Ever stood up too quickly and felt the room tilt for half a second?
That’s dizziness.
Imagine sitting still in a chair with the room spinning around you on a carnival ride. That’s vertigo. Two completely different sensations. Two completely different issues.
However most people use those terms interchangeably. Meaning when you say to your doctor “I feel dizzy” they become a detective. Which means playing guesswork can lead to months of improper advice, medication and little to no progress.
Here’s the good news:
Once the difference is clear, the treatment path gets a whole lot simpler.
Here’s what you’ll uncover:
- What Dizziness Actually Describes
- What Makes Vertigo Different
- Why The Wrong Label Wastes Months
- How Gaze Stabilisation Exercises Retrain The System
- Warning Signs That Need Urgent Attention
Dizziness Is An Umbrella Term (And That’s The Problem)
“Dizziness” is an umbrella term. It includes light-headedness, wooziness, feeling faint, feeling unsteady on your feet, and that floaty “not-quite-here” feeling.
Notice what’s missing from that list?
Spinning.
None of those word choices describe movement. They describe a fuzzy, off-balance sensation that could originate from many different areas of the body:
- Low blood pressure or dehydration
- A drop in blood sugar
- Medication side effects
- Anxiety and rapid breathing
- Stiff, restricted neck joints
- Heart rhythm problems
That’s a long list. Which is why the isolated finding of “dizzy” tells the clinician very little. It’s a symptom, not a diagnosis. Studies show dizziness of some variety affects 15% to 20% of adults each year, making it about as common as headaches or back pain.
Vertigo Is A Very Specific Sensation
Vertigo is different because it has direction.
That feeling you get when you spin around or tilt your head, or rock back and forth, or someone pushes you sideways. You feel like you’re moving when everything is perfectly still. The room swirls around you but your feet don’t move.
That particular sensation is a signal from a particular system: your vestibular system, located in your inner ear. Small liquid-filled tubes located behind each eardrum communicate to your brain where your head is positioned. When those tubes transmit incorrect information, your eyes and inner ear have a disagreement about which direction is up.
Your brain doesn’t like that argument. It counters with whirling, nausea, and wanting to curl up on the floor so you don’t move.
This is why getting the correct assessment with vestibular physiotherapy at The Alignment Studio can be so helpful, as the testing determines if you require a repositioning manoeuvre, a course of gaze stabilisation exercises, or possibly another intervention altogether. Playing guessing games rarely has a favourable outcome. Gaze stabilisation exercises do not help if the problem is not vestibular related, and loose crystals in the ear canal are not going to settle with rest and reassurance.
The distinction sounds academic. It isn’t.
Why The Wrong Label Wastes Months
Here’s what usually happens when the two get muddled up.
Someone explains their spinning attacks as “dizzy spells”. They hear it must be stress, or blood pressure, or getting old. They’re given a tablet to make it go away with no attempt to find cause. Time goes by. Attacks persist.
Meanwhile the actual cause sits there untreated.
Benign paroxysmal positional vertigo – aka BPPV – is by far the most common cause. It happens when calcium crystals get into a part of the inner ear where they don’t belong. It affects 46% of older adults who complain of dizziness. BPPV can often be treated in 1-2 office visits with a simple repositioning manoeuvre by a trained clinician.
One or two appointments. Compared to months of nothing.
And the risks only increase as we age. Falls become much more likely if vestibular issues are untreated, and a fall for an older adult can alter their life entirely. Vertigo is also two to three times more prevalent in women than men, which most people don’t know.
How Gaze Stabilisation Exercises Retrain The System
Now what if the crystals have returned but the world still shakes?
That’s where gaze stabilisation exercises come in.
Your eyes and inner ear are connected through a neural pathway known as the vestibulo-ocular reflex. Whenever your head moves, the reflex positions your eyes in the opposite direction at just the right velocity for the image on your retina to remain clear. That’s how you can read a street sign while walking.
When there is damage to your vestibular system, that reflex becomes uncalibrated. Your image moves. The world swims and jumps every time you move your head, and your brain interprets that jump as vertigo.
Gaze stabilisation exercises fix the calibration.
The basic version looks almost too simple to work:
- Hold a small letter or target at arm’s length
- Keep your eyes locked on it
- Turn your head slowly from side to side
- Keep the target perfectly clear the entire time
- Build up to 60–90 seconds, several times a day
The target is stationary. Only the head moves toward it. That difference is the training signal. The brain slowly adjusts the reflex to conform to it.
Getting The Dose Right Matters
Here’s the part people get wrong.
Ideally, gaze stabilisation exercises should cause mild symptoms. If they don’t bother you at all they are too easy and the brain has no incentive to change. If they knock you out for hours, they’re too difficult.
The sweet spot sits in between. Mild symptoms that settle within a few minutes.
Progressions can include moving your head quicker, adding vertical travel, standing up, using a cluttered patterned background or moving the target opposite to your head movement. Earn each step, don’t rush it.
That is why this self-coached method from a video always plateaus. The workout itself is simple to replicate. The dosing, progression, and knowing when to stop are difficult.
Warning Signs That Need Urgent Attention
The majority of dizziness and vertigo isn’t serious. Here are signs that it might be serious though, and you should seek medical attention:
- Sudden, severe headache alongside the dizziness
- Double vision or trouble speaking
- Weakness or numbness on one side of the body
- Difficulty walking in a straight line
- Sudden hearing loss in one ear
- Chest pain or a racing, irregular heartbeat
Dizziness and vertigo cause millions of visits to the emergency department annually. Some of these (roughly 1-5%) are actually strokes instead of inner ear issues. When you’re unsure, get checked out properly.
Tying It All Together
Dizziness is an umbrella term. Vertigo is a spinning sensation caused by a certain issue. Confusing the two is how patients find themselves months behind where they could have been.
If it is a crystal issue, then a good assessment will quickly rule this out. From there the road is normally clear-cut – manoeuvres to reposition crystals if indicated, and a progressive set of gaze stabilisation exercises to restore the relationship between the eyes and inner ear.
The room shouldn’t be spinning. And usually there is something that can be done about that.
