What is Dizziness?
Dizziness is a term people often use to describe a range of sensations — feeling faint, woozy, unsteady, or like the room is spinning (known as vertigo). It’s one of the most common reasons people visit the doctor, especially older adults. In fact, about 15-20% of adults experience dizziness every year, with women being slightly more affected than men.
But here’s the thing: dizziness isn’t a diagnosis — it’s a symptom. And it can signal a wide variety of conditions, ranging from minor to more serious.
How Does Dizziness Happen?
To understand dizziness, imagine your body as a balancing act between three systems:
- Your eyes — tell your brain where you are in space.
- Your inner ears (vestibular system) — act like a GPS for motion and balance.
- Your joints and muscles — give your brain information about movement and position.
When these systems send mismatched signals to your brain, confusion happens — and that’s when dizziness strikes.
Think of it like this: you’re on a boat. Your inner ear feels the rocking, but your eyes see a stable cabin wall. That conflict can make you feel dizzy — or even nauseous.
What Causes Dizziness?
Dizziness can have many underlying causes. Here’s a quick breakdown of the major ones:
1. Inner Ear Disorders (vestibular problems):
These are the most common culprits. Around 40% of dizziness cases are caused by inner ear issues.
- Benign Paroxysmal Positional Vertigo (BPPV) – brief spinning episodes triggered by head movements.
- Vestibular neuritis/labyrinthitis – inflammation in the inner ear, often after a viral infection.
- Meniere’s disease – recurring vertigo with ringing in the ears and hearing loss.
2. Blood Flow Issues (circulatory problems):
Your brain needs constant blood supply. When it’s disrupted:
- Low blood pressure – can make you feel faint when you stand up.
- Heart rhythm problems (arrhythmia) – can reduce blood flow to the brain.
- Dehydration – leads to reduced volume and dizziness.
- Anemia – low red blood cells
3. Neurological Disorders:
Though less common, conditions like migraines, multiple sclerosis, or even strokes can cause dizziness.
4. Medication Side Effects:
Some drugs, especially those for blood pressure, anxiety, or seizures, can cause lightheadedness.
5. Anxiety Disorders:
Panic attacks and chronic anxiety can lead to a sensation of floating, imbalance, or feeling “off.”
Who is Most at Risk?
Anyone can get dizzy, but some people are more prone than others. Here’s a quick look at common risk factors:
- Age over 65 – inner ear function and blood pressure regulation tend to decline with age.
- People with cardiovascular disease – less efficient blood circulation increases dizziness risk.
- Women – more likely to experience migraines or hormonal shifts that can trigger dizziness.
- Individuals on multiple medications – interactions or side effects can contribute to dizziness.
- Those with anxiety or panic disorders – emotional stress can manifest physically.
Other Symptoms That Can Happen with Dizziness
Dizziness rarely travels alone. Depending on the cause, it may come with:
- Vertigo (spinning sensation)
- Nausea or vomiting
- Balance problems or falls
- Tinnitus (ringing in the ears)
- Hearing loss
- Blurred vision
- Fainting or blacking out
When dizziness becomes more severe or is part of a bigger problem, red flags include:
- Sudden difficulty speaking
- Numbness or weakness in the face or limbs
- Double vision
- Chest pain
- Severe headache
These may signal something more serious — like a stroke or heart issue — and need urgent care.
Tests to Identify the Cause
The first step? A detailed history and physical exam. Your doctor will ask:
- When did it start?
- What does it feel like?
- Does anything trigger it?
Then come the tests. The Dix-Hallpike manoeuvre is a key one if BPPV is suspected — it involves tilting your head back to trigger vertigo. For more in-depth evaluation, other tests may include:
- Audiometry – tests your hearing for inner ear disorders.
- Electronystagmography (ENG) or Videonystagmography (VNG) – measure eye movements.
- MRI or CT scan – rule out structural issues or brain problems.
- Blood pressure checks – both sitting and standing, to detect orthostatic hypotension.
- Blood tests – to check for anaemia, infections, or thyroid disorders.
Treatment for Dizziness
The good news? Most causes of dizziness are treatable. Here’s a breakdown of the main treatments:
1. Benign Positional Vertigo (BPPV):
- Epley manoeuvre – a simple head movement done by a doctor to reposition particles in your inner ear.
- Vestibular rehabilitation – a type of physical therapy for balance.
2. Vestibular Neuritis or Labyrinthitis:
- Often viral – so rest and medications (like anti-nausea or steroids) may be prescribed.
- Vestibular rehab can speed recovery.
3. Meniere’s Disease:
- Low-salt diet, diuretics (water pills), and sometimes injections or surgery.
4. Circulatory Causes:
- Adjusting medications, increasing fluid/salt intake (for low blood pressure), or treating heart conditions.
5. Anxiety-related Dizziness:
- Cognitive behavioural therapy (CBT)
- Anti-anxiety medication
- Breathing techniques and stress reduction
6. Medication Side Effects:
- Adjusting or changing your prescriptions may help resolve dizziness.
Always consult a doctor before making any changes to medication or starting treatment.
Final Thoughts
Dizziness can feel unsettling — even frightening. But in most cases, it’s manageable once the root cause is identified. If you’re frequently feeling dizzy, don’t brush it off. It could be your body’s way of asking for help.
Have you or someone you love struggled with unexplained dizziness? You’re not alone — and there are answers out there.
References
- “Dizziness and Vertigo: A Practical Approach” – American Family Physician, 2021. https://www.aafp.org/pubs/afp/issues/2021/0401/p425.html
- “Evaluation of the Dizzy Patient” – Cleveland Clinic, 2020. https://my.clevelandclinic.org/health/articles/11881-dizziness
- “Benign Paroxysmal Positional Vertigo (BPPV)” – Mayo Clinic, 2022. https://www.mayoclinic.org/diseases-conditions/vertigo/symptoms-causes/syc-20370055