What causes dizziness?

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.
• Eyes.
• Muscles.
• Joints.
• Skin.

Inner ear disorders are frequently the cause of feeling dizzy. The most common causes include benign paroxysmal positional vertigo (BPPV), Meniere’s syndrome and ear infections.

Benign paroxysmal positional vertigo (BPPV)

Benign paroxysmal positional vertigo (BPPV) makes you dizzy when you change your head or body position (like bending over). It usually only lasts a few seconds or minutes. This harmless condition happens when calcium crystals in your inner ear move out of place.

You may have BPPV as a result of a head injury or simply from getting older. The good news is that the treatment is easy. Your healthcare provider can lead you through a series of simple moves, called canalith repositioning procedure (CRP). These movements get the crystals back to their proper position.

Meniere’s syndrome

Meniere’s syndrome involves having too much fluid in the inner ear. Experts aren’t sure why it accumulates. Anyone can develop Meniere’s, but it’s most common in people ages 40 to 60. If you have Meniere’s syndrome, you may also experience:

• Hearing loss.
• Muffled or distorted hearing.
• Nausea and vomiting.
• Tinnitus (ringing in the ear).

Meniere’s attacks usually happen suddenly. They can last from 20 minutes to 24 hours. Treatment methods include anti-nausea and anti-vertigo medications. Lifestyle changes may help, too, including:

• Following a low-salt diet.
• Limiting use of alcohol and caffeine.
• Changing medications.
• Quitting smoking.

If your condition doesn’t respond to simple measures, your healthcare provider may recommend more aggressive treatments. Those include injecting medication directly into the ear and surgery.

Ear infections

Viral or bacterial ear infections can cause inflammation (irritation) in the inner ear. The inflammation interferes with the messages your inner ear sends to your brain.

A nerve in the inner ear, the vestibulocochlear nerve, has two branches. Each branch communicates with the brain:

• The vestibular nerve sends signals about balance. When the vestibular nerve is inflamed, you develop vestibular neuritis.
• The cochlear nerve sends signals about hearing. If inflammation also affects the cochlear nerve, you develop labyrinthitis. Labyrinthitis also causes ringing in the ears and hearing loss.

Ear infection treatments include medications to relieve the symptoms of nausea and dizziness. You might also need antibiotics, antiviral drugs or steroids.

Other causes of dizzy spells and lightheadedness

There are many other factors that can cause dizziness. Within the heart and vascular system, conditions that can cause dizziness include:

• Irregular heartbeat (atrial fibrillation).
• Low blood pressure (hypotension).
• Narrowed arteries (atherosclerosis).

Brain-related conditions that can cause dizziness include:

• Head injury or traumatic brain injury (TBI).
• Migraine.
• Multiple sclerosis.

Additional conditions that can cause dizziness include:

• Alcohol use.
• Anxiety and stress (if you hyperventilate or breathe too quickly).
• Carbon monoxide poisoning.
• Low blood sugar (hypoglycemia).
• Medications.
• Vision problems.

How are dizziness and vertigo treated?

Treatment for vertigo and dizziness varies widely depending on the cause. Your healthcare provider may refer you to an audiologist for vestibular and balance assessment to help determine the cause for dizziness, and help determine next steps in management. If you have an ear infection, you may just need anti-nausea medication until the infection is gone. For long-term (chronic) conditions, your healthcare provider may recommend vestibular rehabilitation. It’s similar to physical therapy, with the goal of improving your balance through specific exercises.

What can I do to prevent falling?

If you have dizziness or vertigo, you should avoid several activities, including:

• Driving (until your doctor gives you approval).
• Standing in high places, such as climbing a ladder.
• Walking in the dark.
• Wearing high-heeled shoes.

Take these steps to reduce your risk of falling:

• Always use handrails when walking up and down stairs.
• Change positions or turn slowly. Have something nearby to hold onto.
• Install hand grips in baths and showers.
• Practice exercises that can improve balance, such as tai chi or yoga.
• Remove floor clutter that you might trip over like throw rugs, loose electrical cords and stools. Be careful around small pets that might get underfoot.
• Sit on the edge of the bed for several minutes in the morning before you stand up.
• Use a cane or walker.

When should I see my healthcare provider?

If your dizziness won’t go away or keeps coming back, it’s important to talk to your healthcare provider about it. Seek emergency care if you also have any of the following symptoms:

• Chest pain.
• Double vision or blurred vision.
• Fainting (syncope).
• High fever.
• Numbness, tingling or weakness in your face, arms or legs.
• Slurred speech or a stiff neck.
• Trouble walking.

Your sense of balance is an intricate process that relies on many body parts. It’s easy to take it for granted until it goes haywire. Your ear, brain and heart can all affect your balance. It can take time to nail down the exact cause. But in most cases, dizziness and vertigo are symptoms of treatable conditions.