Vertigo: How to Manage the Condition When Your World Starts Spinning

For those who’ve experienced it—roughly 20-30% of the population—just hearing the word vertigo is likely to elicit a groan.

More intense than just feeling a bit dizzy or lightheaded, vertigo makes it feel like the world is spinning even when you’re completely still. People with vertigo often experience:

► An intense sensation the world is spinning

► Difficulty walking; falls are also common

► Trouble focusing 

► Nausea and vomiting

► Shivering

► Hearing loss in one or both ears

► Ringing in the ears 

Symptoms often intensify when the head is moved. Vertigo can last for a few seconds, a few hours, and in severe cases, it can stick around for days or months.

Interestingly, vertigo is not a condition itself, but rather a symptom of other issues.

The most frequent culprits behind vertigo are inner ear problems. Here are some common causes:

1. Benign Paroxysmal Positional Vertigo (BPPV): This tongue-twister of a condition occurs when tiny calcium particles in your inner ear get dislodged and become trapped in your semicircular canals (inner ear structures that control balance). 

BPPV often goes away on its own but, if not properly treated, it can recur—sometimes months, sometimes years—after the first incident.

2. Ménière’s Disease: A chronic inner ear disorder, Ménière’s disease causes recurrent episodes of vertigo, hearing loss and tinnitus (ringing in the ears). Episodes may last a few minutes or for several days. Symptoms may worsen over time and permanent hearing loss and chronic balance issues may be experienced.  
3. Vestibular Neuritis or Labyrinthitis: Both conditions are typically caused by viral infections that lead to inflammation of the inner ear.

Other less common causes include migraines, head or neck injuries, and certain medications.

If you're experiencing vertigo, it's a good idea to see your doctor who can help determine the underlying cause and recommend appropriate treatment. Often, vertigo resolves on its own as your brain adapts to the changes in your inner ear. However, if you’re not that fortunate, there are several treatment options available:

1. Vestibular Rehabilitation: This type of physical therapy helps train your brain to compensate for inner ear problems.
2. Canalith Repositioning Maneuvers: For BPPV, specific head movements can help move those pesky calcium particles back where they belong. There are a number of how-to videos for performing these maneuvers safely at home.
3. Medications: In some cases, drugs may be prescribed to relieve symptoms like nausea or to address underlying causes.

If you're prone to vertigo, there are some practical steps you can take to manage your symptoms and stay safe:

► Move slowly and carefully, especially when changing positions

► Use good lighting, particularly at night

► Consider using a walking stick if you're at risk of falling

► Stay hydrated and get enough rest

► Practice relaxation techniques to reduce stress

Remember, while vertigo can be disruptive, it's often manageable and treatable. If you're experiencing persistent or severe symptoms, don't hesitate to seek medical advice. With the right approach, you can keep your world from spinning out of control and get back to enjoying life on solid ground.

Alison Camarda, MSN, RN, NPD-BC, CEN, CPEN, SANE is the director of clinical education at Southwestern Vermont Medical Center