Dizziness and vertigo are two common complaints that many people experience at some point in their lives. While often used interchangeably, they represent distinct sensations and have different underlying causes. Dizziness can refer to various sensations like lightheadedness, feeling faint, or a sense of unsteadiness. On the other hand, vertigo is a specific type of dizziness characterised by a false sensation of spinning or movement, either of oneself or the surroundings. In this blog, we will delve into the world of dizziness and vertigo, exploring their differences and similarities. Additionally, we will discuss the possible causes, symptoms, and effective management strategies to help individuals regain their balance and reduce the impact of these sensations on their lives.
Section 1: Distinguishing Dizziness and Vertigo
Dizziness is a general term used to describe a range of sensations related to a disturbed sense of spatial orientation and balance. It can manifest as feeling:
- lightheaded
- woozy
- disoriented
Individuals experiencing dizziness may feel like they are about to faint or lose their balance.
On the other hand, vertigo is a more specific form of dizziness, characterised by a sensation of:
- spinning
- swaying
- tilting
People with vertigo often describe feeling as if they or their surroundings are moving when, in reality, they are stationary. This false perception of movement can be unsettling and lead to nausea and vomiting in severe cases. Distinguishing between these sensations is crucial for accurate diagnosis and appropriate treatment.
Section 2: Common Causes of Dizziness and Vertigo
Dizziness can have various underlying causes, ranging from relatively benign to potentially serious. Common triggers include sudden changes in blood pressure, dehydration, hypoglycaemia (low blood sugar), and side effects of medications. Additionally, anxiety and panic disorders can induce dizziness due to changes in breathing patterns and the body’s stress response.
In the case of vertigo, the root cause is often related to the inner ear and the vestibular system. Benign paroxysmal positional vertigo (BPPV) is a common condition that occurs when small calcium crystals called otoliths become dislodged in the inner ear, affecting the balance signals. Vestibular neuritis, another cause of vertigo, is caused by inflammation of the vestibular nerve. Meniere’s disease, a disorder of the inner ear, and vestibular migraine, a type of migraine headache with vertigo as a prominent symptom, are other potential causes.
Section 3: Identifying Symptoms of Dizziness and Vertigo
Dizziness and vertigo can manifest with various symptoms, and understanding these distinctions can aid in accurate diagnosis. Dizziness may present as a sensation of light-headedness or a feeling of being off-balance or unsteady on one’s feet. Some people may describe feeling faint or woozy, especially when standing up quickly or after prolonged periods of sitting.
Vertigo, on the other hand, is characterised by a false sense of spinning or movement, often described as feeling like the room is rotating or that the ground is tilting beneath one’s feet. This sensation is typically episodic and can be triggered by specific head movements or changes in body position. Nausea, vomiting, and difficulty maintaining balance are common accompanying symptoms during a vertigo episode.
Section 4: Seeking Medical Evaluation
When experiencing frequent or persistent dizziness or vertigo, it is crucial to seek medical evaluation to determine the underlying cause. A healthcare professional, often a primary care physiotherapist, physician, or an ENT (ear, nose, and throat specialist), can conduct a thorough evaluation. The diagnostic process may involve a comprehensive medical history review, physical examination, and balance tests. In some cases, imaging studies like magnetic resonance imaging (MRI) or computed tomography (CT) scans may be necessary to rule out more severe underlying conditions.
Section 5: Management and Treatment Options
Managing dizziness and vertigo often involves a combination of lifestyle modifications, specific manoeuvres, and, in some cases, medications. For individuals experiencing dizziness due to low blood pressure or dehydration, staying hydrated and making dietary adjustments can help alleviate symptoms. Managing stress and anxiety through relaxation techniques, such as deep breathing exercises or meditation, may also reduce dizziness associated with these conditions.
The Epley manoeuvre is a specific technique used to treat BPPV, one of the most common causes of vertigo. It involves a series of head movements designed to reposition the dislodged calcium crystals in the inner ear, alleviating vertigo symptoms.
For more complex cases, various medications can be prescribed to control symptoms and manage underlying conditions. However, these medications should be used with caution, as some may have side effects and interactions with other medications.
Section 6: Vestibular Rehabilitation Therapy (VRT)
Vestibular Rehabilitation Therapy (VRT) is a specialised form of physical therapy designed to address issues related to the vestibular system and improve balance and stability. VRT involves exercises and activities that aim to retrain the brain to interpret and process signals from the inner ear correctly. By compensating for vestibular imbalances, VRT can help reduce symptoms of dizziness and vertigo, improve postural stability, and enhance overall quality of life.
VRT is typically administered by trained vestibular physiotherapists who tailor the exercises to the individual’s specific needs and challenges. The therapy may include eye exercises, balance exercises, and habituation exercises, where patients gradually expose themselves to movements or positions that trigger vertigo to reduce sensitivity over time.
Conclusion:
Dizziness and vertigo can significantly impact a person’s daily life, making it essential to understand their causes and symptoms. By seeking medical evaluation and a proper diagnosis, individuals can identify the root cause of their dizziness or vertigo, leading to more targeted and effective management. Lifestyle adjustments, specific manoeuvres like the Epley manoeuvre, medications, and Vestibular Rehabilitation Therapy (VRT) are among the available treatment options to help individuals regain their balance and reduce the impact of dizziness and vertigo. If you or someone you know experiences frequent or persistent dizziness or vertigo, it is crucial to consult with a healthcare professional for evaluation and guidance on managing these sensations effectively. Remember, each case is unique, and personalised treatment can lead to improved well-being and a better quality of life.
References:
De Hertogh et al. Outcome for dizzy patients in a physiotherapy practice: an observational study. Ann Med. 2022 Dec;54(1):1787-1796
Stewart, V. et al (2019). Clinical effectiveness of a physiotherapy-led, hospital-based vestibular service. Otorinolaringologia. 69(1), pp. 1-8
McDonnell MN, Hillier SL.. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2015;1
