Vertigo is the false sense that you, or the room around you, are spinning, tilting or swaying. It’s one type of dizziness, a broad term that also covers feeling lightheaded, woozy or off balance. Vertigo treatment starts with finding the cause, because an inner ear problem needs very different care than a blood pressure or heart problem. Physical Medicine & Rehabilitation of NY & CT (PMR) evaluates dizziness and balance problems and offers vestibular rehabilitation, with two offices in Danbury, CT and Brewster, NY.
When to get urgent care
Dizziness can be the first sign of a stroke or a heart problem. Call 911 if vertigo or dizziness:
- Starts suddenly along with weakness, numbness, a drooping face, slurred speech or trouble walking
- Arrives with the worst headache of your life, sudden severe neck pain, double vision or vision loss
- Comes with chest pain, palpitations, trouble breathing or passing out
- Begins after a head injury or a fall
- Is constant and severe, and you can’t stand or keep fluids down
A stroke can cause spinning without obvious weakness. If you’re older, smoke, or have high blood pressure, diabetes or a heart rhythm problem, treat sudden, severe and nonstop vertigo as an emergency. Sudden hearing loss in one ear also needs same-day medical care.
Common causes of vertigo and dizziness
BPPV
Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. Tiny calcium crystals in the inner ear slip into a canal where they don’t belong. Rolling over in bed, looking up or bending down then sets off a spin that usually lasts less than a minute.
Vestibular neuritis and labyrinthitis
Inflammation of the inner ear or its balance nerve, often after a viral illness, can cause sudden, intense vertigo that lasts for days. Unsteadiness may linger for weeks. Labyrinthitis also affects hearing.
Meniere’s disease
Meniere’s disease causes attacks of vertigo lasting from 20 minutes to several hours, with ringing, fullness and changing hearing in one ear. An ear, nose and throat (ENT) doctor diagnoses and manages it, and rehab may help with unsteadiness between attacks.
Vestibular migraine
Vestibular migraine can bring episodes of vertigo with or without a headache, often with sensitivity to light, sound or motion. It’s a common cause of repeated dizzy spells. Your physician manages the migraine itself, and our headaches and migraines page covers related neck and head pain care.
Neck-related dizziness
Neck pain and stiffness, after whiplash or long hours at a screen, can come with unsteadiness rather than true spinning. This is called cervicogenic dizziness, and it’s diagnosed only after other causes are ruled out. Care focuses on the neck itself; learn more about neck pain treatment.
Causes that need a physician
Lightheadedness on standing, fainting, medicine side effects, dehydration, anemia, low blood sugar and heart rhythm problems are medical issues. If your symptoms point this way, PMR will refer you to your doctor or a specialist.
How vertigo treatment works at PMR
Dizziness treatment is matched to the cause:
- BPPV: repositioning maneuvers, such as the Epley maneuver
- Inner ear weakness: gaze stabilization and balance exercises
- Motion sensitivity: gradual habituation exercises
- Neck-related dizziness: hands-on care, mobility and posture work from our chiropractors and physical therapists
- Medical causes: referral to your doctor, an ENT or a neurologist
Vertigo physical therapy is active, with exercises in the clinic and at home; our vestibular rehabilitation page describes the sessions. Results vary, and some causes also need medical treatment. Vertigo is one of many conditions we treat at PMR.
What your first visit checks
Before your visit, jot down when your dizzy spells happen, how long they last and what seems to trigger them. Bring a list of your medicines. If your dizziness is severe, ask someone to drive you.
Your clinician will review your history and screen for warning signs, then may check:
- How your eyes move at rest and when you change position
- Whether lying back or turning in bed brings on vertigo
- Your balance, walking and risk of falling
- Your neck’s range of motion
You’ll leave knowing what the findings suggest. Next steps may include vertigo treatment in the clinic, a home exercise plan or a referral to a physician.
Frequently asked questions
Can vertigo go away on its own?
Sometimes. BPPV can settle by itself over weeks, and the brain often adjusts after vestibular neuritis. Even so, repositioning maneuvers often relieve BPPV faster than waiting, and exercises can help when unsteadiness lingers. Dizziness that keeps returning deserves an evaluation, both to find the cause and to lower your risk of a fall.
Should I see a doctor or a physical therapist for vertigo?
If you have any emergency warning signs, go to the ER first. For new, unexplained dizziness, your primary care doctor is a good first stop to rule out medical causes. For positional vertigo, inner ear weakness or ongoing imbalance, a physical therapist trained in vestibular care can test and treat you. Many people benefit from both.
What should I do when a vertigo spell starts?
Sit or lie down right away and keep your head still. Focus on one steady point until the spinning eases, then get up slowly. Don’t drive, climb or use machinery until you feel steady, and at night keep a light on and the path to the bathroom clear. If any warning signs appear, call 911.
Get help for vertigo and dizziness
Call the PMR office nearest you to ask about vertigo treatment. You can also book an appointment online.
- PMR of Danbury, CT: (203) 744-8013
- PMR of Brewster, NY: (845) 279-1135