Vertigo & Dizziness: what it is and how we help

Balance and dizziness at a glance

Dizziness can mean spinning (vertigo), light-headedness or feeling unsteady. The most common cause of spinning vertigo is BPPV, when tiny crystals in the inner ear move out of place, and it is one of the most treatable conditions we see, often resolving in one or two sessions. Other inner ear, neck and nervous system problems also respond well to vestibular rehabilitation.

Vertigo symptoms: what vertigo feels like

Vertigo is the false feeling that you, or the room around you, are spinning, tilting or moving when nothing is. People describe it as being on a boat or as if they have just stepped off a roundabout. Common vertigo symptoms include:

• Spinning or tilting, often set off by rolling over in bed, looking up or bending down
• Feeling off balance or unsteady on your feet, or drifting to one side when walking
• Nausea or vomiting, especially during an attack
• Jerky eye movements (nystagmus) that someone else may notice
• Sweating and feeling unwell while the spinning lasts
• Hearing changes, such as ringing, a full feeling or hearing loss in one ear, which point to an inner ear cause

How long each episode lasts is one of the best clues to the cause. Seconds with a head movement suggests BPPV, minutes to hours with a headache suggests vestibular migraine, and constant vertigo for days after a cold suggests vestibular neuritis or labyrinthitis. See how long vertigo lasts.

What is vertigo? Meaning and the reasons for it

Vertigo is a symptom rather than a disease in itself. It usually means something is disturbing the vestibular system, the balance organs of the inner ear and the brain pathways that read their signals. The most common reason for vertigo is BPPV, followed by inner ear inflammation and vestibular migraine. Rarely, vertigo comes from the brain itself, such as a stroke, which is why sudden vertigo with the warning signs below needs emergency care. Read more in what causes vertigo and what the vestibular system is.

Types of dizziness

• Vertigo: a spinning sensation, often triggered by rolling over, looking up or bending down.
• Imbalance: feeling unsteady on your feet or drifting to one side.
• Light-headedness: feeling faint, often linked to blood pressure or dehydration.

Common causes

• Benign paroxysmal positional vertigo (BPPV)
• Vestibular neuritis and labyrinthitis after a viral infection
• Vestibular migraine
• Meniere's disease
• Neck problems and post-concussion symptoms
• Anxiety, which can both cause and follow dizziness

For the full range of causes and when to get help, see why you might feel dizzy, what causes vertigo, why you may feel light-headed and whether tiredness can cause dizziness.

How is dizziness treated?

BPPV is treated with repositioning manoeuvres such as the Epley. Other vestibular problems are treated with vestibular rehabilitation, a programme of exercises that retrains the brain to process balance signals. Your GP will check for causes such as blood pressure problems or medication side effects. For what helps in the moment, see how to stop feeling dizzy.

Dizziness and balance disorder treatment in Chiswick

• Vestibular First: specialist assessment, the Epley manoeuvre and balance rehabilitation, from £50.
• Physiotherapy: for neck-related dizziness and falls prevention. Initial assessment and treatment £99.
• Tai chi: strong evidence for improving balance and reducing falls in older adults. Group classes £15, every Wednesday at 9:30am and Friday at 1:30pm, with a seated option. See tai chi for over 50s and seniors.
• Home visits: for anyone too dizzy to travel, with home physiotherapy across West London from £110.

We see people with vertigo, dizziness and balance disorders from Chiswick, Turnham Green, Hammersmith and across West London. Book a vestibular assessment online.

What is BPPV?

Benign paroxysmal positional vertigo happens when tiny calcium crystals in the inner ear move into one of the balance canals. Certain head movements, such as rolling over in bed, looking up or bending down, then trigger a brief spinning sensation, usually lasting less than a minute. It is the most common cause of vertigo, especially over 50, and a repositioning manoeuvre such as the Epley often resolves it within one to three sessions.

Vertigo medication: does it help?

Short courses of medicines such as prochlorperazine or some antihistamines can ease spinning and nausea in the first few days of a vertigo attack, and a GP may prescribe antibiotics if an infection is the cause. These medicines ease symptoms rather than treat the cause, do not help BPPV, and are not meant for long-term use because they can slow the brain's natural recovery. For most people, the right repositioning manoeuvre or vestibular exercises are the more effective way to treat vertigo.

What triggers vertigo attacks?

Triggers depend on the cause: rolling over in bed, looking up or bending down with BPPV; a recent cold or flu with labyrinthitis; stress, poor sleep, missed meals or certain foods with vestibular migraine; and some medicines, so check the leaflet for dizziness as a side effect. Keeping a short diary of when attacks happen helps us pinpoint the cause at your assessment.

Can you drive with vertigo?

Do not drive while you feel dizzy or during an attack. NHS guidance says that if you drive, you must tell the DVLA about your vertigo, and your GP can advise when it is safe to drive again. If you need urgent care for vertigo, do not drive yourself to A&E.

Why do I feel dizzy when I stand up?

Brief light-headedness on standing is usually caused by a temporary drop in blood pressure, known as postural hypotension. Dehydration, some blood pressure medicines, heat, alcohol and standing up too quickly make it more likely. Stand up slowly, drink enough fluid and speak to your GP if it happens often or you faint.

Can stress cause dizziness?

Yes. Anxiety can cause light-headedness and unsteadiness, and dizziness from an inner ear problem can itself trigger anxiety, creating a cycle. Persistent postural-perceptual dizziness (PPPD) is a common condition in which unsteadiness lingers after an initial trigger; it responds well to vestibular rehabilitation and support for anxiety.

What to expect at Omnia

Your vestibular assessment starts with a detailed history of your dizziness: what it feels like, how long it lasts and what triggers it. We then test eye movements, balance and positional responses to identify the cause. If BPPV is found, we can often treat it in the same session. Otherwise you receive a tailored exercise programme, reviewed as you improve, and we refer to your GP if anything needs further investigation.

What you can do at home

• Get up slowly and sit on the edge of the bed before standing
• Keep moving; avoiding movement slows recovery
• Try Brandt-Daroff exercises for BPPV
• Read how long vertigo lasts and whether stress can cause vertigo

For a safe home programme of standing and chair exercises, see our guide to balance exercises for seniors.

For how structured rehabilitation works, see what vestibular rehabilitation is.

Vertigo and dizziness are assessed and treated at Omnia Lifestyle, 8 to 9 Bedford Corner, The Avenue, Chiswick W4 1LZ, close to Turnham Green station, on bus routes 94, E3 and 272. Limited parking is available on request when booking. Book a vestibular assessment or call 020 4515 0000.

For practical steps, read our guide on how to get rid of vertigo.