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Why am I dizzy?

Dizziness and difficulty with balance is a common complaint among older adults. However, individuals of all ages can experience a sudden onset of dizziness. An estimated 42% of the adult population reports episodes of dizziness or vertigo to their physicians, and in 85% of these patients, the cause is Vestibular dysfunction. Some times individuals feel dizzy when they sit up in bed, some times they feel like they are “walking on a trampoline”, other times the dizziness occurs at what seems like random times throughout their day. So why does this dizzy feeling happen?


There can be a few different causes of dizziness, and are most commonly due to a disorder in the Vestibular system. Although we could go into a lot of detail about how this system works, for this post we will keep it as simple as possible. The Vestibular system is a combination of a sensory apparatus in the inner ear that senses where you are, a central processing system located in the brain (specifically the brain stem and cerebellum) that interprets the input from the inner ear, and a motor output system that reacts to the information interpreted in the brain. The motor output system generates eye movements and body movements that compensate based on the information they receive. As you can imagine, if any part of this system is not working properly, the other parts cannot react properly, and the sensations of dizziness and/or feeling “off balance” occur.


Possibly the most commonly known cause of dizziness is BPPV, or benign paroxysmal positional vertigo. BPPV occurs when the crystals in an individuals inner ear move into the wrong canal, causing the individual to feel dizzy when turning their head or changing positions. This can be corrected with a maneuver (such as Epley’s maneuver) that moves the crystals back into the correct canal in the inner ear. Although you can find videos of maneuvers for BPPV online, we recommend you see a movement specialist, such as a Physical Therapist or Chiropractor, who has been trained in Vestibular Therapy to assess your symptoms and determine the correct maneuver to complete. If it is true BPPV, symptoms can often resolve in a few sessions with a provider and a home program.


A lesser known cause of dizziness is cervicogenic dizziness, which is dizziness that is caused by tightness of neck muscles and poor posture. Individuals with cervicogenic dizziness do not typically feel symptoms with position changes or turning their head, but can feel “foggy” or as if they are “walking on a trampoline” throughout their day. A program to improve cervical flexibility and postural strength can alleviate these symptoms.


There are many other disorders of the Vestibular system that could cause dizziness, including but not limited to Vestibular neuritis, Labrynthitis, and Meniere’s Disease. Many of these disorders present with very similar symptoms, but are not treated the same. Therefore, it is important to consult with an ENT or Vestibular Therapist as soon as possible in order to determine the possible causes and initiate proper treatments.


So what type of treatments might be recommended? If it is true BPPV, as mentioned above, a maneuver may be recommended to move the crystals back into the correct canal. Gaze stabilization exercises, postural strengthening exercises, and balance exercises may be prescribed based on the assessment completed by the movement specialist.


If you are feeling dizzy, contact us at AKPT for an assessment to determine what is causing your symptoms, and how we can help you.


Resources:

Gill-Body, Kathleen M. And Janet Callahan. Current Concepts in The Management Of Individuals With Vestibular Dysfunction, 2nd Ed. Topics in Physical Therapy: Neurology. Alexandria, VA. American Physical Therapy Association.

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