Vertigo is a symptom, rather than a condition itself. It's the sensation that you, or the environment around you, is moving or spinning.

This feeling may be barely noticeable, or it may be so severe that you find it difficult to keep your balance and do everyday tasks.

Attacks of vertigo can develop suddenly and last for a few seconds, or they may last much longer. If you have severe vertigo, your symptoms may be constant and last for several days, making normal life very difficult.

Other symptoms associated with vertigo may include:

• loss of balance – which can make it difficult to stand or walk

• feeling sick or being sick

• dizziness

Seeking medical help

You should see you GP if you have persistent signs of vertigo or it keeps coming back.

Your GP will ask about your symptoms and can carry out a simple examination to help determine some types of vertigo. They may also refer you for further tests.

What causes vertigo?

Vertigo is commonly caused by a problem with the way balance works in the inner ear, although it can also be caused by problems in certain parts of the brain.

Causes of vertigo may include:

• benign paroxysmal positional vertigo (BPPV) – where certain head movements trigger vertigo

• migraines – severe headaches

• labyrinthitis – an inner ear infection

• vestibular neuronitis – inflammation of the vestibular nerve, which runs into the inner ear and sends messages to the brain that help to control balance

Depending on the condition causing vertigo, you may experience additional symptoms, such as a high temperature, ringing in your ears (tinnitus) and hearing loss.

How is vertigo treated?

Some cases of vertigo improve over time, without treatment. However, some people have repeated episodes for many months, or even years, such as those with Ménière's disease.

There are specific treatments for some causes of vertigo. A series of simple head movements (known as the Epley manoeuvre) is used to treat BPPV.

Medicines, such as prochlorperazine and some antihistamines, can help in the early stages or most cases of vertigo.

Many people with vertigo also benefit from vestibular rehabilitation training (VRT), which is a series of exercises for people with dizziness and balance problems.

Self care

Depending on what's causing your vertigo, there may be things you can do yourself to help relieve your symptoms. Your GP or the specialist treating you may advise you to:

• do simple exercises to correct your symptoms

• sleep with your head slightly raised on two or more pillows

• get up slowly when getting out of bed and sit on the edge of the bed for a minute or so before standing

• avoid bending down to pick up items

• avoid extending your neck – for example, while reaching up to a high shelf

• move your head carefully and slowly during daily activities

• do exercises that trigger your vertigo, so your brain gets used to it and reduces the symptoms (do these only after making sure you won't fall, and have support if needed)

TINNITUS

Tinnitus is the term for hearing sounds that come from inside your body, rather than from an outside source.

It's often described as "ringing in the ears", although several sounds can be heard, including:

• buzzing

• humming

• grinding

• hissing

• whistling

Some people may hear sounds similar to music or singing, and others hear noises that beat in time with their pulse (pulsatile tinnitus).

You may also notice that your hearing is not as good as it used to be or you're more sensitive to everyday sounds (hyperacusis).

Is it serious?

Tinnitus is rarely a sign of a serious underlying condition. For some people it may come and go and only be a minor irritation.

However, it can sometimes be continuous and have a significant impact on everyday life. Severe cases can be very distressing, affect concentration, and cause problems such as difficulty sleeping (insomnia) and depression.

In many cases, tinnitus will get better gradually over time. But it's important to seek medical advice to see if an underlying cause can be found and treated, and to help you find ways to cope with the problem.

When to see your GP

You should see your GP if you continually or regularly hear sounds such as buzzing, ringing or humming in your ears.

They can examine your ears to see if the problem might be caused by a condition they could easily treat, such as an ear infection or earwax build-up. They can also do some simple checks to see if you have any hearing loss.

If necessary, your GP can refer you to a hospital specialist for further tests and treatment.

What causes tinnitus?

Tinnitus can develop gradually over time or occur suddenly. It's not clear exactly why it happens, but it often occurs along with some degree of hearing loss.

Tinnitus is often associated with:

• age-related hearing loss

• inner ear damage caused by repeated exposure to loud noises

• an earwax build-up

• a middle ear infection

• Ménière's disease – a condition that also causes hearing loss and vertigo (a spinning sensation)

• otosclerosis – an inherited condition where an abnormal bone growth in the middle ear causes hearing loss

However, around one in every three people with tinnitus doesn't have any obvious problem with their ears or hearing.

Who is affected?

Most people have experienced short periods of tinnitus after being exposed to loud noises, such as after a music concert.

In the UK, more persistent tinnitus is estimated to affect around six million people (10% of the population) to some degree, with about 600,000 (1%) experiencing it to a severity that affects their quality of life.

Tinnitus can affect people of all ages, including children, but is more common in people aged over 65.

Treating tinnitus

There's currently no single treatment for tinnitus that works for everyone. However, research to find an effective treatment is continuing.

If an underlying cause of your tinnitus can be found, effectively treating it may help improve your tinnitus – for example, removing a build-up of earwax might help.

If a specific cause can't be found, treatment will focus on helping you manage the condition on a daily basis. This may involve:

• sound therapy – listening to neutral sounds to distract you from the sound of tinnitus

• counselling – therapy that aims to educate you about tinnitus and help you learn to cope with it more effectively

• cognitive behavioural therapy (CBT) – therapy that aims to help change the way you think about your tinnitus so it becomes less noticeable

• tinnitus retraining therapy (TRT) – therapy that aims to help retrain the way your brain responds to tinnitus so you start to tune the sound out and become less aware of it

You may also find self-help measures, such as relaxation techniques or sleep hygiene measures, helpful.