What is Peripheral Vertigo?
Introduction
Have you ever felt like the room was spinning even though you were standing still? Sometimes the spinning sensation only last seconds, and other times it can last minutes, hours, or even days depending on the the type of vertigo and the cause of the vestibular symptoms. Peripheral vertigo indicates that the dizziness comes from problems in the inner ear, the part of your body that helps control balance and can be described as your internal gyroscope. While it can feel alarming, the good news is that peripheral vertigo is often treatable with the right care.
What Is Peripheral Vertigo?
Your inner ear (vestibular organ) sends signals back to your eyes and brain about positional changes that are occurring (ie: getting up and down out of bed, bending forward, turning the head up/down and R/L). Vertigo results when signals from your inner ear get disrupted. Your brain receives confusing messages which leads to dizziness, spinning sensations, and balance problems.
Common Causes
Several inner ear conditions can trigger peripheral vertigo:
Benign Paroxysmal Positional Vertigo (BPPV): caused by tiny crystals in the inner ear that move into the wrong spot
Vestibular Neuritis: inflammation of the vestibular nerve, often after a viral infection
Ménière’s Disease: a condition with fluid buildup in the inner ear, leading to vertigo, hearing changes, and ringing in the ears
Labyrinthitis: viral infection that results in dizziness and an acute loss of hearing
Eustachian Tube Dysfunction and Sinus related Dizziness: a fluid imbalance in the inner ear that results in instability and poor balance, but usually does not produce true room spinning dizziness
Symptoms to Watch For
People with peripheral vertigo may notice:
Sudden spinning or dizziness, often triggered by laying flat, bending forward, quick head changes
Nausea or vomiting
Trouble keeping balance (often requires a couple of min to orient themselves in the AM or when first getting up from laying flat)
Sensitivity to head motion
In some cases, ringing in the ears or changes in hearing
How is Peripheral Vertigo Diagnosed?
A healthcare professional may use:
A balance exam and VOR testing
The Dix-Hallpike maneuver to check for BPPV
Hearing assessments or medical imaging, depending on symptoms
VNG (performed by an ENT)
Treatment Options
The best treatment depends on the underlying cause, but common approaches are:
Vestibular Rehabilitation Therapy (VRT): special exercises guided by a physical therapist to retrain balance and reduce dizziness
Canalith Repositioning Maneuvers: for BPPV, techniques such as the Epley maneuver help move misplaced inner ear crystals back where they belong
Medication: sometimes prescribed to ease nausea, reduce inflammation, manage viruses, and manage fluid and pressure build up in the ears
Lifestyle Adjustments: limiting salt and caffeine intake and avoiding sudden head movements may help manage symptoms
How Physical Therapy Helps
At Mind Body Balance Physical Therapy PLLC, we specialize in vestibular rehabilitation. Our therapists design individualized programs that may include:
Balance training to reduce fall risk
Gaze stabilization exercises to improve vision control during movement
Step-by-step repositioning maneuvers for BPPV
Education to give you tools for managing dizziness in daily life
With consistent therapy, many patients notice a significant decrease in dizziness and are able to return to normal activities.