Dizziness and Vestibular Problems: Causes, Symptoms and Treatment

Dizziness can feel like lightheadedness, unsteadiness, or a spinning sensation called vertigo. Although inner ear problems are a common cause, dizziness can also result from dehydration, changes in blood pressure, medications, or other medical conditions.

Identifying the cause is the first step toward appropriate treatment.

What Is a Vestibular Disorder?

Benign Paroxysmal Positional Vertigo (BPPV)

BPPV occurs when tiny calcium crystals move into an inner ear canal where they do not belong. It causes brief episodes of vertigo triggered by head movements, such as rolling over in bed or looking up.

Vestibular Neuritis and Labyrinthitis

Vestibular neuritis is inflammation of the nerve that transmits balance signals to the brain. It can cause sudden vertigo, nausea, and unsteadiness but typically does not affect hearing.

Labyrinthitis affects the inner ear and can cause symptoms similar to those of hearing loss or tinnitus. Both conditions are often associated with viral infections; antibiotics are appropriate only when a bacterial infection is suspected.

Ménière’s Disease

Ménière’s disease causes recurring episodes of vertigo, hearing changes, tinnitus and a feeling of fullness in the ear. Its symptoms are associated with an inner ear fluid imbalance, but the underlying cause remains uncertain.

Vestibular Migraine

Vestibular migraine can cause vertigo, nausea, and balance problems—with or without a headache. Treatment focuses on managing the migraine and associated symptoms.

How Are Dizziness and Vestibular Problems Diagnosed?

Your provider will ask when your symptoms started, how long they last, what triggers them, and whether you have hearing changes or other symptoms.

Evaluation may include blood pressure measurements, a medication review, and an examination of your balance and eye movements. Depending on the findings, hearing tests, specialized balance testing, imaging, or a specialist referral may be appropriate. Not everyone needs every test.

Treatment Options

Treatment depends on the diagnosis and may include:

• Repositioning maneuvers, such as the Epley maneuver, for BPPV.
• Short-term medication to relieve nausea or severe vertigo.
• Vestibular rehabilitation to improve balance and movement tolerance.
• Treatment of an underlying condition or provider-directed medication adjustments.
• Condition-specific lifestyle changes or specialist care.

Surgery is reserved for specific conditions—not dizziness in general.

While dizzy, sit or lie down safely and avoid driving, climbing ladders, or operating machinery. Do not stop prescribed medication without medical guidance.

When to Seek Medical Care

Arrange an evaluation for new, recurring, persistent or worsening dizziness. Sudden hearing loss requires urgent medical attention.

Call 911 if you experience sudden dizziness with trouble speaking, weakness, vision changes, inability to walk, or a sudden, severe headache. These can be signs of a stroke. Dizziness with chest pain or shortness of breath also requires emergency care.

Get Help for Dizziness and Balance Concerns

For non-emergency symptoms, tru Primary & Urgent Care can help evaluate your concerns and discuss appropriate next steps, including specialist referrals when needed.