Vertigo vs Dizziness: What’s the Difference and When Should You See a Physio
Have you ever felt like the room was spinning? Or like you might fall over when you stand up too fast? You've probably typed "vertigo" or "dizziness" into Google and felt even more confused after reading.
These two words get mixed up all the time. But they actually mean different things. And knowing the difference can help you figure out what's really going on and who can help you.
I'm Aathi, a vestibular physiotherapist in Blacktown. Every week I see patients from across Western Sydney who tell me they're "dizzy" - but when I ask more questions, they all describe something different. Some feel like they're spinning. Some feel like they might faint. Some just feel wobbly when they walk. Each of those means something different, and each one has a different fix.
Let me break it all down for you.
What Is Dizziness?
Dizziness is a big, catch-all word. It just means you feel "off" - like something is wrong with your balance or your sense of where you are in space.
Dizziness can feel like:
• You're about to faint or "go black"
• Your head feels light or foggy
• You feel like you're floating or rocking - like you're on a boat
• You feel unsteady when you walk
• The room seems to be spinning (that one is actually vertigo - more on that in a second)
Dizziness can come from lots of different parts of your body - your inner ear, your brain, your heart and blood vessels, your neck, or even stress and anxiety. That's why figuring out the cause is so important. There isn't just one fix for "dizziness."
What Is Vertigo?
Vertigo is a specific type of dizziness. It's the feeling that you or the room around you is spinning or moving - even when nothing is actually moving.
Imagine you just got off a merry-go-round. Everything still feels like it's spinning, even though you're standing still. That's what vertigo feels like - except it can happen without any merry-go-round.
People with vertigo often say things like:
• The room spins when I roll over in bed
• I feel a sudden jolt when I look up or bend down
• I feel like I'm on a boat, even at home
• I get short, intense spinning spells that go away after about a minute
The big clue with vertigo: it almost always involves a spinning or movement feeling. And it almost always comes from a problem in your inner ear.
Your Inner Ear: The Balance System Inside Your Head
You probably know your ears are for hearing. But your inner ear does something else too - it helps you balance.
Deep inside your ear, there's a tiny system called the vestibular system. It works like a built-in GPS for your body. It tells your brain which way is up, how fast you're moving, and when your head is turning.
When it's working properly, you can walk in the dark without falling over. You can turn your head fast without the world blurring. You can stand on one leg (at least for a few seconds!).
When something goes wrong with this system, the signals it sends to your brain go haywire. Your brain gets confused information and the result is dizziness, spinning, wobbling, or nausea.
The good news: this system can be retrained. With the right exercises and treatment, most people feel a lot better.
What Causes Vertigo? The Main Conditions
BPPV - The Most Common Cause of Vertigo
BPPV stands for Benign Paroxysmal Positional Vertigo. That's a mouthful, so let's break it down:
• Benign - not dangerous
• Paroxysmal - it comes in short, sudden bursts
• Positional - it's triggered by changing position
• Vertigo - that spinning feeling
BPPV happens when tiny crystals inside your inner ear (called otoconia) fall out of their normal spot and roll into the wrong place. When your head moves, those loose crystals send a false spinning signal to your brain.
It usually causes spinning episodes that last less than a minute. Classic triggers are rolling over in bed, sitting up, tilting your head back, or bending forward to pick something up.
The good news: BPPV is very treatable. A physio can use a specific head movement technique (called the Epley Manoeuvre) to guide those crystals back where they belong. Most people feel significantly better within one or two sessions.
Vestibular Neuritis - When a Virus Attacks Your Balance Nerve
Sometimes a virus (like a common cold or flu virus) inflames the nerve that connects your inner ear to your brain. This is called vestibular neuritis.
It hits hard and fast - sudden, severe spinning that can last for hours or days, often with nausea and vomiting. It's not triggered by head movements; it just comes on and stays.
After the worst of it passes, many people are left feeling unsteady and "off" for weeks or months. That's where vestibular physiotherapy comes in - specific exercises that help your brain learn to work around the damaged nerve.
Labyrinthitis - Similar but With Hearing Changes Too
Labyrinthitis is like vestibular neuritis, but it also affects the part of the ear responsible for hearing. So alongside vertigo, you might notice muffled hearing or ringing in your ears (called tinnitus). Treatment is similar to vestibular neuritis.
Meniere's Disease - Too Much Fluid in the Inner Ear
Meniere's disease happens when too much fluid builds up inside your inner ear. It causes episodes of strong vertigo (lasting anywhere from 20 minutes to several hours), along with hearing changes, ringing ears, and a feeling of fullness or pressure in the ear.
Managing Meniere's usually involves more than one type of health professional. Vestibular physiotherapy helps reduce the impact on your balance and daily life.
Cervicogenic Dizziness - When Your Neck Is the Problem
Not all dizziness comes from your ears. Your neck also plays a big role in your balance system. Joints in the top part of your neck (called the upper cervical spine) send balance signals to your brain.
If something is wrong with those neck joints - from whiplash, a sports injury, a car accident, or even years of poor posture - those signals can go wrong and cause dizziness, headaches, and a foggy feeling in your head.
This kind of dizziness responds really well to physiotherapy that combines neck treatment and vestibular exercises.
What If It's Not Vertigo? Other Causes of Dizziness
Sometimes dizziness has nothing to do with your ears. Other common causes include:
• Low blood pressure when you stand up - you stand up too fast and feel like you're going to faint for a few seconds
• Anxiety - dizziness and anxiety can feed each other in a difficult cycle
• Medication side effects - many common medications (like blood pressure tablets or antidepressants) list dizziness as a side effect
• Dehydration - not drinking enough water
• Low iron (anaemia) - not enough red blood cells to carry oxygen to your brain
A good physio will check for these kinds of causes during your assessment. If your dizziness looks like it's coming from your heart or another medical issue, we'll refer you to the right person straight away.
How Can a Physio Help With Dizziness or Vertigo?
Vestibular physiotherapy is a specialised type of physio focused on your inner ear and balance system. It's not just general physio - it requires specific training and assessment tools.
At your first appointment, your physio will:
• Ask detailed questions about your symptoms - when they started, what makes them worse, how long each episode lasts
• Move your head in specific positions to test whether BPPV is causing your vertigo
• Test how well your eyes and ears are talking to each other (called oculomotor testing)
• Watch how you walk and balance under different conditions
• Check your neck if that might be contributing
From there, treatment is matched to your specific diagnosis. BPPV gets repositioning manoeuvres. A nerve injury gets a gradual programme of eye and balance exercises. A neck problem gets hands-on physio plus targeted exercises.
At Rehab Pro in Blacktown, every vestibular assessment is one-on-one in a private room. We take our time to work out exactly what's happening - and explain it to you in plain language so you leave knowing what's wrong and what the plan is.
When Should You See a Physio for Dizziness or Vertigo?
Come and see us (or your GP first if you're not sure) if:
• Your dizziness gets worse when you move your head
• You had a sudden bout of severe vertigo that has left you feeling unsteady ever since
• You've had a head injury, concussion, or whiplash and now feel dizzy
• You had COVID-19 and developed new dizziness or balance problems afterwards
• Dizziness is affecting your ability to drive, work, or look after your family
Go to emergency immediately if: Your dizziness comes with a sudden severe headache, double vision, trouble speaking, or weakness in your arms or legs. These can be signs of a stroke. Call 000.
You Don't Have to Stay Dizzy
The most common thing I hear from patients? "I thought I just had to put up with it."
You don't.
Whether you've felt dizzy for three weeks or three years, the right assessment can give you answers. And in most cases, there's a clear treatment path.
Rehab Pro is a specialist vestibular and neurological physiotherapy clinic in Blacktown. We see patients from across Western Sydney - Parramatta, Seven Hills, Mount Druitt, and the Hills area.
If you're not sure whether you have vertigo, dizziness, or something else - that's okay. That's exactly what your first appointment is for.
Ready to get answers? Book An Appointment Now
