why does vertigo happen?
Are you experiencing vertigo and wondering what might be causing it? Understanding the root cause of your symptoms is crucial for effective treatment and recovery. In this comprehensive guide, we'll delve into the various factors that can lead to vertigo and provide insights into what you can do next.
Vertigo is often misunderstood as a standalone condition, but it's essential to recognize that it's a symptom rather than a disease in itself. Much like describing a car problem to a mechanic, pinpointing specific details about your vertigo symptoms can significantly aid in identifying the underlying cause.
Let's break down the potential causes of vertigo into distinct categories based on the bodily systems involved, keep in mind this is not an exhaustive list, but the most common causes:
Cardiovascular System:
Often the quality of symptoms involving the cardiovascular system are described as a lightheadedness or fainting feeling as there may not be enough blood flow getting to the brain. This can be distinguished from a spinning sensation that typically involves the vestibular system. Cardiovascular system problems can often include shortness of breath, but not always.
Orthostatic hypotension: A drop in blood pressure upon standing.
Arrhythmias: Irregular heartbeats that can lead to lightheadedness.
Anemia: Reduced oxygen-carrying capacity of the blood.
Dehydration: Insufficient fluid intake affecting blood circulation.
Pulmonary System:
Pulmonary system dizziness may be similar to the description of cardiovascular dizziness, more lightheadedness, may also include shortness of breath.
Conditions such as COPD, asthma, or pulmonary hypertension can cause dizziness due to inadequate oxygen supply.
Endocrine System:
Imbalances in blood sugar levels, thyroid function, or hormone fluctuations can contribute to dizziness.
Autonomic Nervous System:
Disorders like postural orthostatic tachycardia syndrome (POTS) or vasovagal syncope can disrupt blood flow regulation and lead to dizziness.
Peripheral Vestibular System:
Benign paroxysmal positional vertigo (BPPV): Tiny calcium carbonate crystals that are supposed to reside within your vestibular system get displaced into the canals and cause dizziness.
Vestibular neuritis: Inflammation of the vestibular nerve causes a weakness or poor conduction of sensory information from the vestibular system to the brain, causing what we call a hypofunction. The discrepancy between the weakened side and the intact side causes vertigo.
Meniere’s Disease: The exact cause of Meniere's disease is not fully understood, but it's believed to involve abnormal fluid buildup in the inner ear, leading to symptoms such as vertigo, hearing loss, tinnitus (ringing in the ear), and a feeling of fullness or pressure in the ear. While it primarily affects the inner ear, Meniere's disease can have secondary effects on the vestibular system, which contributes to imbalance and difficulty spatial orientation.
Labyrinthitis, acoustic neuroma, or other inner ear disorders can also induce vertigo.
Central Nervous System:
Vestibular migraine: While pathophysiology of migraines is still not completely understood, it is thought that there is an electrical event leading changes in the flow of neurotransmitters, vascular events, and inflammation. These events can cause migraineurs to be hypersensitive to their environment, as the brain is unable to efficiently process information it receives.
3PD (Persistent Postural Perceptual Dizziness) - 3PD is a condition that occurs when the brain has difficulty processing sensory information efficiently (information from your vision, inner ear/vestibular system, and somatosensory system/weight shift in your feet). This often happens after a vestibular dysfunction such as a vestibular neuritis or with vestibular migraines, the brain has difficulty adapting back to normal.
Stroke/CVA - A stroke or cerebral vascular accident (CVA) is where there is either a blood clot (ischemic) or bleed (hemorrhagic) in the brain preventing blood from getting to a certain area. If there is no blood supply to these cells then they start to die off, interrupting connections that control our bodies such as muscle movements, speech, thought, etc. About 4-15% of all people going to the ED with dizziness have stroke/CVA as a cause.
Concussion/TBI - Head injury disrupts connections between neurons in the brain, affecting how the brain processes information and can lead to dizziness if the brain is having difficulty filtering or processing that sensory information.
Tumors, anxiety disorders, or autoimmune conditions can also manifest as vertigo.
Other Causes:
Cervicogenic dizziness: The neck gives you a sense of where you are in space (proprioception). If you have impairments in the neck (weakness, tightness, inflammation, joint misalignment), this can cause dizziness and disorientation.
Autoimmune inner ear disease: Immune system attacks on the inner ear structures.
Medication side effects can contribute to vertigo.
Understanding the multitude of factors that can lead to vertigo empowers you to take proactive steps towards recovery. By gaining insights into the underlying cause of your symptoms, you can work with your healthcare provider to develop an effective treatment plan tailored to your needs.
Remember, knowledge is key to navigating your journey towards better health and well-being. Your journey to recovery starts with understanding, so let's embark on it together.
what does vertigo feel like?
Vertigo is the sensation of movement without a stimulus, and can have many different descriptions as people often have a wide variation in how they describe their symptoms. Vertigo is most often associated with a “room spinning” sensation.
is vertigo the same as dizziness?
Vertigo is a subset of dizziness. They can be used interchangeably, although dizziness may have a few more descriptors that would fall under it. I view dizziness as a broad umbrella term that covers descriptions such as room spinning, head spinning, lightheadedness, rocking, swaying, fogginess, feeling off balance, etc. I always ask my patients to further define what they are feeling if they say they are feeling dizziness or vertigo, as those terms are too generic and not descriptive enough.
will vertigo go away on it’s own?
Often vertigo can go away on it’s own, but it depends on what is causing it (see above). In the case of BPPV, the crystals CAN spontaneously resolve themselves, but you may be waiting weeks, months or a year for that to happen. BPPV is a quick fix, I recommend you find a vestibular physical therapist near you to help you resolve it as soon as possible to reduce your risk of falls and of developing more chronic conditions.
Vertigo from a vestibular neuritis often resolves on it’s own but you can be left with a different type of dizziness with quick head movements as well as imbalance. Participating in vestibular physical therapy sooner will help you regain more function back than if you wait. The risk of waiting comes with possible development of chronic conditions like 3PD.
With concussions, 80% of cases have symptoms resolve within two weeks. If your symptoms are persisting for longer than that, see a medical professional or a physical therapist that specializes in concussion rehabilitation.
Dizziness associated with 3PD will not often go away on it’s own. It requires vestibular exercises to retrain the brain and help it process sensory information more efficiently.
who should I see for vertigo?
A vestibular physical therapist can perform an evaluation, determine what is causing your dizziness, and provide treatment. If you see a physician they will often refer you to an ENT. If the ENT specializes in vestibular disorders then they may give you a diagnosis, but most of the time, the ENT will end up sending you to a vestibular physical therapist for treatment.
Find a vestibular physical therapist near you! Check with your nearest vestibular physical therapist to see if they have direct access.
