What Causes Vertigo? Top Triggers and Underlying Reasons
Discover the main causes of vertigo, common triggers, and underlying reasons. Learn how to identify, manage, and treat vertigo effectively.
Written by Dr. M L Ezhilarasan
Reviewed by Dr. Rohinipriyanka Pondugula MBBS
Last updated on 9th Sep, 2025
Introduction
That sudden, terrifying sensation that the room is spinning around you—that’s vertigo. More than just simple dizziness, vertigo is a specific symptom of an underlying issue related to your inner ear or brain. It can strike without warning, making you feel nauseous, unsteady, and unable to focus. Understanding what leads to signs of vertigo is the first crucial step toward managing it and finding relief. This article will demystify the common and less common causes of vertigo, from benign ear crystals to more complex neurological conditions. We'll explore the mechanics of your balance system, break down the symptoms, and guide you on when it's essential to seek professional medical advice. Whether you experience occasional spells or chronic episodes, knowing the root cause is key to effective treatment.
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Understanding the Balance System: How Your Body Stays Upright
To grasp what goes wrong in vertigo, you first need to understand how your body maintains its balance. Your sense of equilibrium is a complex partnership between three main systems:
- The Inner Ear (Vestibular System): This is the primary command centre for balance. It contains fluid-filled canals and sensitive hair cells that detect rotational and linear head movements, sending signals to your brain about your head's position.
- The Eyes (Visual System): Your eyes tell your brain where your body is in space and how it's moving relative to your surroundings.
- Sensory Nerves (Proprioception): These nerves in your skin, muscles, and joints send information about your body's position to the brain.
When these three systems send conflicting information to the brain—for example, if your inner ear senses movement but your eyes are fixed on a stationary object—the result can be dizziness or vertigo symptoms.
Common Causes of Vertigo (Peripheral Vestibular Disorders)
Most cases of vertigo originate from problems in the inner ear, known as peripheral vestibular disorders.
Benign Paroxysmal Positional Vertigo (BPPV)
BPPV is the undisputed leader in causing vertigo. It occurs when tiny calcium carbonate crystals (otoconia) become dislodged from their normal location in the utricle and migrate into one of the semicircular canals. Here, they interfere with the normal flow of fluid, sending false signals to your brain that your head is spinning, even when it's still. BPPV episodes are typically brief (less than a minute) but intense, and are triggered by specific changes in head position, like rolling over in bed, looking up, or bending down.
Vestibular Neuritis and Labyrinthitis
These conditions are often linked to a viral infection, like a cold or the flu.
- Vestibular Neuritis is an inflammation of the vestibular nerve. It causes severe, constant vertigo that can last for days, often accompanied by nausea and difficulty with balance, but usually without hearing loss.
- Labyrinthitis involves inflammation of both the vestibular nerve and the cochlea (the hearing organ). Therefore, it causes vertigo along with hearing loss and tinnitus (ringing in the ears).
Meniere's Disease
- Meniere's disease is a chronic inner ear disorder characterised by a triad of symptoms: sudden vertigo attacks, fluctuating hearing loss, and tinnitus. It is caused by a buildup of excess fluid (endolymph) in the inner ear, which disrupts normal balance and hearing signals. These episodes can be debilitating and last for several hours.
Other Medical Conditions Linked to Vertigo
Sometimes, the cause of vertigo lies outside the inner ear.
Migraine-Associated Vertigo (Vestibular Migraine)
- For many people, migraines aren't just about headaches. Vestibular migraines can cause vertigo, dizziness, and balance issues even without a painful headache. The vertigo can last from minutes to hours and is often accompanied by sensitivity to light and sound.
Head and Neck Injuries
- A concussion or whiplash injury can damage the inner ear or the parts of the brain that process balance, leading to post-traumatic vertigo. This can be a persistent issue after a car accident or a significant blow to the head.
When Vertigo Signals a Serious Problem: Central Causes
While less common, vertigo can be a sign of a problem in the brain itself, known as a central vestibular disorder.
- Stroke or TIA (Transient Ischaemic Attack): A stroke affecting the brainstem or cerebellum can cause sudden, severe vertigo. This is a medical emergency, especially if the vertigo is accompanied by other warning signs like double vision, slurred speech, weakness in the face or limbs, or severe incoordination.
- Acoustic Neuroma: This is a rare, non-cancerous tumour on the nerve connecting the inner ear to the brain. It usually causes gradual hearing loss and tinnitus on one side, accompanied by a loss of balance and persistent dizziness rather than spinning vertigo.
Diagnosing the Root Cause: What to Expect
Because vertigo has so many potential causes, diagnosis involves a thorough evaluation. A doctor will:
- Take a Detailed History: They will ask about your symptoms, their duration, triggers, and any accompanying issues like hearing loss or headache.
- Perform a Physical Exam: This includes checking your eye movements (nystagmus), balance, and coordination.
- Conduct Positional Testing: The Dix-Hallpike test is commonly used to diagnose BPPV by provoking vertigo through specific head movements.
- Order Further Tests: In some cases, hearing tests (audiometry), blood tests, MRI, or CT scans may be needed to rule out central causes. Apollo24|7 offers convenient home collection for tests like vitamin D or HbA1c, which can sometimes be relevant in investigating underlying metabolic causes of dizziness.
Living with and Managing Vertigo Triggers
Identifying and avoiding your personal triggers is a key part of management. Common triggers include:
Sudden head movements
- Stress and anxiety
- Certain foods (high salt, caffeine, alcohol, MSG)
- Dehydration and lack of sleep
- Certain medications
- Keeping a "dizziness diary" can help you and your doctor pinpoint patterns and specific triggers.
Conclusion: Taking Control of Your Balance
Vertigo can be a disorienting and frightening experience, but it's important to remember that it is often manageable and treatable. The journey to overcoming vertigo begins with identifying its root cause. From the simple, crystal-repositioning manoeuvres for BPPV to dietary changes for Meniere's disease and medication for vestibular migraines, effective treatment is highly specific to the diagnosis. While this guide provides a comprehensive overview of what leads to signs of vertigo, it is not a substitute for professional medical evaluation. If your vertigo is severe, recurrent, or accompanied by any neurological symptoms like weakness or speech problems, it is crucial to seek immediate care. For persistent but less severe symptoms, consult a doctor online with Apollo24|7 for further evaluation and a personalised path to steady ground.
Consult a Specialist for Personalised Advice
Consult a Specialist for Personalised Advice
Dr. Gaddam Manoj
General Practitioner
1 Years • MBBS
Hyderabad
Aaradhya clinic, Hyderabad
Dr Syed Mateen Pasha
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. Anand Ravi
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. M L Ezhilarasan
General Practitioner
6 Years • MBBS
Visakhapatnam
Apollo 24|7 Clinic - Andhra Pradesh, Visakhapatnam
Dr. Madhuri Sai Sreepada
General Practitioner
9 Years • MBBS
Hyderabad
BRIGHT SMILES MEDICARE & DENTAL CARE, Hyderabad
Consult a Specialist for Personalised Advice
Dr. Gaddam Manoj
General Practitioner
1 Years • MBBS
Hyderabad
Aaradhya clinic, Hyderabad
Dr Syed Mateen Pasha
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. Anand Ravi
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. M L Ezhilarasan
General Practitioner
6 Years • MBBS
Visakhapatnam
Apollo 24|7 Clinic - Andhra Pradesh, Visakhapatnam
Dr. Madhuri Sai Sreepada
General Practitioner
9 Years • MBBS
Hyderabad
BRIGHT SMILES MEDICARE & DENTAL CARE, Hyderabad
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Frequently Asked Questions
What is the most common reason for vertigo?
The most common cause is Benign Paroxysmal Positional Vertigo (BPPV), where tiny calcium crystals in the inner ear become dislodged and disrupt fluid balance, causing brief but intense spinning sensations with head movement.
Can dehydration cause vertigo symptoms?
Yes, absolutely. Dehydration can lead to a drop in blood pressure or reduce blood volume, which can cause lightheadedness and dizziness. In people prone to conditions like vestibular migraines, dehydration can also be a direct trigger for a vertigo episode.
How can I tell if my vertigo is from my ear or something more serious?
Peripheral vertigo (from the ear) is often accompanied by nausea and nystagmus (involuntary eye movements) but rarely with other neurological symptoms. Central vertigo (from the brain) may be accompanied by severe headache, double vision, slurred speech, or weakness. Any vertigo with these 'red flag' symptoms requires immediate medical attention.
Are there any quick home remedies for a vertigo attack?
If you know you have BPPV, the Epley manoeuvre (performed correctly) can be effective. For sudden vertigo, the best immediate action is to sit or lie down in a safe place, avoid sudden movements, focus on a stationary object, and wait for the episode to pass. Deep breathing can help manage anxiety.
When should I be worried about vertigo and see a doctor?
You should seek prompt medical advice if your vertigo is recurrent, lasts for more than a few days, or if a single episode is severe and accompanied by a new or severe headache, hearing loss, fever, weakness, numbness, difficulty speaking, or chest pain.