What Is Vertigo and What Causes It: Symptoms & Triggers Explained

Okay, let's talk vertigo. That awful spinning feeling when you're standing perfectly still? I remember my first episode – washing dishes when suddenly the kitchen tilted like a funhouse. Grabbed the counter thinking it was an earthquake. Turned out it was my own brain playing tricks. If you're here wondering "what is vertigo and what causes it," you're not alone. This isn't just "dizziness." This is your world literally turning upside down.

What Vertigo Actually Feels Like (No Sugarcoating)

Vertigo isn't just feeling lightheaded after standing up too fast. It's a specific type of dizziness where you feel like either:

• You're spinning (like you just got off a wild carnival ride)
• The room is spinning around you (walls and floor doing a crazy dance)
• Tilting or swaying (like walking on a boat in choppy water)

It often hits without warning. Brushing your teeth? Boom. Looking up at a shelf? Spinning. It can last seconds, minutes, or even hours. Nausea is super common too – your brain gets motion sickness from the false movement signals. Not fun. Frankly, it can be terrifying when it first happens.

The Real Culprits: Why Your Balance System Freaks Out

Here's where many articles get fuzzy. Explaining "what is vertigo and what causes it" needs specifics. Most causes boil down to glitches in your vestibular system – the inner ear and brain network controlling balance. Think of it like a gyroscope gone haywire.

The Usual Suspect: Benign Paroxysmal Positional Vertigo (BPPV)

This is the big one. Causes about 20% of vertigo cases. Imagine tiny calcium crystals (otoconia) in your inner ear. They're supposed to stay put. Sometimes they break loose and float into the fluid-filled canals sensing head rotation. Wrong place, wrong time.

• Triggers: Rolling over in bed, tipping head back (like at the hairdresser), bending down. Position changes are key.
• Duration: Short bursts – usually 15-60 seconds of intense spinning.
• My Experience: My BPPV flares up every few years. Rolling onto my left side? Immediate spinning. Annoying but treatable.

Inner Ear Inflammation: Vestibular Neuritis and Labyrinthitis

Often starts after a cold or flu virus. Inflammation damages the vestibular nerve or inner ear labyrinth.

• Horrible Onset: Waking up to severe spinning, vomiting, can't walk straight. Lasts days to weeks.
• Scary Part: Mimics stroke symptoms. Go to ER if sudden vertigo comes with: Double vision, slurred speech, severe headache, arm/leg weakness, facial drooping.

Meniere's Disease: Pressure Build-Up

Caused by excess fluid (endolymph) in the inner ear chambers. Creates pressure bursts.

• Classic Triad: Vertigo attacks (20 mins - 24 hrs), Fluctuating hearing loss (usually low tones), Ear fullness/pressure (like being underwater), Tinnitus (ringing).
• My Friend's Struggle: She avoids salty foods religiously now. Salt makes her body retain more fluid, worsening the pressure.

Vestibular Migraine: It's Not Just a Headache

Yep, migraines can cause vertigo WITHOUT the headache pain. Brain's electrical misfiring affects balance centers.

• Pattern Matters: Vertigo usually lasts minutes to hours and happens alongside other migraine symptoms (light/sound sensitivity, aura, nausea) or between headache attacks.
• Trigger Central: Stress, lack of sleep, certain foods (aged cheese, wine, MSG), hormones, bright lights.

Honestly? This one is tricky to diagnose. Many doctors miss it.

Less Common (But Important) Causes

While the inner ear is the main battlefield, vertigo can signal other issues:

• Blood Pressure Spikes/Drops: Sudden drops when standing (orthostatic hypotension) cause lightheadedness sometimes confused with vertigo. True vertigo feels like movement.
• Medication Side Effects: Some antibiotics (gentamicin), diuretics, antidepressants, blood pressure meds, even aspirin in high doses. Check your meds!
• Head or Neck Injury: Whiplash or concussion can damage inner ear structures or nerves.
• Perilymph Fistula: Tiny tear between inner and middle ear (leaking fluid). Can happen after pressure changes (scuba diving, heavy lifting), head injury, or ear surgery. Causes unsteadiness worse with activity.
• Acoustic Neuroma: Rare, non-cancerous tumor on the nerve connecting ear to brain (<1% of vertigo cases). Usually causes gradual hearing loss/tinnitus and imbalance rather than violent spinning.
• Anxiety/Panic Attacks: Can trigger dizziness and sensations similar to vertigo (derealization). It's a vicious cycle – vertigo causes anxiety, anxiety worsens dizziness.

How Doctors Actually Figure Out "What Is Vertigo and What Causes It"

Diagnosing vertigo isn't guesswork. Doctors use specific tests:

The Physical Exam Goldmine

• Dix-Hallpike Maneuver: The gold standard for BPPV. Doctor quickly lays you back with head turned. Watching for specific eye movements (nystagmus) confirms which ear and canal has loose crystals. I felt silly doing it, but it pinpointed my BPPV immediately.
• Head Impulse Test (HIT): Doctor gently jerks your head side-to-side while you focus on their nose. If your eyes jump off target, it indicates nerve inflammation (like vestibular neuritis).
• Romberg Test & Fukuda Stepping: Tests balance with eyes open/closed and marching in place. Checks how well your brain compensates.
• Hearing Test (Audiometry): Crucial to spot Meniere's or acoustic neuroma.

When Scans Are Needed

• MRI: Not routine! Usually only if stroke, MS, or tumor is suspected (e.g., if you have neurological symptoms like weakness or slurred speech along with vertigo).
• CT Scan: Checks for skull fracture after trauma. Less useful than MRI for inner ear/brain tissue.
• Videonystagmography (VNG) or Electronystagmography (ENG): Records eye movements with infrared goggles. Pinpoints inner ear weakness by tracking responses to warm/cold water/air in ears (caloric test).

Don't be surprised if your doctor does a lot of watching your eyes. They reveal a ton about the inner ear problem.

Getting Back on Solid Ground: Fixing Vertigo

Treatment depends entirely on the "what causes it" part of "what is vertigo and what causes it."

Vestibular Rehab Therapy (VRT): This is physio for your balance system. Doesn't matter what caused your vertigo – if you've had it chronically, VRT is gold. Exercises retrain your brain to use vision and body senses better when the inner ear is wonky. Takes commitment, but worth it.

Your Vertigo Survival Kit: Practical Daily Stuff

Living with vertigo means adapting. Here’s what actually helps:

• Home Safety:
  • Nightlights everywhere (bathroom path is critical). Getting up to pee at 3 AM while dizzy? Not fun.
  • Non-slip mats INSIDE the shower/tub and outside.
  • Grab bars in shower/toilet area. Not just for grandma.
  • Keep floors clutter-free.
• During an Attack:
  • Sit or lie down immediately. Don't fight it.
  • Focus on a stationary point (a spot on the wall).
  • Avoid bright lights and screens. Darkness can help.
  • Sip cold water. Dehydration worsens it.
  • Deep, slow breathing. Panic amplifies the spinning.
• Driving: Please don't drive during an attack or when feeling unstable. Pull over if it hits. Talk to your doctor about safety.

Top Habits That Actually Prevent Flare-Ups

• Hydrate Like It's Your Job: Dehydration thickens inner ear fluid. Aim for 2+ liters daily.
• Sleep More Than You Think You Need: Lack of sleep is a major vertigo trigger, especially for migraines. Seriously.
• Manage Stress Relentlessly: Yoga, meditation, walks – whatever works. Cortisol messes with inner ear fluid.
• Limit Salt & Caffeine (Especially for Meniere's): Salt holds fluid, caffeine can spike anxiety/migraines.
• Move Slowly: No sudden head turns or position changes. Be deliberate.
• Do Your VRT Exercises Daily: Consistency beats intensity.

It's annoying, I know. But these lifestyle tweaks make a measurable difference for many people.

Your Vertigo Questions Answered (FAQs)

Q: What is vertigo and what causes it?
A: Vertigo is the sensation of spinning, tilting, or swaying when you're stationary. It's caused by problems in the inner ear (like loose crystals, fluid buildup, or inflammation) or the brain pathways processing balance signals. Common causes include BPPV, Meniere's disease, vestibular neuritis, and vestibular migraines.

Q: How long does a vertigo episode usually last?
A> It totally depends on the cause. BPPV spells last seconds to a minute. Vestibular neuritis spins for days. Meniere's attacks can be 20 minutes to 24 hours. Migraine vertigo might last hours. Chronic vertigo can persist for weeks/months if not treated.

Q: Is vertigo a sign of something serious like a stroke?
A> Vertigo itself is usually NOT a stroke. However, *sudden* vertigo *combined with* new weakness/numbness on one side, severe headache, double vision, slurred speech, or facial drooping IS a medical emergency (call 911). Don't panic, but know the red flags.

Q: Can stress and anxiety cause vertigo?
A> Yes and no. Anxiety doesn't directly cause inner ear damage like BPPV. But chronic stress can trigger vestibular migraines or worsen Meniere's symptoms. Anxiety also heightens dizziness perception and makes recovery harder. It's a vicious cycle.

Q: What's the difference between dizziness and vertigo?
A> Dizziness is broad: lightheadedness (feeling faint), imbalance (unsteadiness), disorientation. True vertigo specifically means the false sensation of movement – you or the world is spinning/tilting/swaying. Vertigo is a *type* of dizziness.

Q: Should I get an MRI for vertigo?
A> Not usually first-line. Doctors rely heavily on physical exams and hearing tests. MRIs are typically ordered only if stroke, tumor (like acoustic neuroma), or MS is suspected (based on other neurological symptoms). Don't insist on one unless your doctor sees a reason.

Q: Can earwax cause vertigo?
A> Not directly. Severe earwax blockage might cause muffled hearing or mild imbalance, but not violent spinning vertigo. If vertigo starts AFTER ear syringing, it could be due to water temperature affecting the inner ear or a rare complication.

Q: Are there any home remedies for vertigo?
A> For BPPV, specific maneuvers (like Epley) done correctly at home can help (find a good physical therapist to teach you first!). Ginger (tea, capsules) can ease nausea. Hydration and rest are crucial. But don't ignore it – see a doc for diagnosis. Home remedies won't fix Meniere's or neuritis.

Finding clear answers to "what is vertigo and what causes it" can be tough. I wrote this because when I was spinning, I needed practical info, not jargon. Getting the right diagnosis is step one. Treatments exist. Life gets back to normal. Stick with it.