“I feel dizzy.”
It’s one of the most common phrases we hear in clinic — and one of the most important to unpack.
Because while many people use the words vertigo and dizziness interchangeably, they actually describe very different sensations — and often point to very different causes.
Understanding the difference is the first step toward getting the right treatment — and feeling steady again.
When It’s Vertigo: The Spinning Sensation
Vertigo is a very specific type of dizziness.
Patients experiencing vertigo often describe a clear spinning or whirling feeling. Some say it feels like the room is moving around them. Others feel as though they themselves are spinning, even when perfectly still.
It can be intense, disorienting, and frequently accompanied by nausea, imbalance, or difficulty focusing visually.
Vertigo almost always originates from the vestibular system — the balance organs housed within the inner ear.
These organs work closely with the brain and eyes to help us understand where we are in space. When they become irritated or disrupted, the brain receives mixed signals — creating the illusion of movement.
One of the most common causes is benign paroxysmal positional vertigo (BPPV), where tiny calcium crystals in the inner ear shift into the wrong canal. This type of vertigo is often triggered by head movements such as rolling in bed or looking up.
Other inner ear causes include vestibular neuritis, labyrinthitis, Ménière’s disease, and vestibular migraines.
The good news is that many vertigo conditions respond very well to vestibular physiotherapy, particularly repositioning manoeuvres and balance retraining.
When It’s Dizziness: The Umbrella Term
Dizziness, on the other hand, is much broader.
It describes a general sense that something feels “off,” but without the spinning sensation that defines vertigo.
Patients might say they feel lightheaded, foggy, faint, or unsteady. Some feel as though they might pass out. Others describe a floating or disconnected sensation.
Because dizziness is a general term, its causes are more varied.
Low blood pressure, dehydration, blood sugar fluctuations, medications, anxiety, concussion, and cardiovascular factors can all contribute.
Neck dysfunction is another common — and often overlooked — driver. This is called cervicogenic dizziness, where altered joint and muscle input from the cervical spine disrupts balance perception.
In these cases, treating the neck can significantly improve dizziness symptoms.
Why the Distinction Matters
While both vertigo and dizziness affect balance and confidence, treatment differs depending on the root cause.
For example, BPPV vertigo can often be resolved quickly using specific repositioning manoeuvres that guide inner ear crystals back into place.
Neck-related dizziness, however, responds better to manual therapy, posture correction, and cervical strengthening.
Concussion-related dizziness may require a combination of vestibular, visual, and graded exercise therapy.
If all dizziness is treated the same way, important contributing factors can be missed — leading to prolonged or recurring symptoms.
This is why a detailed assessment is essential.
When to Seek Help
Occasional lightheadedness can happen to anyone — particularly with dehydration, illness, or sudden position changes.
However, professional assessment is recommended if symptoms:
• Recur frequently
• Affect walking or balance
• Cause falls
• Limit driving or daily activities
• Include nausea or vision changes
• Follow concussion or injury
Vestibular-trained physiotherapists are specifically educated to differentiate between inner ear, neck, vision, and balance system causes of dizziness.
The Take-Home Message
A simple way to understand the difference:
Vertigo is spinning.
Dizziness is everything else that feels off-balance.
Both can be unsettling. Both can affect quality of life. And both are often highly treatable once properly assessed.
If you or someone you know is experiencing persistent dizziness or vertigo, know that effective help is available — and feeling steady again is a realistic goal.
