When You Should Worry About Dizziness

Causes and treatments are wide-ranging

Dizziness is not a problem you should ignore. It can affect people differently, making you feel like you are spinning, light-headed, imbalanced, woozy, or it can cause a floating or rocking sensation. You may also experience nausea and visual problems, such as a decrease in focus, says vestibular therapist Janet Kucinic.

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She says it’s important to tell your doctor if you feel these symptoms because it can be caused by a variety of issues, including:

  • A problem in your inner ear, brain or neck
  • Neurological issues
  • Heart-related issues
  • Changes in your medication or dosage

“The most important thing is to seek medical attention in order for a doctor to make appropriate assessments and diagnoses,” Ms. Kucinic says.

She says your doctor may recommend further diagnostic tests, including an MRI and/or CT of the brain and/or neck; cardiac tests; or vestibular test battery, a gold standard in assessing inner ear function.

The primary doctor may also refer you to an ENT or neurologist, Ms. Kucinic says.

When it’s an emergency

If dizziness is ever accompanied by any of the following, go to the ER:

  • Slurred speech
  • Blurred vision
  • Pain or numbness/tingling in the arm(s)
  • Nausea
  • Severe headache
  • Chest pain
  • Pressure or heaviness
  • Shortness of breath

Common causes for dizziness

While dizziness can be caused by various factors, it often occurs when the vestibular system – which controls balance and spatial orientation — becomes injured or damaged.

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This may occur when:

  • Small crystals of calcium carbonate within one of the organs of the inner ear becomes detached and moves into another part of the inner ear. Called Benign Paroxysmal Positional Vertigo (BPPV), this dizziness is usually short-lived. It can happen when you bend, look up, roll over in bed or move from a lying to sit or sit to lying position.
  • You experience an acute onset of symptoms including dizziness, nausea/vomiting, imbalance and visual challenges. This can be caused by vestibular neuritis and may follow an upper respiratory infection or a gastrointestinal tract infection.
  • You experience symptoms that are similar to neuritis, but it also can involve hearing loss and tinnitus due to a condition called vestibular labyrinthitis.

Less common types of dizziness can be caused by:

  • An opening in the temporal bone overlying the superior semicircular canal of the inner ear, which is called superior canal dehiscence.
  • A hole in the oval or round window, which separates the middle ear from the inner ear, which is called a perilymphatic fistula.
  • A benign tumor growing on the vestibulo-cochlear nerve called an acoustic neuroma.

Other problems that can trigger dizziness are Menieres disease and migraines, Ms. Kucinic says.

Neck problems related to dizziness

Ms. Kucinic says it is also possible to experience dizziness related to the cervical spine, even if you don’t have neck pain.

“When there are joint restrictions in the neck, especially in the upper cervical spine, this can cause a misfiring of how the neck and brain communicate. This, in turn, can cause dizziness,” she says.

“There are also particular muscles in the neck that can cause dizziness if there is an increase in tone in these particular muscle groups,” she adds.

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Dizziness therapies

“Sometimes, initially, patients with an acute onset of dizziness need various medications to assist with lessening the symptoms,” Ms. Kucinic says.

“These medications are called vestibular suppressants. In addition, there are anti-nausea medications to assist with nausea and vomiting that patients tend to experience initially,” she says.

Depending upon the causes of your dizziness, treatments may include:

  • Retraining of the visual, vestibular and somatosensory systems (involving muscles and joint receptors),
  • Guidance through some physical maneuvers to help resolve the positional vertigo
  • Strengthening and balance training
  • Manual intervention, postural training and performance of appropriate exercises

“The good news is that many people who suffer from dizziness can get some form of relief,” Ms. Kucinic says, noting that there are various support groups, such as The Vestibular Disorders Association.

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