Dizziness and vertigo have become synonymous with one another; an interchangeable set of terms describing the same symptom. Regardless of whether someone says they are “dizzy” or they “have vertigo”, chances are you’re painting the same picture in your mind. 

 This connection makes sense. After all, the definitions of both these symptoms are essentially the same: a sensation of involuntary motion or spinning. However, as much as vertigo is a symptom, it can also be a condition. 

Shaun Koth, PT, Vestibular Rehab Specialist at Spooner Surprise, makes it a priority to educate his patients on the difference between vertigo as a symptom, and vertigo as a condition.  

“I often spend a fair amount of time in an initial evaluation helping the patient to understand the distinction. It is not all just, ‘rocks floating in the ears’ (I hear that one a lot!),” Shaun explains. “Patients, and even some doctors and therapists, use the term ‘vertigo’ as a catch-all for anything reported as dizziness. However, the cause and treatment for true vertigo (Benign Paroxysmal Positional Vertigo, also referred to as BPPV) is much different than for other forms of dizziness.” 

Shaun lends us his experience and expertise in explaining why this distinction is important to understand, expanding upon some of the other causes of dizziness, and highlighting why physical therapy is often the best first line of defense for combatting these symptoms and conditions. 

Understanding the Difference Between Vertigo and Dizziness

When Shaun was asked why it’s important for patients to understand the difference between true vertigo (BPPV) and other causes of dizziness, his answer was simple, “The treatment is different for BPPV than for other dizziness conditions. Patients should know what is causing their symptoms and have a clear understanding of the how and why behind their treatment.”  

BPPV is a mechanical problem in which tiny calcium crystals become loose in the inner ear canal. BPPV can be treated successfully using the Epley maneuver. This simple, effective approach involves sequentially turning the head in a way that helps move the crystals to a part of the inner ear where it cannot trigger vertigo symptoms.  

Epley maneuver for BBP, vertigo and dizziness

Shaun Koth, PT performing the Epley maneuver

Other causes of dizziness and unsteadiness often require re-training the vestibular (balance) and neurologic systems via specific rehabilitation activities. The result is a recalibration of those systems that helps minimize and eliminate a patient’s experienced symptoms with normal daily activities.  

There can be a number of reasons as to why you’re experiencing feelings of dizziness, and your plan of care should be catered to your unique, individual needs. Shaun said, “The proper course of treatment relies on a comprehensive examination to determine the true cause(s) of a patient’s symptoms. It is not a one-size-fits-all approach!” 

Common Causes of Dizziness

As mentioned earlier, there are a multitude of sources that can lead to sensations of dizziness. Let’s look at some of the more common causes and gain a better overview of the different possibilities at play when determining the source of one’s dizziness: 

Benign Paroxysmal Positional Vertigo (BPPV) – caused by free-floating calcium crystals in the inner ear canals. It can often cause the patient to feel nauseous, and even vomit (think of motion sickness). BPPV can occur spontaneously, or is sometimes associated with blows to the head and/or concussion in car accidents, falls, or sports-related collisions. 

Inner Ear Infection – also known as “Labyrinthitis.” This occurs when bacteria cause deep structures within the ear to become inflamed, often causing vestibular dysfunction and leading to feelings of dizziness and a loss of balance.  

Concussion – a forceful impact to the head can cause headaches, sensitivity to light, whiplash, nerve damage; all of which can cause symptoms of dizziness. In addition, the impact itself could cause free-floating crystals in the ear, leading to BPPV. 

Medications/Antibiotics – certain medications can have effects on the nervous system that cause dizziness and lightheadedness. 

Migraines – severe headaches can often lead to symptoms of dizziness. 

Poor Posture – resting and moving in the wrong positions, especially related to the neck, can lead to muscle straining, spine compression, and nerve and blood-flow disruptions. All of which can affect perception and balance. 

Nutrition – dehydration and/or low-blood sugar will often leave you feeling dizzy and uncoordinated. 

These are just a handful of the different causes of dizziness, and it is worth noting that these are not mutually exclusive. As Shaun explains, “A patient can be experiencing both BPPV and another form of vestibular dysfunction at the same time. With that being said, BPPV must always be treated and cleared first before proceeding with treatment for other vestibular issues.” 

Where to Turn First?

So, say that you are experiencing a bout of dizziness. You now know a lot about the causes, but who is going to help you find a solution? Who should your first call go to? Who is going to help you get to the root source of your condition and eliminate your symptoms sooner rather than later? 

“Sudden and severe onset of BPPV can be a frightening and debilitating condition,” Shaun states. “The sooner we can see a patient with acute onset BPPV, the more quickly we can help the patient ‘stop the world from spinning’ and start feeling better. Treatment is often very quick and effective.” 

If there is any uncertainty or concern about your condition and whether a physical therapist can help, Shaun provides some reassurances there. “As therapists, we are trained to recognize signs and symptoms of conditions that are outside our scope of practice, or that require immediate emergency medical attention. If such were the case, we would respond accordingly: call 911, transport to ER, contact patient’s physician, etc.” 

Regardless of what is contributing to your dizziness, Shaun explains that physical therapy is often the best first line of defense for combatting these symptoms. “In most cases, the patient would be best-served coming to see a Vestibular Specialist at Spooner Physical Therapy first. It can save them time, money, and get their symptoms under control much sooner.” 


If you or a loved one is struggling with symptoms of dizziness and want to learn more, visit one of Spooner’s Vestibular Rehab Specialists. Schedule an appointment or complimentary assessment, and let’s get you moving better and feeling better!