HEALTH

In a spin? What you should know about vertigo

7 March, 2024 . 0

Vertigo may feel alarming, but this type of dizziness is common. Here is what causes that spinning sensation and how to treat it.

If you feel like you’re spinning around – and not in a good, Kylie Minogue kind of way – you could be suffering from vertigo.

And this type of dizziness is far more common than you might think.

What is vertigo?

Vertigo is an illusion of movement that is commonly described as a spinning sensation, The Vertigo Co principal vestibular physiotherapist Laura Power says.

“However, it may be perceived as a variety of other sensations such as rocking, bobbing, swaying, tilting, floating or tumbling,” Laura says.

It may also cause ringing in the ears (known as tinnitus), fluctuating hearing loss, nausea or vomiting.

Is vertigo a disease?

Dizziness and Balance Disorders Centre director Professor Margie Sharpe says many people incorrectly think vertigo is a disease.

“Vertigo is a symptom, like a headache, tinnitus, loss of hearing or abdominal pain,” Prof Sharpe says.

While most cases of vertigo are nothing to worry about, experts say you should always seek medical advice if you’re experiencing dizziness.

Who is more likely to suffer from vertigo?

Approximately 40 per cent of adults will experience vertigo at least once in their lifetime, and women are more likely to be affected than men.

Fluctuations in oestrogen and progesterone associated with perimenopause and menopause can result in dizziness because of their impact on various bodily systems, Laura says.

“In particular, oestrogen loss can affect calcium crystals in the inner ear, making perimenopausal and menopausal women more susceptible to benign paroxysmal positional vertigo, or BPPV,” she says.

Why do I feel dizzy?

Laura explains the feeling that you’re spinning or swaying is connected to the vestibular system – the system of balance in the inner ear.

She says the two most common causes of vertigo are BPPV and vestibular migraine.

“Vestibular migraine can cause varying types of vertigo and dizziness episodes with or without associated headache,” Laura explains.

However, Prof Sharpe adds many diseases can also cause vertigo.

This may include Ménière’s disease, a condition that could lead to dizzy spells due to a problem with the inner ear.

“Hence, it’s so important to seek medical help, irrespective of whether you are vertiginous or not at the time of the consultation,” Prof Sharpe says.

Can stress cause vertigo?

“Although this is not strongly supported by the literature, anecdotally, stress is a big trigger for vertigo attacks, particularly BPPV and vestibular migraine,” Laura says.

She explains anxiety may also cause your head to spin, with “42 per cent of people with postural perceptual dizziness (PPPD) suffering from comorbid anxiety”.

Why does my head spin when I lie down?

Laura says if you feel dizzy when lying down, it could be because of BPPV.

This happens when tiny calcium crystals in your inner ear move out of position.

“You may feel dizzy when you’re rolling in and getting out of bed, looking up or bending over,” she explains.

A vestibular physiotherapist can treat this quite successfully using repositioning manoeuvres, Laura says.

“While a small proportion of positional vertigo can be caused by … vestibular migraine, a vestibular physiotherapist will be able to differentiate between these two conditions,” she adds.

How long does vertigo last?

How long your head spins can differ from person to person, Laura says.

Ménière’s disease may cause vertigo to last for 20 minutes to 72 hours, while persistent PPPD is more of a constant sense of rocking and swaying, she explains.

“For those with BPPV, the vertigo can be very short bursts lasting around 30 seconds in certain positions,” Laura says.

“Meanwhile, vestibular migraine could take minutes, hours, days, or it could be chronic, whereby dizziness comes and does not go away.

“Vestibular neuritis vertigo generally lasts for 24 to 48 hours, followed by dizziness and unsteadiness after this time.”

How to treat vertigo

While there is a range of treatment options for vertigo, Laura says vestibular physiotherapy is one of the most effective.

This involves repositioning manoeuvres, as well as desensitisation and balance exercises to assist the brain in learning to overcome dizziness and unsteadiness.

“Sufferers may need to see a specialist neurologist called a ‘neuro-otologist’ who treats vertigo and dizziness if their symptoms do not respond to rehabilitation, or if they require medication for their symptoms,” Laura says.

Medication may include motion sickness medicine for nausea, diuretics to reduce swelling caused by fluid build-up in the inner ear in Ménière’s disease, or migraine medication to treat vestibular migraine.

“In some instances, dietary changes and supplements may also be recommended,” Laura says.

Surgery is used in some cases.

What exercises may help vertigo?

Besides repositioning manoeuvres for BPPV, Laura says there are specific vestibular rehabilitation exercises that could help with other vestibular conditions such as vestibular migraine, vestibular neuritis, Ménière’s disease or PPPD.

“This includes habituation exercises to desensitise the patient to movement and balance exercises to assist in retraining their balance, which are highly effective for these conditions,” she says.

Read more on tinnitus and migraines:

Originally written by Dimity Barber, 12 August 2022. Updated by Melissa Hong, March 2024.