Vertigo vs. Dizziness: Causes, Symptoms, and Key Differences

Feeling dizziness a sensation of lightheadedness, unsteadiness, or feeling faint? You're not alone-about 1 in 5 adults deals with dizziness each year. But if you're spinning or feeling like the room is moving, that's vertigo a specific type of dizziness where you feel like you or your surroundings are spinning. The difference between these two sensations isn't just semantics-it changes everything about how doctors treat you. Misdiagnosing vertigo as general dizziness can lead to weeks of unnecessary medication or even dangerous delays in treatment. Let's break down exactly what sets them apart, why it matters, and what to do next.

What's the Difference Between Dizziness and Vertigo?

Dizziness is a general term for feeling lightheaded, unsteady, or like you might pass out. It's often linked to low blood pressure, dehydration, or anxiety. Vertigo, however, is a specific type of dizziness where you feel like you or your surroundings are spinning. It's not just feeling off-balance-it's a false sense of movement. Think of it this way: dizziness is like the ground feels shaky under your feet, while vertigo is like you're on a merry-go-round even when you're standing still.

For example, standing up too quickly after sitting might make you feel dizzy-but that's not vertigo. If you turn your head and suddenly feel like the room is spinning for 30 seconds, that's likely vertigo. The key difference? Vertigo always involves movement sensations. Dizziness doesn't.

Common Causes of Dizziness

Dizziness has many possible causes. The most common ones include:

• Orthostatic hypotension: A sudden drop in blood pressure when standing up. This happens when blood doesn't reach your brain fast enough. It's common in older adults or people taking blood pressure medications.
• Low blood sugar: Skipping meals or diabetes management issues can cause dizziness, along with sweating and confusion.
• Anemia: Not enough red blood cells to carry oxygen. This makes you feel weak and lightheaded.
• Medication side effects: Many drugs-like sedatives or certain antidepressants-can cause dizziness as a side effect.
• Anxiety and stress: Panic attacks often include dizziness as part of the physical reaction.

According to Mayo Clinic Health System's 2022 data, cardiovascular issues cause about 20-30% of dizziness cases, metabolic problems like low blood sugar account for 15-20%, and psychological factors contribute 10-15%. The good news? Many of these causes are easy to fix with simple lifestyle changes or adjusting medications.

Common Causes of Vertigo

Vertigo almost always comes from problems in your inner ear or brain. Here's what you need to know:

• Benign Paroxysmal Positional Vertigo (BPPV) a condition where tiny calcium crystals in the inner ear get dislodged and cause vertigo when moving the head: This is the most common cause of vertigo. Tiny calcium crystals in your inner ear get dislodged and mess with your balance. It's triggered by head movements like rolling over in bed or looking up. BPPV affects about 2.4% of people annually, with half of cases in adults over 50.
• Ménière's disease a condition where fluid builds up in the inner ear, causing vertigo, tinnitus, and hearing loss: A condition where fluid builds up in the inner ear. It causes vertigo attacks, ringing in the ears (tinnitus), and hearing loss. This affects about 615,000 Americans.
• Vestibular neuritis an inflammation of the vestibular nerve, usually from a viral infection: Usually caused by a viral infection that inflames the vestibular nerve. It leads to sudden, severe vertigo lasting days, often with nausea.
• Vestibular migraine migraines that affect the balance system, often without headache: Migraines that affect your balance system. This causes vertigo without a headache in many cases. It's often misdiagnosed as sinusitis or anxiety.
• Neurological issues conditions like stroke, multiple sclerosis, or brain tumors affecting the brain's balance centers: Less common but serious causes include stroke, multiple sclerosis, or brain tumors. These often come with other symptoms like double vision, slurred speech, or weakness on one side of the body.

King Edward VII Hospital's 2022 data shows BPPV accounts for 20-30% of vertigo cases, while Ménière's disease is 10-15%. Vestibular neuritis makes up 5-10%, and vestibular migraines represent 7-10% of cases. The critical thing here is that vertigo causes are much more specific than dizziness causes, which is why accurate diagnosis matters.

How Doctors Diagnose the Issue

Doctors use specific tests to tell dizziness from vertigo. Here's what they look for:

• Videonystagmography (VNG) a test that tracks eye movements to assess inner ear function: This test tracks eye movements while you move your head. It's 95% sensitive for peripheral vertigo causes like BPPV.
• Head impulse test a quick head movement test to check inner ear response: The doctor quickly moves your head side to side to check if your inner ear is working properly. It's 75-85% specific for vestibular neuritis.
• Nystagmus involuntary eye movements that indicate vestibular dysfunction: Physical exam checks for nystagmus (involuntary eye jerking) and balance issues. Vertigo often causes rhythmic eye movements at 2-6 Hz frequency.
• Red flag symptoms signs that indicate a serious neurological condition: If you have sudden severe headache, double vision, slurred speech, or weakness on one side, doctors will order immediate imaging like an MRI to rule out stroke or other neurological issues.

The American Academy of Neurology's 2023 guidelines stress that only 1-2% of acute vertigo cases need immediate imaging-usually when "red flag" symptoms are present. Most vertigo cases can be diagnosed with simple tests and a physical exam.

Treatment Options That Work

Treatment depends entirely on the cause. Here's what helps:

• Epley maneuver a head movement technique to reposition inner ear crystals: The Epley maneuver is a simple head movement technique done in the doctor's office. It resolves symptoms in 1-3 sessions for 80-90% of cases. Many people do it at home after training.
• Transtympanic gentamicin a treatment for Ménière's disease involving gentamicin injections: Diuretics and low-salt diets help manage fluid buildup. Transtympanic gentamicin injections (approved in June 2023) can reduce vertigo attacks when other treatments fail.
• Vestibular rehabilitation therapy (VRT) customized exercises to help the brain compensate for inner ear problems: Medications for nausea and short-term steroids help. Balance exercises over 6-8 weeks help your brain adapt.
• Preventive medications drugs to manage vestibular migraine symptoms: Migraine management strategies, including beta-blockers or anti-seizure drugs.
• Hydration and compression stockings methods to manage orthostatic hypotension: Drinking more water, wearing compression stockings, and avoiding sudden position changes.

Vestibular rehabilitation therapy (VRT) is a common treatment for many vestibular disorders. It involves customized exercises that help your brain compensate for inner ear problems. UCHealth's 2023 guidelines show 89% success rates for VRT when patients stick with it. The key is consistency-most people see improvement after 4-6 weeks of daily exercises.

When to See a Doctor Immediately

Not all dizziness or vertigo needs urgent care, but some symptoms mean you should go to the ER right away:

• Sudden, severe headache with vertigo or dizziness
• Double vision or trouble speaking
• Weakness on one side of the body
• Loss of consciousness
• Vertigo with chest pain or shortness of breath

These could indicate a stroke, heart attack, or other serious condition. For less urgent symptoms, see your doctor if dizziness or vertigo lasts more than a week, keeps coming back, or affects your daily life. Many people wait too long to seek help-Reddit's r/vertigo community found 68% of members had diagnostic delays averaging 8.2 months. Early diagnosis makes treatment much more effective.

Frequently Asked Questions