What to do for dizziness

Dizziness can be more than a bothersome experience. It increases the risk that you might fall, and for people with recurrent or chronic dizziness, it can prevent them from being able to do the things they want to do. Luckily there are steps you can take to reduce or even eliminate your dizziness.

In order to determine the best way to treat your dizziness, you need to understand why you are feeling dizzy. The most effective strategy is to work with a professional who is familiar with dizziness syndromes and who can develop a plan that is tailored to your specific needs. For a free assessment with a skilled physical therapy provider, find a FYZICAL location near you.

Types of dizziness

Dizziness is a term that can describe a few different sensations:

• Vertigo: Vertigo is characterized by a spinning or rocking sensation
• Presyncope: Presyncope is the technical term for feeling like you’re about to faint, and it is characterized by lightheadedness
• Disequilibrium: If you feel imbalanced or unstable, you are experiencing disequilibrium

What causes dizziness?

Most cases of dizziness are caused by dysfunction in the inner ear’s peripheral vestibular system. This is one of the most important balance organs in our body, and when it doesn’t work properly, we become dizzy.

The peripheral vestibular system relies on a network of three fluid-filled semi-circular canals to sense rotational (turning) motions and tiny otolithic organs to sense linear movement. Every time your head moves, the peripheral vestibular system sends information about your motion to the central vestibular system, which is located in the brain. Information from the vestibular system is integrated with information from other systems (visual, sensory, motor), which allows you to orient yourself, keep your balance, and plan and carry out movements.

Vestibular disorders affect the integrity of the information that is sent to your brain, which changes how your brain perceives your orientation and movements. For example, if your brain gets incorrect information from the vestibular system saying that you’re spinning in a circle, but information from the visual system says you’re standing still, you will feel dizzy because your brain cannot reconcile these different bits of data.

There are several common peripheral vestibular system disorders, including:

• Benign paroxysmal positioning vertigo (BPPV)
  

  BPPV a peripheral vestibular system disorder that is caused by tiny crystals in the otolithic organs that become detached from a membrane that normally holds them in place. When the crystals become free-floating, they can activate inner ear hair cells that transmit information to the brain saying you’re moving, even if you’re not. If you have BPPV, you will often feel dizzy when you turn your head in a specific way. BPPV symptoms include vertigo that lasts for 15-20 seconds, nausea/vomiting, feeling lightheaded or faint, and nystagmus (rapid, involuntary eye movements). BPPV can affect one or both ears, which may change how you experience your symptoms. Physical therapy is one of the most effective ways to manage and treat BPPV.

• Vestibular paroxysmia
  

  This is a condition where a nerve that connects your peripheral vestibular system and your brain is compressed when you turn your head. In many cases, vestibular paroxysmia can be a chronic, debilitating condition that is characterized by frequent, often spontaneous dizzy spells, tinnitus (ringing in one or both ears), sensitivity to sound, and unsteadiness when you’re standing or walking. Attacks usually last for less than one minute. Physical therapy is a highly effective treatment, since it will strengthen the muscles that supports the vestibular nerves.

• Vestibulopathy
  

  If you are dizzy only when you are walking, especially if you are in the dark or on an uneven surface, you may have unilateral (one side) or bilateral (both sides) vestibulopathy. Normally, when you take a step your brain activates postural reflexes that help you manage balance and keep you upright. Inappropriate activation of these reflexes makes it very difficult to maintain balance when you’re walking. Unilateral vestibulopathy can include vertigo, and you may drift to one side when you try to walk in a straight line. Bilateral vestibulopathy is generally not associated with vertigo. Symptoms may also include nausea and vision problems that occur with an attack. Physical therapy-based vestibular rehabilitation is often an effective treatment for vestibulopathy.

• Ménière’s disease
  

  This is a poorly understood disorder that causes spontaneous, often severe dizziness or vertigo that lasts for more than 20 minutes. Ménière’s disease symptoms are caused by abnormally large amounts of inner ear fluid and are usually progressive in severity and frequency. Early stage Ménière’s disease includes spontaneous, severe vertigo, nausea/vomiting fluctuating hearing loss, tinnitus, and a sense of fullness in the ear. As the disease progresses, symptoms become more severe and vision may become blurry or jerky.

The circulatory system is another common cause of dizziness. An important function of the circulatory system is to make sure the brain is supplied with oxygen- and glucose-rich blood, both of which are required for normal brain cell function. If cells don’t get enough oxygen or glucose, you will feel dizzy or woozy. There are a few common causes of dizziness related to the circulatory system:

• Orthostatic (postural) hypotension (low blood pressure)
  

  If you’ve ever stood up too quickly and become dizzy or lightheaded, you’ve experienced orthostatic hypotension. When we sit or lie down for a while, blood tends to pool in our legs or abdomen. If we jump up suddenly, the circulatory system doesn’t have enough time to increase blood flow to the brain, and we will feel dizzy for about a second.

• Dehydration
  

  Without enough water, you lose some blood volume, which reduces blood pressure. Consequently, your brain doesn’t get adequate oxygen and other nutrients.

• Low blood sugar
  

  Glucose is a sugar that is required for healthy brain function. When we eat, our bodies transport glucose from the digestive tract to the circulatory system. Skipping a meal can cause low blood sugar and dizziness.

• Hyperventilation
  

  Oxygen is crucial for brain function, so you’d expect that breathing rapidly would increase how much oxygen gets to the brain. However, blood vessels constrict if there are low levels of carbon dioxide, so less oxygenated blood can get to the brain. This is why holding a paper bag over your mouth and nose can help you recover if you’re hyperventilating.

How to get rid of dizziness from anxiety

Anxiety is a common cause of dizziness, and dizziness can also increase anxiety levels in people who are experiencing it. We are still learning about the relationship between dizziness and anxiety, but brain imaging studies have identified a bidirectional connection between parts of the brain that are responsible for these sensations. This means that anxiety can activate the parts of the brain that cause dizziness, and vice versa. And the more you use this connection, the stronger it becomes. Over time, this can lead to the development of a psychiatric disorder.

Numerous studies have found that the most effective treatment strategy to help people manage anxiety and dizziness is a combination of behavioral therapy and physical therapy. These holistic methods address the root cause of your symptoms and provide you with tools and techniques that you can use anywhere to reduce anxiety and minimize dizziness.

Food for dizziness treatment

Low blood sugar is a major cause of dizziness and skipping meals can leave you feeling tired and lightheaded. A healthy diet and plenty of water is the best way to prevent the occasional dizzy spell. Some foods are particularly beneficial:

• Fruits: Fruits are a great source of sugars and water and also provide vitamins and fiber
• Nuts: Almonds, cashews and walnuts provide fatty acids and vitamins
• Vegetables: Veggies are loaded with iron, potassium, and other vitamins

If you’re always on-the-go and frequently skip meals, keep a granola bar in your bag. Even a can of soda is a quick source of sugar that can help you if you’re feeling lightheaded.

First aid for dizziness

The most important thing to do if you’re feeling dizzy is to lie down in a safe place and stay still until the spell passes. Drinking water can help relieve dizziness, and if you haven’t eaten in a while, getting some food can also help. Avoiding bright lights, loud sounds, and complicated visual stimuli can help you overcome a dizzy spell. Once your dizziness has abated, get up slowly and avoid sudden movements.

Lightheadedness and fatigue

Lightheadedness, also known as presyncope, describes the sensation of feeling faint or like you might pass out. Rare occurrences of lightheadedness are common and, alone, do not indicate that you have a concerning medical condition. However, if you are regularly feeling lightheaded in combination with fatigue, you may have an underlying disorder.

Common causes of recurrent or chronic lightheadedness and fatigue include:

• Chronic fatigue syndrome (CFS)
  

  CFS is a very frustrating disorder that is very poorly understood. People who suffer from CFS experience persistent, often debilitating fatigue, muscle pain, sleep disorders, headaches, and dizziness in addition to memory loss and lack of concentration.

• Low blood sugar
  

  Glucose is an important energy source that we get from our food. Without enough glucose, we will feel lightheaded and fatigued. Normally, maintaining a healthy diet is the best way to prevent low blood sugar. If you regularly skip meals, you may experience frequent lightheadedness and fatigue. People with diabetes are at particular risk for low blood sugar.

• Concussions
  

  After a concussion or whiplash, people frequently experience postconcussional syndrome. In addition to lightheadedness and fatigue, symptoms include irritability, mood swings, insomnia, weakness, headache, short-term memory loss, and an inability to focus.

Treatment for your lightheadedness and fatigue will depend on the cause. CFS and postconcussional syndrome respond very well to physical therapy, especially when it is combined with behavioral therapy. For most people, getting plenty of sleep, eating a healthy diet and regular exercise will prevent lightheadedness and fatigue. If you live a healthy lifestyle and are still regularly experiencing lightheadedness and fatigue, you may want to see your doctor to rule out a serious medical condition.

Dizziness when lying down

There are a few potential causes of dizziness when you lie down, but BPPV is the most common. If you feel dizzy when you lie down, roll over, or get out of bed, BPPV is a likely cause. BPPV is caused by tiny, free-floating crystals in the inner ear fluid.

Under normal conditions, these crystals are embedded in a membrane that shifts when we move, putting the crystals in position to activate cells that send information to the brain. Age-related degeneration or head trauma can dislodge the crystals so that they float freely in the inner ear fluid and activate cells inappropriately. If you’re lying still in bed, the crystals settle to the surface. But when you roll over, the crystals become re-suspended in the fluid (like a shaken snow globe) and bounce off of the inner ear canal, sending incorrect signals to the brain.

If you only feel dizzy when your eyes are closed, you may have vestibular neuritis or labyrinthitis. These disorders cause inflammation in the nerve that carries information from the peripheral vestibular system to the brain, which affects the information that is being relayed. When your eyes are open, your brain can use visual information to help you understand your spatial orientation, but once your eyes are closed your brain relies mostly on the vestibular system to determine your orientation and movement. If the nerve sending information from the inner ear is inappropriately active, your brain thinks you’re moving even when you’re lying still.

Natural remedies for dizziness and balance

The best way to prevent dizziness and improve balance is to eat a healthy diet, drink plenty of water, and get regular exercise. If you’re still experiencing dizziness, make an appointment with a licensed physical therapy provider to discuss your symptoms and learn about treatment options. Peripheral vestibular system disorder symptoms can be improved with vestibular rehabilitation therapy (VRT).

FYZICAL offers holistic therapeutic approaches to help you manage your dizziness. Using a medication- and surgery-free approach, our providers can develop a tailored plan that can help you get your balance, and your life, back.

FYZICAL offers free assessments that can help you understand why you’re feeling dizzy and help you explore ways to resolve these symptoms and regain your life. Find a FYZICAL location near you and make an appointment today.

To learn more about how FYZICAL Therapy & Balance Centers can help you, download our free e-book.