Dizziness

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Dizziness is a typical feeling of being unbalanced or woozy. It affects the sensory organs, specifically the eyes and ears, so it can sometimes cause fainting. Generally, dizziness isn’t a disease, but rather a symptom of a varying amounts of contributing disorders. ‘Dizziness’ is also often used to describe two of the most common different feelings; lightheadedness and vertigo:

 

  • Vertigo – Is a feeling that you or your surroundings are moving when there isn’t any actual movement. You may feel as though you are off-balance, spinning, whirling, falling, or tilting. When you have severe vertigo, you may feel very nauseated or vomit. You can also have trouble walking or standing, and you may lose your balance and fall.

 

  • Lightheadedness – Lightheadedness is a feeling that you’re about to faint or “pass out”. Although you may feel dizzy, you do not feel as though you or your surroundings are moving. Lightheadedness often goes away or improves when you lie down. If lightheadedness worsens, it can lead to a feeling of almost fainting or a fainting spell (also known as ‘syncope’). You may sometimes feel nauseated or vomit when you are lightheaded.

Causes & Symptoms

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A number of conditions can cause dizziness because balance involves several parts of the body – the brain gets input about movement and your body’s position from your inner ear, joints, skin, muscles, and eyes.

Usually, most patients will be able to easily identify the cause of their own dizziness. However, some symptoms may occur unexpectedly or without any clear reason. The following causes of dizziness can range from temporary physical changes, to more serious underlying medical conditions:

 

  • Ear infections – Viral or bacterial ear infections can cause inflammation in the inner ear. The inflammation interferes with the messages your inner ear sends to your brain. A nerve in the inner ear (known as the vestibulocochlear nerve), has two branches – these two branches (vestibular nerve and cochlear nerve) both send signals for balance and hearing. When the vestibular nerve is inflamed, you are at risk of developing vestibular neuritis. If inflammation also affects the cochlear nerve, you may develop labyrinthitis. Labyrinthitis also causes ringing in the ears and hearing loss.

 

  • Meniere’s syndrome – This type of syndrome involves having an excessive amount of fluid in the inner ear. Experts are not clearly sure why it accumulates, however, anyone can develop Meniere’s syndrome, as it is common in people ages 40-60 years. If you have Meniere’s syndrome, you may experience hearing loss, distorted hearing, nausea and vomiting, and tinnitus (ringing in the ear).

 

  • BPPV (Benign Paroxysmal Positional Vertigo) – BPPV makes you dizzy when you change your head or body position (such as bending over). Fortunately, this condition usually only lasts a few seconds or minutes. You may have BBPV as a result of a head injury or simply from getting older.

 

  • Migraine – A migraine is a type of recurring headache that may cause throbbing or pulsing pain on one side of the head. Sometimes, patients experience dizziness before the onset of a migraine episode. Other neurological symptoms, or auras, can precede the pain of a migraine headache.

 

  • Low-blood pressure – A sudden drop in blood pressure can cause a brief sensation of lightheadedness. Blood pressure changes can occur after sitting or standing up too rapidly. Other conditions that can cause blood pressure changes include blood loss, anaphylaxis (severe allergic reaction), and dehydration.

 

  • Motion sickness – Repetitive motion from being in a vehicle, such as a car, airplane, or boat, can all disrupt the structures of the inner ear, causing dizziness, nausea, and vomiting.

 

There are many other factors that can cause dizziness. A few brain-related conditions that can cause dizziness include multiple sclerosis, head injury, and traumatic brain injury (TBI). Additional conditions that can cause dizziness are:

 

  • Alcohol use

 

  • Stress

 

  • Medications

 

  • Vision problems

 

  • Carbon monoxide poisoning

Who Gets Dizziness?

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Certain risk factors that may increase your risk of dizziness include the following:

 

  • Age – Elders are more prone to have medical conditions that cause dizziness, especially a sense of imbalance. They’re also more likely to take medications that can cause dizziness.

 

  • Past episodes of dizziness – If you have ever experienced dizziness in the past, you are more likely to experience dizziness in the future.

 

  • Pregnancy – Dizziness may also occur later in your pregnancy if you lie on your back, allowing the weight of the baby to press on a large vein called vena cava. (this carries blood from your lower body to your heart).

 

  • Diabetes – Patients who suffer from diabetes may also have causes of low blood flow to the brain, which can lead to dizziness symptoms.

 

  • Allergies – Some people have dizziness when they’re exposed to certain allergens, such as dust, molds, pollens, or foods.

 

  • Alcohol consumption – Excessive alcohol consumption can increase the chances of experiencing symptoms linked to dizziness.

How Does it Affect You? How Serious is it?

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Several serious disorders can develop alongside dizziness if the level becomes severe enough, such as the following:

 

  • Inner ear problems – Disorders of the inner ear account for about half of all causes of ongoing dizziness. Such disorders include vestibular neuritis and Ménière’s disease.

 

  • Brain disorders – A common cause of dizziness is migraine, even without the headache that most patients associate with a migraine. In rare cases, other causes of dizziness can include stroke or other brain diseases.

 

  • Anxiety disorders – Stress or anxiety may play a role in causing dizziness or, more commonly, may be a contributing factor in dizziness from other causes, such as inner ear disease.

 

  • Other conditions – Some cases of dizziness are due to underlying medical conditions such as low blood pressure, infection, heart problems (such as cardiac arrhythmias), and hypoglycemia. Medications that are used to help treat conditions such as epilepsy, coronary heart disease, and high blood pressure can also cause dizziness in some individuals.

Recommended Treatment & Rehabilitation

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If dizziness is suspected to be the cause of a stroke or suffered from a blow to the head, your doctor will order an MRI or CT scan in order to rule out other conditions that are associating with dizziness. Most patients who visit their doctor due to dizziness will be first asked about their symptoms and medications and then be given a physical examination.

During this type of exam, your doctor will begin by checking how you walk and maintain your balance and how the major nerves of your central nervous system are functioning.

You may also be required to undergo a hearing test and balance tests, including the following:

 

  • Head movement test – If your doctor suspects your dizziness is caused by benign paroxysmal positional vertigo (BPPV), he or she may do a simple head movement test to verify the diagnosis.

 

  • Rotary chair test – During this test, you will be seated in a computer-controlled chair that moves slowly in a full circle. At fast velocity, it moves back and forth in a small arc.

 

  • Eye movement test – Your doctor may watch the path of your eyes when you track a moving object. Afterward, you may be given an eye motion test in which water or air is placed in your ear canal.

 

  • Posturography – This test tells your doctor which parts of the balance system you rely on the most and which parts may be giving you problems. You stand in your bare feet on a platform and try to keep your balance under various conditions.

 

Fortunately, most dizziness and imbalances can be successfully treated. Therefore, a physiotherapist can perform tests to help determine the cause of your dizziness and assess your risk of falling. Your physiotherapist will then create a personalized treatment plan for you based on your medical evaluation and your goals for recovery. Their primary focus will be to manage your dizziness and help you return to your regular daily activities.

Physiotherapy treatments for dizziness can take many forms. The following treatment plans might include exercises to:

 

  • Improve your strength, flexibility, and heart health to increase your overall physical health and well-being.

 

  • Improve the network of nerves between the inner ear and the eyes that helps to stabilize your vision during head turns.

 

  • Improve your balance to reduce the chances of falling.

 

The types of exercises that your physiotherapist designs for you will depend on your unique problems; here are some exercise examples you can try to help improve symptoms linked to dizziness:

 

Epley maneuver

Sit upright in bed. Place your legs straight and put a pillow behind you. Afterward, turn your head 45 degrees to the left. Lie back quickly until your shoulders are on the pillow. Wait for your dizziness to subside, then turn your head 90 degrees to the right without lifting it; holding this position for 30 seconds. Turn your body until you’re lying on your right side. Wait for the dizziness to subside, then sit upright on the right edge of the bed. Repeat this exercise 3 times a day.

 

Brandt-Daroff exercise

Sit in the middle of a bed with your feet on the floor. Turn your head 45 degrees to the right. Without moving your head, lie down on your left side. Wait for the dizziness to pass, then wait 30 more seconds before returning to the starting position. Next, turn your head 45 degrees to the left, then return back to your starting position. Complete this exercise with 1 set of 5 repetitions on each side.

 

Foster maneuver

Firstly, kneel down and place your hands on the floor. Secondly, tilt your head up and back as you wait until any dizziness passes. Place your forehead on the floor, tucking your chin toward your knees. Turn your head 45 degrees to face your left elbow. Hold this position for 30 seconds, then, while keeping your head 45 degrees, raise your head until it’s level with your back and shoulders. Finally, hold for 30 seconds, then raise your head to the fully upright position. Perform this stretch 3 times a day.

 

Alternative & Homeopathic Treatment

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Some people with dizziness claim that natural or homeopathic treatments can improve the spinning and dizzy sensations they experience. Some people with vertigo may also benefit from altering their diet. For example, those with Ménière’s disease may find that avoiding certain types of foods or substances can promote fluid balance in the ears and body.

Common culprits that could aggravate vertigo in certain people include salty foods, sugary foods, alcohol, and caffeine. Other studies have shown that a lack of vitamin D can worsen vertigo symptoms in some people. You can increase your levels of vitamin D by taking a supplement, getting more sunlight, or eating foods rich in vitamin D.

Some patients claim that using essential oils, like peppermint, lavender, lemon balm, and ginger can all help improve symptoms of vertigo. While there is some evidence that certain oils have medicinal benefits, the results are often mixed. 

Yoga is another good way to improve flexibility and balance, strengthen muscles, and reduce stress. Simple yoga poses (with a yoga mat for added support) may also help symptoms of vertigo. However, you will want to avoid any positions that require sudden forward bends, as these may worsen vertigo symptoms. Additionally, studies have shown acupuncture may be a safe and effective way to treat vertigo. Acupuncture involves inserting tiny needles into the skin to stimulate certain points on your body.

Other simple remedies include the following below:

 

  • Rest – Sleep deprivation can trigger episodes of vertigo. Try to get at least 7-8 hours of sleep at night to help ease this specific symptom.

 

  • Hydration – It is always recommended to drink enough fluids (either water or beverages contained with electrolytes) to stay hydrated. Some causes of vertigo are linked to dehydration.