February 24, 2026
Feeling dizzy after a carnival ride? Normal. Feeling like the room is spinning while brushing your teeth? Not so much.
Dizziness affects as many as 20% of adults annually. But one in four people with dizziness are actually experiencing vertigo — a specific type of dizziness that can cause feelings of spinning, tilting or swaying. Women are two to three times more likely to experience vertigo, and 80% of people who've had it say that it interrupted their daily lives.
"You can go to sleep one night, perfectly healthy and feeling fine, and wake up to the world spinning around you," says Marc Olive, DPT, an MU Health Care vestibular-trained physical therapist working in the emergency department.
Vertigo, like all types of dizziness, is a symptom of something else happening in your body. Figuring out whether your dizziness is vertigo is critical for identifying and treating that underlying cause. Since some of the issues that cause vertigo can be life-threatening, making assumptions about what's going on may not be the best plan.
To prepare you for your next bout of dizziness, Olive shares the best way to determine whether you're dealing with vertigo and what to do if you are.
Signs Your Dizziness May Be Vertigo
Dizziness and vertigo have a lot in common — both can cause you to feel light-headed and nauseous. But vertigo tends to have other tell-tale signs, including:
- Coming and going in waves
- Difficulty walking straight
- Nausea and vomiting
- Rapid, involuntary eye movements (nystagmus)
- Room spinning
"Typically, vertigo will last a few minutes to a few hours, go away and come back again," Olive says. "Simple movements, like changing your position or moving your head one way or another, can trigger it to come right back."
What Causes Vertigo?
There are many causes of vertigo, and they can be classified as vestibular (peripheral vertigo) or neurological (central vertigo):
Peripheral Vertigo
Peripheral vertigo accounts for 80% to 90% of vertigo cases. It occurs when an inner ear issue affects your vestibular system, which informs your brain where your body is in space and how quickly you are moving. Your brain uses that information to help you balance.
Your inner ear contains tiny bio-crystals (otoconia) that help it detect motion. If those crystals move out of place, your body's sense of balance can get thrown off and signal the brain that you’re moving. The result is vertigo.
Some of the most common inner ear issues causing peripheral vertigo include:
- Benign paroxysmal positional vertigo (BPPV), which occurs when the crystals end up floating in the inner ear fluid
- Inner ear infections, such as labyrinthitis (inflammation of the inner ear)
- Meniere's disease, which involves fluid build-up in the inner ear
Central Vertigo
Vertigo can also be a sign of dysfunction in the central nervous system. The dysfunction may be interfering with your brain's ability to process signals it receives from the vestibular system.
Possible underlying causes of central vertigo include:
- Head injury
- Migraine
- Multiple sclerosis
- Stroke
- Tumor
"The conditions causing central vertigo are typically serious," Olive says. "You always want to treat vertigo as a concerning symptom and get evaluated as quickly as possible."
What to Do if You Suspect Vertigo
A medical professional can do tests to confirm vertigo, rule out serious underlying causes and help you find relief. If the vertigo isn't debilitating, you don't need immediate care. Red flags that you need to get to an emergency department include:
- Difficulty swallowing
- Stroke symptoms, such as slurred speech or numbness, weakness or drooping on one side of the body
- Symptoms that do not go away or get worse
- Vision issues, including double vision or sudden vision loss
"Even if you are not having red flag symptoms, vertigo warrants a visit to your doctor," Olive says. "The longer you let it go, the worse you are going to feel, and the risk of falling and injury is high."
Finding Relief From Vertigo
If a neurological assessment suggests central vertigo, emergency physicians will work to identify and treat the underlying condition. If signs point to peripheral vertigo, a vestibular-certified physical therapist or medical professional may perform physical maneuvers to understand the inner ear issue and relieve the vertigo. The maneuvers are best done by a trained professional since their success relies on perfectly timed movements and practiced expertise.
"Rapidly moving the patient between positions can trigger nystagmus, and those eye movements often tell us what's going on in the inner ear," Olive says. "We have other maneuvers that rely on gravity and head position to put dislodged inner ear crystals back in place. We have a very good success rate using corrective maneuvers for vertigo in the ED."
Depending on your symptoms and response to the maneuvers, you may need follow-up vestibular therapy or be sent home with head-eye coordination exercises to help prevent recurrence.
After having a corrective maneuver performed, Olive says it's important that you take steps to stay safe and give yourself time to recover.
He recommends you:
- Sit upright: Prop yourself up and avoid lying flat for at least 12 hours after corrective maneuvers for vertigo. Olive says that in his own experience, patients who don't lie flat don't tend to return to the ED with vertigo.
- Take it easy: For the first 12 to 24 hours after a maneuver for vertigo, don't move your head quickly or make a lot of positional changes. Since driving and exercise involve both of those movements, Olive says it's best to avoid both for at least a day.
"Vertigo can absolutely be a one-time occurrence," Olive says. "But it can take weeks to months to go away on its own in some cases. A certified medical professional can check for a serious underlying cause and get you the relief you need."
Next Steps and Useful Resources
- Want to discuss more with a doctor? Find one today.
- Want to learn more about vertigo treatment? See our services.
