Column March 12, 2026
Vertigo and Dizziness — The Difference Between Spinning and Lightheadedness
Hyo-seop Kim
Chief Director
Table of Contents
Dizziness is not all the same
Dizziness is broadly divided into rotational vertigo (the world spinning around) and non-rotational dizziness (lightheadedness and unsteadiness). Because the causes and treatments differ completely, accurate differentiation is essential.
Rotational vertigo — phlegm-fluid vertigo (痰飮眩暈)
- BPPV: Severe spinning lasting a few seconds when changing head position → canalith repositioning maneuvers plus Korean medicine treatment for phlegm-fluid
- Meniere's disease: Spinning lasting hours with tinnitus and hearing loss → Zexie-tang and Wuling-san to drain water-fluid retention
- Vestibular neuritis: Severe spinning lasting several days → expel wind and resolve phlegm (祛風化痰) treatment
- Representative formula: Banxia-baizhu-tianma-tang (半夏白朮天麻湯) — the classic prescription for spleen-deficiency phlegm-fluid type vertigo
Non-rotational dizziness — hyperactive liver yang (肝陽上亢)
- Orthostatic hypotension: Lightheadedness when standing up → deficiency of both qi and blood (氣血兩虛) — Bazhen-tang
- Cervicogenic dizziness: Dizziness triggered by neck movement → cervical chuna manipulation plus acupuncture
- Stress-related dizziness: Liver yang rises and the head feels foggy → Tianma-gouteng-yin (天麻鉤藤飮)
Acupuncture treatment
- Fengchi (GB20), Baihui (GV20): Foundational points for dizziness
- Neiguan (PC6): Relieves nausea associated with dizziness
- Taichong (LR3), Taixi (KI3): Subdue liver yang and tonify kidney yin to address the root