10 Jul Treating vertigo: Tips for alleviating the symptoms

Those affected have the impression that their body swings slightly back and forth or sways - similar to being on a boat in waves. The field of vision remains completely stable: nothing rotates, nothing blurs and the surroundings do not visibly change either. Nevertheless, there is a feeling of being off balance or not standing securely on your feet.

This sensation often occurs suddenly or intensifies when walking, in crowds or when looking into larger rooms. Some also describe it as "bottomlessness" or the feeling that the floor is giving way under your feet.

Many sufferers feel unstable, as if they are not fully "grounded" or as if they could lose their balance at any time. When walking, they often have the impression that they cannot control their legs properly or that the ground beneath them is uneven, even though everything is actually normal. This insecurity is often exacerbated in open spaces, on bridges, escalators or in the dark.

When standing, for example in a queue or in the shower, it can feel as if you have to hold on tight to avoid falling over. This constant feeling of instability leads to avoidance behaviour and severe psychological stress for many people.

In situations in which the balance system is under greater strain - for example when walking on cobblestones, on grass or in sand - the symptoms are often particularly noticeable.

Those affected report that they feel as if they are about to tip over or lose their footing at such times. Darkness or poor visibility can also affect balance, as visual stimuli are no longer an important orientation aid. Without this visual stabilisation, it is more difficult for the body to reliably perceive its own position in space, which often further increases the feeling of insecurity.

The unpleasant feeling of dizziness can not only affect your balance, but also your general well-being. Some sufferers experience mild to moderate nausea during periods of dizziness - similar to travel sickness.

This effect can be particularly pronounced when moving or changing position quickly. Drowsiness often accompanies this: a diffuse, wobbly state in which everything slows down or feels "as if in a fog".

This sensation is not a circulatory problem in the classic sense, but is related to the disturbed processing of balance stimuli in the brain. The combination of dizziness, nausea and light-headedness can be very unsettling and severely restrict your ability to cope with everyday stress.

Swaying vertigo can also increase significantly under mental stress. The feeling of instability can increase in stressful moments or busy environments - for example in shopping centres, train stations or at events.

The body reacts to stress with increased muscle tension and heightened alertness, which can also influence the perception of balance disorders.

In crowds, this is aggravated by the fact that visual landmarks are constantly in motion. This overstrains the already sensitive balance system. The result: the feeling of swaying increases, combined with inner restlessness or even panic. This connection between dizziness and mental stress often leads to a cycle of uncertainty and avoidance.

The persistent feeling of unsteadiness when standing or walking can quickly lead to a deep-seated fear - namely that of suddenly falling or no longer being able to control oneself properly. This concern not only affects older people, but also younger people who normally move around safely.

It is particularly stressful that there is often no objective reason for a fall, but the feeling of instability is very real. Many people therefore withdraw from everyday life, avoiding public transport or longer journeys, for example.

The fear of losing control can become so strong that it triggers other symptoms - such as palpitations, sweating or breathlessness. This often results in a spiral of reciprocal stress: the anxiety intensifies the dizziness, and the dizziness in turn feeds the anxiety.

Many people with vertigo experience persistent tension in the neck, shoulders and upper back. This muscle tension can be both the cause and the consequence of vertigo.

On the one hand, they impair blood circulation and nerve supply in the head and neck area, which can have a direct impact on the balance system. On the other hand, the constant feeling of insecurity often unconsciously leads to a cramped posture - for example by permanently tensing the shoulders or a cautious gait. This posture puts additional strain on the muscles and exacerbates the symptoms.

Many sufferers experience a mental void or a kind of "trance state" during or after a period of dizziness. Many sufferers describe how they find it difficult to concentrate, find it hard to grasp thoughts and even everyday tasks take a lot of energy.

This sensation is often described as "like being beside oneself" or "not quite being there". The result is a feeling of alienation from one's own body or surroundings - without loss of consciousness, but with significantly reduced alertness.

Such symptoms can be the result of constant inner tension or overstimulation of the vestibular system. Psychological factors such as anxiety, stress or exhaustion also often contribute to this type of impairment. The experience not only affects performance, but often also self-confidence in everyday life.

The Balance system is located in the inner ear and consists of three semicircular canals and the vestibule with the utricle and saccule. It registers movements and changes in the position of the body. The sensory impressions are transmitted to the brain via the vestibular nerve. There they are compared with impressions from the eyes and the muscles. Only this interaction enables a stable posture and safe orientation in space.

If there is a disruption within this system, the signals become unbalanced. The brain receives contradictory or incorrect information, which leads to feelings of dizziness.

The most common causes of vertigo in the area of the inner ear include

Vestibular neuritis

A sudden, usually unilateral inflammation of the vestibular nerve, which can occur after a viral infection, for example. It leads to severe dizziness, initially often with nausea and vomiting. Later, some sufferers are left with diffuse vertigo.

Meniere's disease

This disease of the inner ear causes excess pressure due to fluid accumulation (endolymph hydrops). Typical for Meniere's disease are paroxysmal rotary vertigo, hearing loss and Ringing in the ears. Persistent vertigo may persist between attacks.

Age-related changes

With age, the function of the vestibular system deteriorates - often accompanied by Hearing loss. These gradual changes often lead to increasing unsteadiness when walking, especially on uneven surfaces or at dusk.

Other diseases of the inner ear - such as a perilymphatic fistula, benign tumours (e.g. vestibular schwannoma) or labyrinthitis - can also disrupt the vestibular system and cause vertigo. A thorough diagnosis in our ENT clinic in Frankfurt is important in order to determine the exact cause and initiate targeted treatment.

Blockages or tension in the cervical spine or neck muscles can disrupt the processing of signals between the body and brain. This form of dizziness occurs particularly when sitting for long periods, in poor posture or after accidents (e.g. whiplash).

Reduced blood flow to certain areas of the brain - e.g. due to low blood pressure, cardiac arrhythmia or vasoconstriction - can affect balance. This can manifest itself in the form of non-specific vertigo.

Certain drugs such as tranquillisers, antihypertensives, antidepressants or strong analgesics can cause a feeling of dizziness as a side effect.

Anxiety disorders, depression or chronic stress play a central role in many people with vertigo. In these cases, there is no organic cause - but the feeling of dizziness is nevertheless real and stressful. Diffuse dizziness is typical, which intensifies under stress or in stressful situations.

In rare cases, vertigo can be the first sign of diseases such as multiple sclerosis, Parkinson's disease or a cerebellar disorder. A thorough neurological examination is therefore important if the symptoms are unclear or persistent.

With increasing age, vision, muscle strength and the ability of the balance system to react deteriorate. The interplay of sensory stimuli becomes less precise - the feeling of insecurity when walking or standing becomes more frequent.

At our ENT clinic in Frankfurt, we are happy to be your first port of call for vertigo - especially if there is a suspected disorder of the vestibular organ in the inner ear.

If you have an inflammation of the vestibular nerve (neuritis vestibularis), for example, drug therapies with anti-inflammatory preparations or antivertiginosa are used. We can also prescribe special medication for symptom control in diseases such as Menière's disease.

If there is also benign positional vertigo, we can use certain positioning manoeuvres to reduce the triggering symptoms. Crystals in the inner ear and significantly alleviate the symptoms.

Another important component is the prescription of vestibular rehabilitation exercises. These special balance exercises help your brain to better process disturbed stimuli and retrain your balance. In some cases, a referral to specialised physiotherapy can be useful if additional muscular or functional factors are present.

We also use audiometric procedures to check whether there is also a hearing loss or another inner ear problem that could influence the symptoms.

The aim of all these measures is to specifically stabilise the balance system, normalise the processing of stimuli in the brain and noticeably improve your quality of life.

Many sufferers benefit from targeted physical measures, especially if muscular tension or problems with the cervical spine are also causing the vertigo.

Physiotherapy and balance training improve body awareness, promote stability and help the brain to better regulate balance. In addition, heat treatments, manual therapy, massages and gentle posture training can relieve tension and improve postural stability. The exercises can usually be continued at home with professional guidance.

In the case of functional or stress-related vertigo, psychotherapeutic support is often effective. In the case of chronic complaints or accompanying anxiety, behavioural therapy can help to improve the handling of dizziness and reduce avoidance behaviour. Relaxation methods such as progressive muscle relaxation or mindfulness training can also provide relief.

A healthy lifestyle can support the treatment of vertigo. Regular exercise strengthens the circulation and improves body awareness - both important factors for a stable balance.

Sufficient sleep, conscious recovery phases in everyday life and the targeted reduction of stress are just as important. Avoiding nicotine and moderate consumption of alcohol and caffeine can also have a positive effect on the symptoms. A balanced diet and sufficient fluid intake also help to stabilise the body as a whole and promote well-being.