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If you have ever been sitting on your couch or walking down the streets and suddenly became overwhelmed by a sensational feeling of room spinning often accompanied by nausea, vomiting, and loss of balance, then you might have vertigo.

Vertigo is a feeling of being off balance that is characterized with dizzy spells and sensation that either you or the world around you is spinning. Depending on what is causing the vertigo, the feeling can be intermittent but can also last for a couple of hours or even several days. Alongside dizziness, some people may experience headaches, nausea, double vision or even racing heartbeat.

Causes and Risk Factors for Vertigo

Pin-pointing the exact cause of your vertigo and what puts you at risk can substantially help your physical therapist or physician prescribed the best course of treatment. When vertigo is the result of a medical condition involving the inner ear it is referred to Peripheral Vertigo.  When vertigo originates from the brain or other region of the central nervous system it is considered Central Vertigo.  Finding out the underlying cause of your dizziness is important because it determines your physical therapy options.

Common Reasons

About 93% of episodes are diseases related to the inner ears (peripheral vertigo) such as benign paroxysmal positional vertigo (BPPV), Meniere’s disease, and vestibular neuritis.

Benign Paroxysmal Positional Vertigo (BPPV)

BPPV is the most common cause of vertigo. It is triggered when calcium carbonate crystals break free and float in the semicircular canal of inner ear.  When this occurs it causes a sensational dizziness that lasts between a few seconds to one minute. Specific head movements in certain positions relative to gravity may reproduce vertigo in people with BPPV.  While vertigo can be the result of trauma to the head the most common reason for positional vertigo is the degeneration of the inner ear that occurs with age. Vertigo that is caused by BPPV is treatable by physical therapy where a doctor guides patients into a series of exercises medically known as Canalith Repositioning Procedures. These exercises helps restore balance by shifting particles in the inner ear back into their correct location.   Treatment of positional vertigo can resolve the condition often in the matter of only a few minutes.

Vestibular neuritis / labrynthitis

It is often caused by an inner ear infection that results in inflammation around the nerves that are responsible for the body sensing and maintaining balance.  In vestibular neuronitis patients often also reports pain, pressure, or ringing of the ear as well as some loss in hearing acuity in addition to their vertigo.  When the condition effects only the balance apparatus of the inner ear it is referred to as Labrynthitis and is not associated with changes in hearing.  Treatment of these disorders requires exercises to restore normal equilibrium and balance while also working on correct ones “visual stability”

Meniere’s disease

This disease is believed to be the result of excessive fluid and pressure build up in the inner ear. It usually causes dizzy episodes along with ringing in the ears accompanied by hearing loss. People with Meniere’s disease may experience sudden and intense bouts of vertigo that can last a long time. The exact cause of Meniere’s disease is unknown, but may be associated with allergies, viral infections of the inner ear, head injuries or genetics.

Less Common Reasons

  • Stroke: A blood clot or bleeding in the brain
  • Acoustic neuroma: A tumor that grows on the nerve that runs from the inner ear to the brain.
  • Perilymphatic Fistula
  • Parkinson’s Disease
  • Diabetes
  • Multiple sclerosis (MS)
  • Otosclerosis
  • Air Pressure Changes
  • Syphilis
  • Pregnancy
  • Chiari Malformation
  • Anxiety Disorders
  • Migraine, among others


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