Doctor, I Have Vertigo. What Can I Do Now?
Patient: Doctor, I am very scared. Since yesterday, I feel like the room is suddenly spinning around me. I have to hold onto the wall to stand. Is this Vertigo?
Doctor: I can see you are distressed. Yes, what you are describing sounds exactly like Vertigo. It is different from just feeling “lightheaded” or weak. Vertigo is a sensation where you feel that you or your surroundings are moving or spinning, even when you are perfectly still… like we feel after getting off a fast merry-go-round.
Patient: What causes this? Is it a brain tumor?
Doctor: That is a common fear, but in most cases, it is not a brain problem. It is usually an Inner Ear problem. Your ear is not just for hearing… it also acts like a “spirit level,” the tool carpenters use, to tell your brain if you are standing straight, leaning or moving.
Patient: How does the ear do that?
Doctor: Inside your ear, there are tiny tubes filled with fluid and microscopic crystals. When you move your head, these crystals move and tell your brain where you are. Sometimes, these crystals get dislodged and float into the wrong tube. So, when you turn your head, they send a wrong and chaotic signal to the brain, causing that sudden spinning sensation. We call this BPPV (Benign Paroxysmal Positional Vertigo).
Patient: That explains why it happens when I turn in bed! Is there anything I should avoid?
Doctor: Exactly. Sudden head movements are the main trigger. Looking up to clean a high shelf, bending down to pick something up, or turning over quickly in bed can trigger it. For now, try to move your head slowly, like a robot, rather than jerking it.
Patient: How long will an episode last?
Doctor: It depends on the cause. In BPPV (the crystal problem), the intense spinning feeling usually lasts less than a minute… though that one minute may feel like an hour! However, if it is due to other causes like a viral infection of the ear (Vestibular Neuritis), it might last longer.
Patient: Is there something I can do immediately when the spinning starts?
Doctor: Yes. Safety first. Immediately sit or lie down on the floor so you don’t fall. Fix your eyes on one fixed object, like a clock or a picture frame, and stare at it. This helps your brain realize that the world is not actually moving and can help in stopping the spinning sensation faster.
Patient: Can I cure this with exercises?
Doctor: Definitely. Since this is often a mechanical problem (crystals in the wrong place), we use mechanical treatments too. There is a specific exercise called the Epley Maneuver. It involves tilting your head in a specific sequence to guide the crystals back to where they belong. You can learn how to do this safely.
Patient: What about diet? My mother said I should stop eating salt.
Doctor: That is helpful if you have a condition called Meniere’s Disease, where fluid pressure builds up in the ear. For that, reducing salt (avoiding pickles, papads, and salty snacks) can help in lowering the pressure. But for common BPPV, diet does not play a big role.
Patient: Will this affect my driving? I travel to work every day.
Doctor: You must be very careful. If your episodes are unpredictable, do not drive. Imagine having a spinning episode while you are in traffic, it is dangerous for you and others. Once we treat it and you are symptom-free for a some time, you can resume driving.
Patient: What if I am alone at home and it happens?
Doctor: Don’t panic. Stay where you are. Crawl if you have to… but don’t walk. Keep your phone near the floor level so you don’t have to stand up to get it. Most episodes end vey quickly.
Patient: Thank you, Doctor. I was worried it was a stroke. I feel much better knowing it’s just the ear.
Doctor: You are welcome. It is frightening, but very treatable.
Dr. Shashikiran Umakanth (MBBS, MD, FRCP Edin.) is the Professor & Head of Internal Medicine at Dr. TMA Pai Hospital, Udupi, under the Manipal Academy of Higher Education (MAHE). While he has contributed to nearly 100 scientific publications in the academic world, he writes on MEDiscuss out of a passion to simplify complex medical science for public awareness.
