Clinically reviewed by What is vertigo
Vertigo is the feeling that you, or the room, is spinning. It is not the same as feeling faint or light-headed, and that difference matters because the causes are different. In Urdu it is sar chakrana.
The commonest cause by far is BPPV, benign paroxysmal positional vertigo. Tiny crystals that normally sit in one part of the inner ear come loose and fall into a balance canal. When you move your head they move the fluid in that canal, and your brain is told you are spinning when you are not.
BPPV feels frightening and it is one of the most treatable conditions in physiotherapy.
Symptoms you might have
- Intense spinning brought on by a change of head position: rolling over in bed, lying down, sitting up, looking up at a shelf or bending down
- Attacks lasting seconds to under a minute, then settling if you keep still
- Often worst on first turning over or getting up in the morning
- Nausea, and vomiting in bad attacks
- Unsteadiness that lingers between attacks
- No hearing loss, no ringing in the ear and no headache. Those point to a different cause
Why it happens
- Age. BPPV becomes much more common after fifty
- A knock to the head, even a fairly minor one
- A long period lying in bed, or always sleeping on the same side
- A previous inner ear infection
- Migraine
- No identifiable cause at all, which is the case for many people
Not all vertigo is BPPV. Spinning that lasts hours with hearing loss, ringing and ear fullness suggests Meniere's disease. Constant spinning for days after a viral illness suggests inflammation of the balance nerve. Both need a doctor's diagnosis.
When you should see a physiotherapist
Come in once the spinning has happened more than once or twice with a change of position. BPPV does not need a scan. It needs a positional test to confirm which ear and which canal, then a repositioning manoeuvre.
Go to a hospital immediately if dizziness comes with any of these: a new severe headache, double vision, slurred speech, weakness or numbness in the face, arm or leg, difficulty swallowing, or repeatedly falling to one side. These suggest a stroke at the back of the brain and they are an emergency.
See a doctor if the spinning is constant rather than coming in short bursts, if it lasts hours at a time, if you have new hearing loss or ringing, or if there is ear discharge or fever.
Al-Shama Physiotherapy Clinic
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اپائنٹمنٹ کے بارے میں پوچھیںAppointment ke liye poochein
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یہ فارم پُر کریں؛ واٹس ایپ پر آپ کی تفصیلات کے ساتھ پیغام تیار ہو جائے گا۔Yeh form bharein, WhatsApp aap ki tafseel ke saath khul jaye ga.
How it is treated
Assessment comes first. Positional tests, done while watching your eye movements, show whether this is BPPV and which ear and which canal the crystals are in. Treating the wrong canal does not work, which is why copying a video usually fails.
- The Epley manoeuvre, a guided sequence of head and body positions that moves the crystals out of the canal. This is the main treatment for the commonest form of BPPV
- Other repositioning manoeuvres where testing shows a different canal is involved
- Habituation exercises for the unsteadiness that can linger after the spinning has stopped
- Gaze stabilisation exercises, retraining the eyes and head to work together
- Balance retraining, particularly for older people, because the real danger from vertigo is a fall
- Manual therapy to the neck where neck stiffness is adding to the dizziness
There is no surgery for ordinary BPPV and no tablet that cures it. Medicines that suppress dizziness can make you feel less sick for a day or two, which is a doctor's decision, but taken for weeks they slow recovery, because the brain needs normal movement to recalibrate.
Exercises, and what to avoid
What helps
- Brandt-Daroff exercises at home, once they have been taught to you, until the spinning stops
- Gaze stabilisation: holding your eyes on a target on the wall while turning your head slowly side to side
- Walking every day, including outdoors, because avoiding movement keeps dizziness going
- Standing balance practice beside a wall or a chair
What to avoid
- Doing the Epley manoeuvre from a video without knowing which ear is affected. Done on the wrong side it can move the crystals somewhere worse
- Driving, climbing or working at height while attacks are still happening
- Lying still for days hoping it passes. The brain recalibrates through movement
- Taking dizziness tablets for weeks on end, which delays recovery
What you can do at home
Sit on the edge of the bed for a few seconds before standing, and get up in stages.
Move your head slowly for a day or two after a manoeuvre, then return to normal movement. You do not need to sleep sitting upright or avoid one side for days. Research has not shown that those restrictions make any difference.
Keep a light on at night. Most falls happen when you cannot see, because your eyes do part of the balance work.
Clear the route from your bed to the bathroom.
Heat and ice have no role here. Note which positions set it off and bring that with you, because it tells us which side to test first.
How long it takes
BPPV usually responds quickly. Most people are substantially better after one or two repositioning sessions, and the large majority are clear within three.
Lingering unsteadiness after the spinning itself has stopped is common. It takes a further two to four weeks of exercises to settle, and longer in older people.
Left alone, BPPV often does settle by itself over weeks to months. There is no good reason to wait when a manoeuvre takes fifteen minutes and the risk meanwhile is a fall.
It comes back in a fair number of people, sometimes years later, and the same manoeuvre usually works again.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
بی پی پی وی میں کان کے اندر کے چھوٹے ذرات اپنی جگہ سے ہٹ کر توازن والی نالی میں چلے جاتے ہیں۔ اسی لیے سر کی حرکت پر چکر آتا ہے۔
پہچان یہ ہے کہ چکر بستر پر کروٹ بدلنے، لیٹنے، اٹھنے یا اوپر دیکھنے پر آتا ہے، اور اکثر ایک منٹ سے کم رہتا ہے۔
اچھی خبر یہ ہے کہ علاج آسان ہے۔ ایپلی مینوور سے ذرات واپس اپنی جگہ پر چلے جاتے ہیں۔ زیادہ تر لوگوں کو ایک یا دو سیشن کافی ہوتے ہیں۔
ویڈیو دیکھ کر خود مینوور نہ کریں۔ پہلے معلوم کرنا ضروری ہے کہ کون سا کان متاثر ہے۔
فوراً ہسپتال جائیں اگر چکر کے ساتھ سخت سر درد، دہری نظر، بولنے میں لگن، یا جسم میں کمزوری ہو۔ یہ فالج کی علامات ہو سکتی ہیں۔
Roman Urdu
BPPV mein kaan ke andar ke chhote zarray apni jagah se hat kar balance wali nali mein chale jate hain. Isi liye sir ki harkat par chakkar aata hai.
Pehchan ye hai ke chakkar bistar par karwat badalne, letne, uthne ya upar dekhne par aata hai, aur aksar ek minute se kam rehta hai.
Achi khabar ye hai ke ilaj asan hai. Epley manoeuvre se zarray wapis apni jagah par chale jate hain. Zyada tar logon ko ek ya do session kaafi hote hain.
Video dekh kar khud manoeuvre na karen. Pehle maloom karna zaroori hai ke kaun sa kaan mutasir hai.
Foran hospital jayen agar chakkar ke sath sakht sar dard, dohri nazar, bolne mein lagnat, ya jism mein kamzori ho. Ye falij ki alamat ho sakti hain.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
A plan built around you.
Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
Understand your next steps
Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
What is the fastest way to stop vertigo?
Can I do the Epley manoeuvre myself at home?
How do I know my vertigo is not something serious?
Will vertigo come back after treatment?
Do I need an MRI for vertigo?
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