Understanding Vertigo vs. Dizziness: Clearing the Confusion

Have you ever felt lightheaded or unsteady on your feet and wondered if it's just a passing feeling or something more concerning, like vertigo? These terms are often used interchangeably, but they represent distinct experiences with different underlying causes. Let's dive into what sets them apart.

Vertigo vs. Dizziness: What's the Difference?

Dizziness is a broad term encompassing various sensations of unsteadiness. It can manifest as feeling faint, weak, lightheaded, foggy or a general feeling of unease. 

There are many causes of dizziness including fatigue or stress, dehydration and blood pressure changes, medication side effects and issues with the visual, vestibular or musculoskeletal system. 

Vertigo, on the other hand, is more specific. It refers to a false sensation of movement, either of yourself or your surroundings. This sensation is typically described as spinning or whirling, as if the room is rotating around you or you are spinning in space.

Vertigo itself is not a diagnosis but a symptom indicative of an underlying issue affecting the vestibular system—the parts of the inner ear and brain that help control balance and eye movements.

Understanding the differences between vertigo and dizziness is crucial when determining vestibular rehabilitation treatment strategies, as is identifying the cause of your symptoms. Below we will explore some commonly seen conditions in physiotherapy. 

Benign Paroxysmal Positional Vertigo (BPPV)

One of the most common causes of vertigo is Benign Paroxysmal Positional Vertigo (BPPV), a condition characterized by brief episodes of intense vertigo triggered by specific head movements. BPPV stands for:

• Benign: although disabling, not caused by serious/sinister disease
• Paroxysmal: short-duration bursts lasting up to a minute
• Positional: provoked by certain positions
• Vertigo: false sensation of movement/spinning

Understanding BPPV: BPPV occurs when tiny calcium carbonate crystals, called otoconia, become dislodged from their usual position in the inner ear. These crystals are normally embedded onto part of the inner ear and help with creating a sensitivity to gravity as they move with different head positions. In BPPV, the crystals migrate into fluid-filled semicircular canals, the part of the ear which senses the rotation of the head. This displacement disrupts the normal fluid movement in these canals and causes a false sense of rotation.

Symptoms of BPPV: Aside from vertigo, individuals may experience nausea, vomiting, difficulty walking, loss of balance, and rapid eye movements (nystagmus). Typical provoking positions which bring on vertigo with BPPV are lying flat or sitting up from lying flat, looking up or bending down and turning over in bed. Vertigo lasts for a very short period of time (seconds to 1-2minutes).

Diagnosis and Treatment: BPPV can be diagnosed through specialized tests which provoke vertigo by completing specific head movements. Treatment involves maneuvers like the Epley maneuver, designed to guide the displaced crystals back to their original position in the inner ear. These treatments are highly effective, providing relief in as little as 1-3 sessions for many patients.

Cervicogenic Dizziness

Cervicogenic Dizziness is a condition where neck movements or certain positions of the neck trigger a feeling of unsteadiness or dizziness. It's thought to stem from dysfunction in the neck proprioceptors—the sensory receptors that provide information to the brain about body position and movement.

Symptoms of Cervicogenic Dizziness may include neck pain or stiffness, dizziness or lightheadedness often exacerbated by head movements, and difficulty with balance.

Diagnosis and Treatment: Diagnosis involves a combination of clinical history and specific tests to differentiate cervicogenic dizziness from other causes of dizziness. Treatment typically includes exercises and manual therapy techniques to improve neck function and alleviate symptoms.

Vestibular Hypofunction

Vestibular hypofunction is a condition which occurs when there is partial or complete loss of one or more of the vestibular organs and/or nerves (unilateral=one side vs bilateral=both sides). This can occur for several reasons. One common cause is from an acute vestibular impairment like vestibular neuritis or labyrinthitis which are thought to be due to viral infections. Other causes of vestibular hypofunction include ototoxicity from drugs/chemicals that are toxic to the vestibular system, as well as age-related degenerative changes.

Symptoms of vestibular hypofunction: For those suffering from unilateral vestibular lesions, they may report acute vestibular symptoms like intense nausea, vomiting, vertigo and nystagmus for a few days. Often once the initial acute phase has passed, patients may be left with more chronic symptoms of persistent dizziness/imbalance. Individuals who have bilateral vestibular hypofunction often have chronic dizziness, and imbalance when walking or standing and can also have visual jumping (oscillopsia).

Diagnosis and treatment: Differentiating vestibular hypofunction from other causes of dizziness involves a thorough clinical history as well as specific tests completed in the clinic. Treatment consists of a vestibular rehabilitation program including symptom management strategies as well as tailored exercises which aim to improve vestibular function. 

Seeking Relief

Vertigo and dizziness are common issues with various causes. If you're struggling with vertigo or dizziness, consider scheduling a consultation with a healthcare professional who has the knowledge and skills to accurately diagnose your symptoms and create an effective treatment plan. Don't hesitate to seek help—relief may be closer than you think!

For more personalized advice or to schedule a free 10-minute consultation, feel free to reach out. We're here to help you navigate through vertigo and dizziness with expertise and care. Book your appointment today!

When to Seek Medical Attention

While many cases of vertigo and dizziness are benign, if accompanied by certain symptoms it may indicate a more serious underlying condition which requires immediate medical attention. These symptoms include weakness of one or more limbs, difficulty swallowing or speaking, double vision, and persistent dizziness or vertigo unrelated to head movements. If you experience any of these, prompt medical evaluation is recommended by going to the emergency room or calling 911.

Disclaimer: This blog post is for informational purposes only and should not replace professional medical advice. Always consult a healthcare provider for diagnosis and treatment recommendations tailored to your specific condition.