preventing vertigo

Overview

Vertigo is a false feeling that you or your surroundings are spinning or moving. It feels like motion even when you are perfectly still. Vertigo is a symptom, not a disease itself. It often points to a problem in the inner ear, which is your body's balance center.

Vertigo is quite common. At least 1 in 10 people will experience vertigo at some point in their lives. It becomes more frequent as people get older.

Vertigo can affect anyone, but it is more common in adults over 50, and some forms occur more often in women. People with migraines or a history of ear infections may also be more prone.

Symptoms

Common symptoms

• A spinning or whirling sensation, either in yourself or the room
• Feeling off-balance or unsteady on your feet
• Nausea or vomiting
• Dizziness or lightheadedness
• Sweating
• Difficulty focusing your eyes
• Headache or a feeling of pressure in the ear

Symptoms in children

• Children may say they feel 'wobbly' or 'like a merry-go-round'
• They might stagger, hold onto furniture, or sit down suddenly
• Pale skin, nausea, or vomiting
• Complaints of a funny feeling in their ears or head

Symptoms in older adults

• Greater risk of falls and injuries
• Feeling unsteady even when sitting or lying down
• May have trouble walking or getting up from a chair
• Can be accompanied by hearing changes or ringing in the ears

Causes

Main causes

• Benign paroxysmal positional vertigo (BPPV) – tiny calcium crystals in the inner ear get dislodged and move into the wrong canals, causing brief spinning with head movements
• Vestibular neuritis – inflammation of the inner ear nerve, often after a viral infection
• Meniere's disease – a buildup of fluid in the inner ear that can also cause ringing and hearing loss
• Migraine-related vertigo – some people with migraines get vertigo with or without a headache
• Head injury that damages the inner ear or balance nerves
• Less common causes: stroke, brain tumors, or certain medications that affect the ear or balance

Risk factors

• Being over the age of 50
• Having had a previous head injury
• Viral infections of the ear or upper respiratory tract
• Migraine attacks, especially in those prone to them
• Family history of Meniere's disease or other balance disorders
• Certain medications that can affect balance (ask your doctor or pharmacist if you're concerned)

When to see a doctor

See a doctor urgently if:

• Vertigo with a sudden severe headache, weakness on one side, trouble speaking, or chest pain – this could be a stroke or another emergency
• Vertigo with sudden hearing loss
• Vertigo after a fall or bang to the head

Book a routine appointment if:

• It is your first episode and it lasts more than a few days
• You keep having episodes that come and go
• Vertigo is making it hard to work, drive, or do daily activities
• You have hearing loss, ringing in your ears, or fullness in your ear along with vertigo
• You are over 60 and have dizzy spells or unsteadiness

Diagnosis

A doctor will ask you about your symptoms, such as when they started, what triggers them, and how long they last. They will also examine you, check your eye movements, and might ask you to move your head or body in certain ways to see if it brings on your dizziness.

Tests that may be done

• Dix-Hallpike test – a simple test where you lie back with your head turned to one side to check for inner ear crystals
• Hearing tests – to check for hearing loss or Meniere's disease
• MRI or CT scan – if the doctor wants to rule out brain or nerve problems
• Caloric testing – warm or cool air or water is placed in the ear to see how well your balance nerves respond

What to expect at your appointment

During the appointment, the doctor will likely move your head and body into different positions. This can feel dizzy for a few seconds, but it's helpful for diagnosis. Let the doctor know about all your current medicines, past illnesses, injuries, and any other health conditions.

Treatment

Treatment depends on the cause of your vertigo. For inner ear crystals, a simple repositioning manoeuvre performed by a doctor or physiotherapist often fixes it. For other causes, medicines for dizziness or nausea, balance therapy, or lifestyle changes may help. Many people recover with treatment within days to weeks.

Self-care at home

• Sit or lie down in a quiet, dimly lit room during an attack
• Try to keep your head still and fixed on a spot in front of you
• Move slowly when you change positions – sit up for a moment before standing
• Avoid bending over, reaching up, or rapid head movements
• Stay well-hydrated and eat small, light meals
• Avoid bright lights, loud sounds, and screens if they make you feel worse

Medical treatments

Doctors may prescribe medicines to reduce dizziness and nausea, or medicines that calm the inner ear. For vertigo linked to migraines, treatment may focus on migraine prevention. If there is an infection, antibiotics or anti-inflammatory medicines might be used. A specialist may also recommend vestibular rehabilitation – a type of physiotherapy that retrains your brain to adapt to balance signals. Always ask your doctor or pharmacist for advice about any medicine, and never take medicines prescribed for someone else.

When is surgery considered?

Surgery is rarely needed for vertigo. It may be considered only when other treatments have not worked and the cause is a serious inner ear disorder, such as Meniere's disease, or when there is a structural problem like a nerve compression. Surgery would be discussed in detail with a specialist.

Living with this condition

Live with vertigo by taking things slowly. Sit on the edge of your bed for a few minutes before standing in the morning. Use good lighting and hold onto handrails when going up or down stairs. Keep walking paths clear at home to reduce your risk of tripping during a dizzy spell.

Lifestyle tips

• Get enough sleep and rest when you feel tired
• Stay hydrated and limit caffeine, alcohol, and salt
• Find ways to reduce stress, such as deep breathing or gentle yoga
• Avoid triggers like flashing lights, crowded places, or rapid head turns
• Wear well-fitting, low-heeled shoes with good grip

Diet and exercise

Eating a balanced diet helps your overall health and may ease some types of vertigo, especially if it's linked to migraines. Regular gentle exercise, such as walking, tai chi, or swimming, can improve your balance and reduce anxiety related to dizziness. Some people with Meniere's disease feel better on a lower-salt diet – speak to your doctor before making major changes.

Mental health and emotional wellbeing

Vertigo can be frightening and exhausting, especially if it comes without warning. It's normal to feel anxious, worried, or frustrated. It can even lead to depression. Talk to your healthcare provider about how you're feeling – they can support you and refer you for counselling or other mental health help if needed.

Prevention

You can't always prevent vertigo, but you can lower your risk. Move your head slowly when changing positions, protect your head during sports with proper helmets, treat ear infections promptly, and manage migraines with help from your doctor. Keeping your home safe and clutter-free also reduces injury from falls.

Vaccines

Some viruses that cause ear infections and vestibular neuritis can be prevented with routine vaccinations, such as the flu vaccine and other recommended childhood or adult vaccines. This may indirectly reduce the risk of infection-related vertigo, but vaccines do not directly prevent most types of vertigo.

Screening programmes

There is no routine screening for vertigo in healthy people. However, if you are having falls, dizziness, or balance problems, your doctor may check your balance and hearing as part of your regular health review. Older adults should mention any dizziness or unsteadiness at check-ups.

Complications

If left untreated

• Falls and injuries, such as hip fractures or head injuries
• Difficulty staying at work, driving, or doing everyday tasks
• Persistent anxiety or fear of moving (a condition called kinesiophobia)
• Rarely, if vertigo is a sign of a serious underlying problem like a stroke or infection, ignoring it can lead to worse outcomes

Long-term outlook

The outlook for vertigo is generally very positive. Most people improve with simple treatment or even on their own within a few weeks. Some types, like BPPV, can be fixed in a single session with a repositioning movement. Even when vertigo is a long-term issue, many strategies can keep it under control and allow you to live a full, active life. The key is to get a correct diagnosis and find a treatment plan that works for you.

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