Vertigo is a sensation of spinning and dizziness. It may cause balance problems and nausea. Vertigo stems from a problem with the inner ear, brain, or sensory nerve pathway. Possible causes include labyrinthitis, pregnancy, and stroke.

Dizziness, including vertigo, can happen at any age, but it is common in people aged 65 yearsTrusted Source or over.

People may experience vertigo temporarily or long term. It can occur during pregnancy or as a symptom of an ear infection. People with an inner ear disorder, such as Ménière’s disease, sometimes also experience vertigo.

Keep reading to learn more about vertigo, including the various potential causes, treatments, and some useful exercises.

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Vertigo is a common sensationTrusted Source of spinning dizziness. A person may feel as though the room or surrounding environment is spinning in circles around them. Many people use the term to describe a fear of heights, but this is inaccurate.

Vertigo can happen when a person looks down from a great height, but the actual term vertigo usually refers to any temporary or ongoing spells of dizziness due to problems in the inner ear or brain.

Vertigo is not an illness but a symptom of an underlying condition. Many different conditions can cause vertigo.

A person with vertigo feels as though their head or the space around them is moving or spinningTrusted Source.

Vertigo is a symptom, but it can also lead to or occur alongside other symptoms.

These may include:

  • balance problems
  • lightheadedness
  • a sense of motion sickness
  • nausea and vomiting
  • ringing in the ear, called tinnitus
  • a feeling of fullness in the ear
  • headaches
  • nystagmus, where the eyes move uncontrollably, usually from side to side

Vertigo can last for varying amounts of timeTrusted Source, from just a few seconds to several days, depending on the underlying cause. Most often, it lasts a couple of seconds or minutes.

Various conditions can lead to vertigo, which usually involves either an imbalance in the inner ear or a problem with the central nervous system (CNS).

Conditions that can lead to vertigo include the following.

Labyrinthitis

This disorder can happenTrusted Source when an infection causes inflammation of the inner ear labyrinth. Within this area is the vestibulocochlear nerve.

This nerve sends information to the brain about head motion, position, and sound.

Apart from dizziness with vertigo, a person with labyrinthitis may experience hearing loss, tinnitus, headaches, ear pain, and vision changes.

Vestibular neuritis

An infection causes vestibular neuritisTrusted Source, which is inflammation of the vestibular nerve. It is similar to labyrinthitis but does not affect a person’s hearing. Vestibular neuritis causes vertigo that may accompany blurred vision, severe nausea, or a feeling of being off-balance.

Cholesteatoma

This noncancerous skin growth develops in the middle ear, usually due to repeated infection. As it grows behind the eardrum, it can damage the middle ear’s bony structures, leading to hearing loss and dizziness.

Ménière’s disease

This disease causes a buildup of fluid in the inner ear, which can lead to attacks of vertigo with ringing in the ears and hearing loss. It tends to be more common in people between 40–60 years oldTrusted Source.

The National Institute on Deafness and Other Communication Disorders estimatesTrusted Source that 615,000 people in the United States currently have a diagnosis of Ménière’s disease, with doctors diagnosing about 45,500 new cases annually.

The exact cause is unclear, but it may stem from blood vessel constriction, a viral infection, or an autoimmune reaction. There may also be a genetic component, meaning that it runs in some families.

Benign paroxysmal positional vertigo (BPPV)

The otolith organs are structures within the inner ear that contain fluid and particles of calcium carbonate crystals.

In BPPV, these crystals become dislodged and fall into the semicircular canals. There, each fallen crystal touches sensory hair cells during movement.

As a result, the brain receives inaccurate information about a person’s position, and spinning dizziness occurs. People typically experience periods of vertigo that last less than 60 seconds, but nausea and other symptoms may also arise.

Other factors

Vertigo can also occur with:

  • migraine headaches
  • a head injury
  • ear surgery
  • perilymphatic fistula, when inner ear fluid leaks into the middle ear due to a tear in either of the two membranes between the middle ear and inner ear
  • shingles in or around the ear — herpes zoster oticus
  • otosclerosis, when a middle ear bone growth problem leads to hearing loss
  • syphilis
  • ataxia, which is the result of muscle weakness
  • a stroke or a transient ischemic attack, which people sometimes refer to as a ministroke
  • cerebellar or brain stem disease
  • acoustic neuroma, which is a benign growth that develops on the vestibulocochlear nerve near the inner ear
  • multiple sclerosis

Nausea and dizziness are usual problems during pregnancy. Hormonal changes appear to play a role, as they affect the characteristics of the fluid in the body and cause blood vessels to relax and widen.

These changes increase the blood flow to the developing baby, but they also mean a slow return of blood in the veins to the rest of the body. As a result, an individual’s blood pressure is lower than usual, which reduces blood flow to the brain. This can cause temporary dizziness.

Changes in fluid characteristics in the inner ear can lead to symptoms such as:

  • vertigo
  • instability with loss of balance
  • tinnitus and hearing difficulties
  • a feeling of fullness in the ear

Low blood sugar in pregnancy can also lead to dizziness. People who are anemic may be more prone to dizziness than others.

During pregnancy, hormonal changes bring about alterationsTrusted Source in the inner ear. These can cause issues with balance and symptoms of nausea and dizziness. Changes in body weight and posture during pregnancy may also contribute to balance problems.

In a 2017 reviewTrusted Source involving four case studies, the authors suggest that hormonal changes may lead to BPPV during pregnancy. Estrogen, specifically, may also play a role.

Vertigo itself is not necessarily hereditary. However, it could be a symptom of various hereditary conditions and syndromes. Therefore, a doctor may ask a person with vertigo about their family medical history.

Scientists have recently discovered six gene variantsTrusted Source they associate with vertigo. These genes play a role in inner ear development, maintenance, and problems.

Examples of conditions that can trigger vertigo and appear to involve genetic factors include:

Vestibular migraine can involve vertigo. Find out more about this condition here.

Some types of vertigo resolve on their own, but a person may need treatment for an underlying issue.

A doctor may, for example, prescribe antibiotics for a bacterial infection or antiviral drugs for shingles.

Medications are available that can relieve some symptoms. These drugs include antihistamines and antiemetics to reduce motion sickness and nausea.

An individual may need surgery if other treatments do not help. If someone has BPPV or acoustic neuroma, doctors may recommend surgery.

Antihistamines are available over the counter or to purchase online.

Treating Ménière’s disease

A doctor may prescribe medication for people with Ménière’s disease. These may includeTrusted Source meclizine, glycopyrrolate, or lorazepam, which can help relieve dizziness due to this condition.

Other options include:

  • limiting sodium intake and using diuretic therapy to reduce fluid levels
  • trying pressure pulse treatment, which involves fitting a device to the ear
  • having a doctor inject antibiotics or corticosteroids into the middle ear
  • avoiding caffeine, chocolate, and alcohol and not smoking tobacco

Individuals can take measures at home to help resolve vertigo and limit its effects.

Lifestyle changes

Steps that can help reduce the effects of vertigo include:

  • lying still in a quiet, dark room when the spinning is severe
  • sitting down as soon as the feeling of dizziness appears
  • taking extra time to perform movements that trigger symptoms, such as getting up, looking upward, or turning the head
  • squatting instead of bending over to pick something up
  • using a cane when walking
  • sleeping with the head raised on two or more pillows
  • making adaptations in the home
  • turning on lights when getting up at night to help prevent falls

Anyone who experiences vertigo or other types of dizziness should not drive or use ladders.

Herbal remedies

Some herbal solutions may help improve symptoms. These include:

There is not enough evidence to confirm that herbal remedies can relieve vertigo. However, a clinical trial is currently underway to investigate the effects of Gongjin-dan.

A 2015 studyTrusted Source found that 30 minutes of acupuncture helped reduce symptoms in 60 people who visited an emergency department with dizziness and vertigo. However, more research is necessary to confirm the effectiveness of this treatment method.

People should ask their doctor before using any alternative treatments. They should also consult a doctor if vertigo starts suddenly or worsens, as they may need treatment for an underlying condition.

Learn more about home remedies for vertigo.

Exercises can help relieve symptoms in some cases.

The Epley maneuver for BPPV

A technique known as the Epley maneuverTrusted Source can help some people with vertigo that stems from BPPV.

It aims to move calcium carbonate particles from the semicircular canals back to the otolith organs of the vestibule, where they are less likely to cause symptoms in the inner ear.

For BPPV involving the left inner ear:

  1. Sit on a bed and place a pillow behind the body where the shoulders will be while lying down.
  2. Rotate the head 45 degrees to the left.
  3. Keeping the head in position, lie down on the back with the shoulders on the pillow so that the head tilts back slightly and touches the bed. Hold for 30 seconds.
  4. Rotate the head to the right by 90 degrees and hold for 30 seconds.
  5. Turn the body and head, in their current positions, 90 degrees to the right. Hold for 30 seconds.
  6. Slowly sit up and lower the legs on the right-hand side of the bed.
  7. Hold for a couple of minutes while the inner ear makes adjustments.

There are different typesTrusted Source of vertigo, which vary in their cause.

Peripheral vertigo

This type of vertigo accounts for about 80% of cases. Peripheral vertigo usually results from problems in the inner ear.

Tiny organs in the inner ear respond to gravity and the person’s position by sending messages via nerve signals to the brain. This process enables people to keep their balance when they stand up.

Changes to this system can produce vertigo. BPPV and inflammation are common causes. Other causes include Ménière’s disease and acoustic neuroma, among others.

Central vertigo

Central vertigo relates to problems with the CNS. It usually stems from a problem in a part of the brain stem or cerebellum. Approximately 20% of cases are of this type.

Possible causes include vestibular migraine, demyelination, and tumors involving the affected CNS region or regions.

A problem with the cervical spine can also lead to vertigo. Learn more here.

A doctor needs to determine the underlying cause of the dizziness. Therefore, they may carry out a physical examination, ask the person how their dizziness makes them feel, and take their medical history.

The doctor may also carry out some simple tests, including:

  • Romberg’s testTrusted Source: The doctor asks the person to stand with their arms by their sides and feet together, then to close their eyes. If the person then becomes unsteady, this could signal a CNS problem.
  • Fukuda-Unterberger’s testTrusted Source: The doctor asks the person to march on the spot for 30 seconds with their eyes closed. If they rotate to one side, this may indicate a lesion in the inner ear labyrinth, which could cause peripheral vertigo.

Depending on the results of these and other tests, the doctor may recommend a head CT or MRI scan to obtain more details.

Q:

I am 64 years old, and I have recently started feeling dizzy and sick all of the time. I have had tests on my ears, but the doctors have not found anything. I am a gardener, but I am finding it hard to work or do my daily tasks. What could it be, and what can I do?

A:

The cause of your dizziness may take time to figure out. There could be multiple contributing factors, such as aging, dehydration, environmental factors, or an underlying medical disorder.

Keeping a journal may help you pinpoint certain times or situations during which you experience symptoms of dizziness. Journaling details about the surrounding environment, the type of dizziness — for example, whether the room spins, whether you feel off-balance, etc. — and any other symptoms, such as nausea, vomiting, or fatigue, may provide insight as to what is happening in your body during these episodes.

A doctor can work with you to help understand why you have these symptoms.

Stacy Sampson, DOTrusted Source Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Vertigo is a feeling of spinning dizziness, but it may also mean someone feels lightheaded, sick, or has ear problems.

Vertigo is a symptom of various conditions where someone has a problem with the inner ear, brain, or sensory nerve pathway.

Conditions that may cause vertigo include labyrinthitis, vestibular neuritis, Ménière’s disease, and benign paroxysmal positional vertigo (BPPV). Some individuals experience vertigo when they are pregnant.

Sometimes vertigo resolves on its own. Other times a doctor recommends medication or lifestyle changes to help. They may also advise surgery under some circumstances.