Feeling dizzy on a regular basis can be scary and even disabling. Some people living with psoriatic arthritis (PsA) report having dizzy spells, also referred to as vertigo. Some scientific evidence suggests that psoriatic arthritis inflammation can cause inner ear damage, which could cause vertigo — as well as balance and hearing issues — for people with PsA.

“Day started out pretty bad — had a vertigo attack and spent the day in bed, spinning,” wrote one MyPsoriasisTeam member.

In this article, we’ll share what vertigo feels like for people with psoriatic arthritis, the possible causes of dizzy spells, and ways to prevent and manage dizziness to help you feel steady and balanced.

What Is Vertigo?

People sometimes use the terms “dizzy spell” and “vertigo” interchangeably, but they actually have slightly different meanings. Dizziness is an abnormal sensation where you feel a distortion of where you are within a space. When you’re dizzy, you may feel off-balance or lightheaded, unsteady, or mentally foggy. With vertigo, you feel your surrounding environment is moving — as if either your head or the room is spinning.

Having a rare dizzy spell or feeling of vertigo may be more common than you think. In fact, about one-third of all Americans experience these sensations once in a while, according to Mayo Clinic. Sometimes they can happen from standing up too quickly, riding a roller coaster, or not drinking enough water — just to name a few examples.

The key here is that these types of episodes are rare and mild, and they don’t impact your ability to engage in daily activities. If you experience vertigo or dizzy spells often, if they’re severe, or if they restrict your life, they could be the sign of something more serious. They may or may not be related to your psoriatic arthritis.

What Does Vertigo Feel Like?

Members of MyPsoriasisTeam describe ways that dizzy spells or vertigo-like symptoms impact their ability to go about their day. Dizziness is often associated with other symptoms, too. Below are some descriptions of dizziness from members in their own words:

• “Can’t seem to shake the nausea and dizziness.”
• “I woke up with dizziness today in the early morning. I couldn't even sit up on the side of the bed.”
• “I have a constant headache and vertigo from the time I get up in the morning until I fall asleep.”
• “I have recently had periods of extreme dizziness. I fall a lot and have difficulty remembering things. I will actually lose a day or two. I think I have read about something like this that was referred to as ‘brain fog.’ These ‘spells’ have happened at least three times, as far as I can remember.”

Some members of MyPsoriasisTeam had questions about whether vertigo may be a side effect of one of their psoriatic arthritis medications:

• “I had a lot of dizziness at first when I was taking that medication.”
• “Week three on methotrexate and feeling fairly ill.”
• “Some other side effects are sort of like dizziness and confusion or a disoriented feeling.”
• “I have a question for anybody who is on Stelara injection — about side effects ... I have had terrible dizziness, disorientation, and nausea for the past month.”

What Causes Vertigo in Psoriatic Arthritis?

Psoriatic arthritis is an autoimmune disease that can cause inflammation in your cardiovascular system and nervous system, as well as joint pain. Researchers think the symptoms of dizziness or vertigo for people with PsA may result from inflammation. If your own immune system mistakenly attacks its healthy cells in the inner ear, it can damage the vestibular system. This is the body’s system responsible for your sensation of balance and coordination.

Several studies suggest that inflammation from PsA may indeed affect a person’s balance and hearing: In a study from 2014 of 60 people living with PsA, Researchers found that 60 percent of participants with PsA had evidence of inner ear damage and hearing loss — compared to 5 percent of controls (participants used for comparison). They also found that 23 percent of participants with PsA had balance problems.

In a 2017 study, researchers discovered that 33 percent of study participants with psoriatic arthritis had problems with their vestibular system, compared to 6 percent of those without psoriatic arthritis.

More research is needed to determine how common vertigo and dizziness is in people living with PsA and what causes it.

Dizziness as a Side Effect

Another cause of dizziness could be the medication you take, whether for PsA or another condition. Some psoriatic arthritis medications have dizziness as a known side effect. These include corticosteroid injections, as well as nonsteroidal anti-inflammatory drugs (NSAIDs), including:

• Ibuprofen (Advil and Motrin)
• Naproxen (Aleve)
• Celecoxib (Celebrex)
• Aspirin

Some disease-modifying antirheumatic drugs (DMARDs) also may cause dizziness, including:

• Adalimumab (Humira)
• Cyclosporine (Gengraf)
• Golimumab (Simponi)
• Infliximab (Remicade)
• Ixekizumab (Taltz)
• Leflunomide (Arava)
• Methotrexate (Rasuvo, Orexup, and Trexall)
• Secukinumab (Cosentyx)
• Sulfasalazine (Azulfidine)
• Tofacitinib (Xeljanz)
• Upadacitinib (Rinvoq)
• Ustekinumab (Stelara)

For some of these medications, dizziness is a common side effect; for others, it’s a rare event. Dizziness can also be a symptom of an allergy to any medication.

Other Causes of Vertigo

There are many other potential causes of dizziness or vertigo besides psoriatic arthritis. Some include:

• Conditions of the inner ear such as Meniere’s disease, benign paroxysmal positional vertigo, and labyrinthitis
• Migraine
• Low blood pressure
• Dehydration
• Diabetes
• Abnormal heart rhythms
• Head injury
• Ear surgery
• Multiple sclerosis
• Certain tumors, such as acoustic neuroma

When To See a Doctor

If you experience sudden, severe, and recurrent episodes of dizziness or vertigo — or you have fallen because of vertigo — it’s time to call your doctor. There may also be an underlying cause that is treatable. Additionally, there are medications and treatments available for vertigo if it’s impacting your quality of life.

If you are experiencing a first-time episode of new, severe dizziness, it could be the sign of a medical emergency, especially if it’s associated with any of the following symptoms. Seek emergency care if, in addition to dizziness, you have any of the following:

• Severe headache
• Chest pain
• Trouble breathing
• Vomiting
• Weakness or numbness in arms or legs
• Weakness or numbness in the face
• Confusion
• Trouble speaking or slurred speech
• Trouble walking
• Seizures
• Sudden change in your ability to hear

3 Ways To Reduce Vertigo

The good news is that there are steps you can take to lower your risk for dizzy spells or treat the underlying cause of vertigo.

1. Practice Healthy Habits

There are many common causes for dizziness, so it’s important to cover the basics first. Dehydration can cause dizziness, so make sure you are drinking plenty of water on a daily basis.

Certain drinks and foods can also lead to vertigo. Common examples include too much caffeine, alcohol, tobacco, sugar, and salt. Limiting these items can help if you’re feeling lightheaded or unsteady.

Eating a balanced diet and engaging in exercise as tolerable, such as yoga, can help reduce symptoms of vertigo. By a similar token, moving slowly, especially when you stand up, is important. Avoid bending down to pick something up, and instead ask for help.

Sleeping with your head elevated by using several pillows may help too.

2. Talk to Your Doctor About Medications

Some medications noted above for treating PsA — and other conditions — are known to cause dizziness as a side effect. Your doctor can help you determine which medication is causing problems and adjust the dosage or timing or recommend an alternative.

On the other hand, sometimes vertigo can be due to inflammation from psoriatic disease. In these cases, you may need to find a more effective DMARD or a different dosage of the one you’re taking to help combat inflammation throughout your body. Again, your doctor is the best person to speak with, as they understand your personal health details and what will help you feel your best.

3. Try Vestibular Rehabilitation

Vestibular rehabilitation is an exercise-based treatment to treat vertigo, especially for people whose vertigo stems from an autoimmune disease. Vestibular rehab therapy emphasizes balance, stability, and limiting how much dizziness affects you. Although it can help with symptoms, it does not cure vertigo.

If vertigo continues to be a problem despite making other changes, ask your doctor whether vestibular rehab might be helpful for you.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, more than 116,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Are you living with psoriatic arthritis? Have you ever had dizzy spells or vertigo? Share your experience in the comments below, or start a conversation by posting on your Activities page.