Defining Dizziness

Feeling lightheaded upon rising from a chair, getting nauseous in a car, experiencing a room as spinning while lying down—these are all different ways of describing dizziness. It becomes more common with age, but there is no one single reason why a person may feel dizzy.

There is, however, a unifying element: Because dizziness significantly increases the risk for falls and injuries, it is definitely not to be ignored. Jennifer Lebowitz, physical therapist, UCLA Department of Rehabilitation Services, has herself struggled with the issue.

“One of the most important aspects is to know your personal signs,” says Lebowitz. “For me, it starts with a slight buzzing in the ears, which is my warning sign to sit down and lower my head. If I ignore this sign, the next one would be loss of vision. Once this step occurs it is imperative to sit or lie down because passing out can come extremely quickly at this point. Knowing your triggers can enable you to get into a safe position and potentially avoid a fall.”


These are among the most typical sensations associated with dizziness, which can usually be treated through physical therapy.

Vertigo is a sensation of spinning or turning. The most common vertigo is benign paroxysmal positional vertigo, or BPPV.

Lightheadedness or wooziness is feeling faint, such as from standing up quickly. It often results from an inner ear disorder or can be associated with blood pressure.

Motion sickness makes you feel nauseous. It can occur from any kind of movement, concussion or ear infection.

Disequilibrium is an unsteady feeling when standing and walking. It’s like getting off a carnival ride and being unable to walk straight.

Decline in the Vestibular System

Vestibular disorders are among the most common reasons why people feel dizzy. The vestibular system processes sensory information about equilibrium, motion, and spatial orientation. Along with vision and hearing, the vestibular system helps you maintain balance.

Benign paroxysmal positional vertigo (BPPV) is the most frequent form of vestibular dysfunction, followed by Meniere’s disease and vestibular neuronitis. Several studies show that the incidence of BPPV increases with age, and affects women more than men. As people get older, there is often some deterioration inside the structures of the ear canal. When small pieces of these structures break away (calcium crystals), these particles get trapped in the semicircular ear canals, disrupt the balance system, and vertigo results.

“A patient with vertigo needs to seek medical attention so that the practitioner can perform a maneuver to jar the crystals back into position so that the dizziness can subside,” says Lebowitz.

Meniere’s disease results from abnormal fluid buildup in the inner ear. Typically, it affects only one ear. Symptoms include vertigo, tinnitus (ringing in the ear), a feeling a fullness in the ear canal and temporary hearing loss. For some people, the dizziness attacks can come upon suddenly then abate for long periods of time. There’s no cure but there are treatments.

Patients with vestibular neuronitis will have sudden symptoms of vertigo and nausea, often related to an upper respiratory infection. Most commonly, the infection is viral, but sometimes it is bacterial in nature. Knowing the difference is important as antibiotics don’t treat viral infections.

Other Dizziness-inducing Maladies

If you have an upper respiratory infection such as the flu, you might also be affected by labyrinthitis, which is an infection or inflammation of the inner ear that causes dizziness and loss of balance.

Perilymph fistula is a leakage of inner ear fluid into the middle ear which causes unsteadiness along with dizziness and nausea. Causes include head injury, dramatic changes in air pressure (such as when scuba diving), physical exertion, ear surgery, or chronic ear infections.

Mal de Debarquement syndrome is more commonly known as motion sickness. It’s a feeling of continuously rocking or bobbing, typically after an ocean cruise or other sea travel. Usually the symptoms go away a few hours or days after you reach land.

Know Your Signs

Knowing what brings on your dizziness, when it occurs, and how long it lasts are very important details to share with your doctor. Report any medications, vitamins and supplements you take, as these cause or increase the severity of dizziness.

According to Lebowitz, as long as you stay on top of your triggers, take care of yourself through diet and exercise, and see your doctor or physical therapist as needed, you may be able to avoid dizziness altogether.

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