Vertigo: Why the Room Is Spinning and What it Means

Finding yourself sitting or standing in a room that won’t stop spinning can be a frightening and jarring experience. Known as vertigo, this form of dizziness may be telling you that something is amiss.

Rather than being its own medical condition, vertigo is a symptom of another condition, usually minor or temporary. The most frequent cause is a common inner ear disorder, benign paroxysmal positional vertigo (BPPV). The vertigo is caused when certain head movements – including looking upward quickly – cause the displacement of tiny particles in the inner ear.

Vertigo can also be caused by a range of other issues – some more serious than others. These include:

• Viral or bacterial inner ear infection
• Problems with structures in the inner ear
• Medication side effects
• Balance disorders
• Dehydration
• Toxin exposure
• Stroke
• Inherited genetic condition
• Brain hemorrhage
• Autoimmune disorders

Symptoms of Vertigo

The most common symptom is the sensation of spinning or the illusion of motion. You might feel like your body is moving when it isn’t. Or the room may feel like it’s moving. This can make it difficult to walk without falling, which is particularly dangerous for older people. Other symptoms include:

• Nausea and vomiting
• Balance issues
• Loss of hearing in one or both ears
• Ringing in your ears (tinnitus)
• Headaches
• Motion sickness
• Your ear may feel full
• Rapid and uncontrollable side-to-side movement of the eyes (nystagmus)   

How Is Vertigo Treated?

Vertigo typically only lasts for a short time and will usually go away on its own. There are strategies you can use at home to ease the symptoms or prevent the onset of vertigo. These include:

• Avoid rapid head movements that might trigger vertigo
• If everything is spinning, lie in a dark, quiet room
• Use an extra pillow to elevate your head while sleeping
• If you feel dizzy, sit down
• Use a cane or walking stick to avoid falling
• Turn on the lights at night if you get up

If you have severe or frequent episodes, you should talk with your doctor. Treatment will vary, based on what’s causing the vertigo. If it hasn’t gone away on its own, your doctor will perform a physical exam to narrow down the potential causes. Bloodwork and imaging tests may also be used.

Treatments include:

Medication: Symptoms may be controlled or lessened through motion sickness medications or antihistamines.

Repositioning maneuvers: BPPV is caused by tiny calcium carbonate crystals (canaliths) moving out of their normal location in your inner ear. By using a series of specific head movements, those crystals can be nudged back where they belong.

Vestibular rehabilitation therapy: A physical therapist will work with you on a range of exercises designed to improve dizziness, unstable vision, balance issues and other symptoms. This could include marching in place, techniques for controlling your eye movement, stretches and strengthening exercises. These can be done at home whenever you experience a vertigo episode.

Surgery: In rare instances, surgery may be needed if there is a serious underlying issue such as a tumor.

When It’s Serious

If you have significant vascular risk factors (including smoking, diabetes, high blood pressure, high cholesterol or a history of stroke or heart attack) and experience a sudden onset of vertigo, you should call 911 or have someone take you to an emergency room for evaluation. If it is a stroke, the sooner you seek treatment, the better your chances for a positive outcome. If, instead, you try to “sleep it off,” your treatment options may be very limited.