pressure when standing too quickly.
While vertigo does cause dizziness, it also leads to feelings of spinning, swaying, or tilting. Some individuals with vertigo feel as though their bodies are moving in space even when they are standing still, while others perceive their surroundings shifting around them. A good way to distinguish vertigo from mere dizziness is that it often comes with nausea: 'A person with vertigo can experience nausea, vomiting, and other symptoms similar to motion sickness,' says David Zee, a neurologist at Johns Hopkins University and an expert in vertigo.
2. IT'S A DISORDER OF THE VESTIBULAR SYSTEM.
The term refers to the system within the inner ear and brain that is responsible for controlling balance and eye movements. The most common vestibular disorders often lead to vertigo. Other conditions include bilateral vestibular hypofunction (which causes issues with balance), acoustic neuroma (a benign tumor that can result in tinnitus or hearing loss), and a variety of autoimmune inner ear diseases.
3. TINY PARTICLES IN YOUR HEAD CAUSE MOST CASES OF VERTIGO…
Doctors classify vertigo into two types: peripheral and central. The former, originating in the inner ear, is much more common than the latter.
The most prevalent form of peripheral vertigo is benign paroxysmal positional vertigo (BPPV). BPPV appears suddenly, causing disorientation and unsteady movement; some even fall out of bed. (It can be mistaken for a stroke, and for good reason—experiencing sudden vertigo and loss of balance at the same time can be symptoms of a stroke.) Most episodes last for about a minute and tend to reoccur over several days or weeks.
Most cases of peripheral vertigo are triggered by otoconia (also known as canaliths), tiny crystals of limestone and protein found deep within the vestibule of the ear. To see a single otoconium, you'd need a microscope with high magnification—they’re about 10 microns wide, or roughly 0.000393701 inches. Despite their minuscule size, 'otoconia cause quite a bit of trouble,' says Zee. 'These small stones can become dislodged and float around, creating a strong sensation of spinning.'
While many of us likely have a few stray stones drifting around in our inner ears, problems arise when large clusters of three or more stones dislodge and move. The exact reason why they become dislodged is still unclear, but in some cases, external movement—such as a bump to the head or a ride on a rough road—can set the stones in motion.
4. … BUT THERE ARE OTHER TRIGGERS.
Migraine headaches can provoke the dizzying sensation, as can exposure to the magnetic field within an MRI machine. Other potential causes include labyrinthitis, an infection in the inner ear, and vestibular neuronitis, an infection of the vestibular nerve, which is responsible for balance. Some individuals experience a rare form of chronic peripheral vertigo known as Menière’s disease, which is caused by a buildup of fluid in the inner ear. In many instances, doctors are unable to determine the exact cause of a vertigo episode.
5. A CERTAIN TYPE OF VERTIGO CAN LAST A LIFETIME—BUT THIS IS RARE.
Central vertigo, though rare, originates from the brain and can cause severe imbalance, often leaving a person unable to walk. A key symptom is involuntary eye movement, known as nystagmus. This type of vertigo may result from brain conditions or injuries like multiple sclerosis, strokes, concussions, or tumors. In some cases, it can persist for weeks or even become a lifelong condition, particularly if there's lasting brain damage.
6. Vertigo affects millions of people across all age groups.
Around one-third of individuals over 40 in the U.S., approximately 69 million people, will experience vertigo at least once in their lifetime. It becomes more prevalent with age, especially in those over 60, but it can affect anyone, including children, although spotting it in kids can be more difficult due to their struggle to describe symptoms. Notable figures such as golfer Jason Day, who was 27 during the U.S. Open, and basketball player Pau Gasol, in his early thirties, both dealt with vertigo. Some medical historians suggest that Charles Darwin may have suffered from vertigo in his later years.
7. Women are three times more likely to experience vertigo than men, but the exact reason remains unknown.
Recent studies indicate that this gender disparity might be linked to bone loss from aging, vitamin D deficiency (which disrupts calcium metabolism—a crucial element in the otoconia’s mineral makeup), or the higher prevalence of migraines among women.
8. Vertigo can be extremely distressing.
Because it causes such disorientation and strikes so unexpectedly, vertigo often leads to anxiety and panic attacks. For some, chronic vertigo can result in depression, as everyday activities—like personal care, looking after family, or even going to work—become impossible. In severe cases, this may even lead to job loss, as tasks like driving are no longer feasible.
9. Certain medications may offer some relief…
Treatment options depend on the type of vertigo someone is experiencing, with most medications targeting the symptoms rather than addressing the underlying cause. Antiemetics, such as meclizine, can help manage nausea and vomiting common with many forms of vertigo. For migraine-associated vertigo, beta blockers, anticonvulsants, or antidepressants might be prescribed. Those with Meniere's disease could benefit from steroids or non-medication treatments, including a low-salt diet to reduce fluid retention or surgical options to alleviate pressure in the inner ear.
10. … But physical therapy is the only treatment that truly helps in most cases of vertigo.
The Epley maneuver (also known as canalith repositioning) is the most frequently used therapy for BPPV. This procedure is essentially a human version of the ball-in-a-maze puzzles you may have played as a child, where you had to roll a bead through a maze to get it into a hole. The goal of this therapy is to guide the dislodged otoconia (the beads) through the maze of inner ear canals and return them to the vestibule (the hole). The process usually takes less than 15 minutes and can resolve symptoms in more than two-thirds of vertigo patients, often after just a few attempts.
11. Dancing can improve symptoms.
As you age, you lose neurons in your inner ears, brain's coordination center, and even in your feet—a combination of losses that can lead to balance issues. However, activities that challenge your balance, such as tai chi, yoga, or dancing, are beneficial in the long run. You don’t need to be as graceful as Johnny Castle doing log dancing or Frank Slade doing the tango—just move to the rhythm when your favorite tunes play.
12. Vertigo doesn’t stop a Guinness World Record holder from climbing buildings.
In 1982, French climber Alain Robert suffered severe injuries when he fell from a cliff during a climb. Although he healed from numerous broken bones, the head trauma left him with chronic vertigo. Despite this, Robert returned to climbing—often without safety equipment—and scaled iconic structures like the Empire State Building, the Eiffel Tower, and many others. He eventually conquered the Burj Khalifa, the world’s tallest building, and now holds the Guinness World Record for climbing the most buildings.
13. In Vertigo, Hitchcock got the special effects right but misinterpreted the condition.
Considered the 'greatest film of all time' by the British Film Institute’s Sight and Sound magazine, Vertigo, starring Jimmy Stewart and Kim Novak, is a psychological thriller full of suspense, mystery, and romance—quintessential Hitchcock. The film is also famous for introducing the 'dolly zoom,' or 'Vertigo effect,' a groundbreaking camera technique designed to simulate the disorienting sensation of vertigo. However, while Hitchcock nailed the special effects, the condition that Stewart’s character experiences is not vertigo—it’s acrophobia, a fear of heights. People with acrophobia may feel dizzy when looking down from a great height, but they are not experiencing a vestibular disorder. This sensation is likely tied to the human instinctual fear of falling.
