Coping with Vertigo

Bob Dylan made headlines last year when he used a machine to sign books because he was suffering from vertigo. Vertigo rarely makes headlines, though. It is the feeling that you are moving or that the room you are in is moving. Almost 40% of Americans experience it at some point in their lives. For some people, it may be a fleeting inconvenience lasting seconds. For others, it can continue for years. 

Fear of falling

If you go to the emergency room with dizziness or vertigo, you will undergo tests to see whether you are experiencing a stroke, traumatic brain injury, or another serious health issue. If the tests are negative you will usually be sent home with advice centered on not falling.

This is useful information for acute, brief spells of vertigo. But vertigo can continue for months. How can you cope with ongoing vertigo?

Understanding vertigo

Vertigo is not an illness — it’s a symptom. It can be caused by many different conditions. Some of the most common:

  • Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. With this condition, movement is the trigger for vertigo. Some people may find that lying down triggers feelings that the room is spinning. Others feel dizzy whenever they move their heads or even their eyes. 
  • Vestibular neuronitis is usually caused by an infection, often a respiratory infection. It may be followed by episodes of BPPV.
  • Labyrinthitis is an infection of the inner ear which often leads to severe dizziness. 
  • Migraine can cause vertigo.
  • Orthostatic hypotension is a condition in which blood pressure gets much lower when you stand than when you lie down or sit. People with this condition may feel dizzy or light headed whenever they stand. 

Three systems

Balance is provided by three systems:

  • Vision. We rely on what our eyes show us to determine whether the environment we’re in is stable or not. Some visual cues, including things we see with Augmented Reality applications or in carnival rides, often cause dizziness and nausea. A lack of connection between vision and other parts of the balance system can create vertigo. Motion sickness may be related to this. 
  • Vestibular system. The inner ear is in charge of feelings of balance. This mechanism can be disordered by illness, injury, medications, and even aging. Vestibular disorders can be hard to diagnose, and sometimes the cause cannot be identified. Special exercises such as the Epley maneuver can help with this system. Over the counter medications such as meclizine or dimenhydrinate (Dramamine) can also help with nausea caused by vestibular problems.
  • Proprioception. The sense of where your body is and what your surroundings are is part of the balance system as well. Sometimes, focusing on how steady your feet feel or the strength of your leg muscles can help reduce balance problems caused by vertigo. Information from this system may reassure your brain when information from the other sources make you feel unsteady.

Concentrating on information from all three of these systems can help reduce vertigo and avoid balance problems.

Next steps

While making sure you don’t fall is important, staying active is the best way to reduce vertigo. Vestibular rehabilitation is a type of exercise therapy specifically designed to improve chronic vertigo, but any kind of movement can be beneficial. If you avoid movements that cause vertigo, the brain does not have an opportunity to recalibrate and the vertigo may not improve. 

Walking outdoors on uneven terrain helps, and looking around while walking is also helpful. Look up till you feel dizzy, for example, and then give yourself a minute to recover. Repeat the action until it no longer leads to dizziness. 

Talk with your primary care physician if vertigo continues. Chronic vertigo is a common condition. it sometimes goes away by itself, but it can often be treated with exercise. It can also be a sign of a more serious condition.