Vertigo has many causes, so what kind of doctor should you first see?

A common cause of vertigo involves the inner ear canal. This might be the cause of your vertigo—which to some sufferers, is described as the room “spinning,” “whirling” or moving. It may also be described as sort of like a motion sickness.

“Vertigo, or more precisely, benign paroxysmal positional vertigo [BPPV], is a condition in which little particles contained within the inner ear’s balance organ lose their positioning accuracy, and you feel dizzy,” says Marc I. Leavey, MD, is a primary care physician with 40-plus years of experience, and has a blog, STRING OF MEDICAL PEARLS.

“You can feel so dizzy that you become nauseated, vomit and even fall down,” he explains. BPPV can also be very mild, in that the patient feels just slightly dizzy or “heady,” but is otherwise fully functional.

“Once diagnosed, the proper treatment is to put those little particles, called canaliths, back where they belong,” says Dr. Leavey.

“By moving the head in a precise pattern, called an Epley maneuver, BPPV can often be easily treated in the office.

“While many physicians can treat vertigo, the therapy is often practiced most skillfully by trained physical therapists, who have the skill and facility to render effective treatment.”

What Type of Doctor to See

If you believe you have benign paroxysmal positional vertigo, your family practitioner will be able to make this diagnosis. Describe the situation. Don’t just say, “I feel dizzy.”

A hallmark feature of BPPV is that the patient feels the dizziness only when they move their head.

For example, you’re busy at your computer. Your head is not moving left to right because your eyes are glued to the screen. All is fine.

You then turn your head 90 degrees to the right to grab your coffee mug…and you feel a wave of dizziness.

The room may seem to shift a little, but this isn’t always the case. Sometimes with benign paroxysmal positional vertigo you feel only that annoying dizziness.

For some patients this disappears when they lie down. For others it gets worse. Often, rising from a lying position will trigger the dizziness.

If they close their eyes while feeling the dizziness, they may feel a sensation of their body or the room spinning about.

In severe cases, the symptoms can be way out of proportion to the benignity of this disorder. Intense dizziness, especially accompanied by vomiting, will be frightening to someone who doesn’t realize this is due to those canaliths.

So if BPPV sounds like what you have, see your general doctor. If your symptoms don’t quite fit this benign type of vertigo, you should still first see your primary care doctor.

Dizziness can have so many causes, and also, some people think they’re dizzy when actually they are experiencing a faintness type of feeling.

Feelings of faintness can be caused by heart arrhythmias, low blood pressure, low blood sugar, pregnancy and side effects of medications, among many other causes. A neurological cause, too, may be behind a wave of dizziness, so as you can see, depending on the cause of the “vertigo,” you may be referred to a specialist by your primary care physician.