Why am I dizzy?

Understanding the Causes of Dizziness: A Comprehensive Guide

Dizziness is a common yet complex symptom that can manifest in various ways, including sensations of spinning (vertigo), lightheadedness, blurred vision, headaches, and imbalance. Identifying the underlying cause of dizziness is crucial for effective treatment, as it can stem from issues within the brain, inner ear, or external systemic factors.

This guide explores three major categories of dizziness: central causes, peripheral causes, and external/systemic causes as well as how physical therapy can aid in managing dizziness related to neurological conditions and vestibular disorders.

1. Central Causes of Dizziness

Central dizziness originates from the brain and central nervous system.

• Stroke: Dizziness can be a symptom of stroke, often accompanied by one-sided weakness, slurred speech, and loss of balance.

• Parkinson’s Disease: This neurodegenerative disorder can cause stiffness, rigidity, and postural instability, leading to dizziness and an increased fall risk.

• Multiple Sclerosis (MS): This autoimmune disease affects nerve conduction, impacting balance and coordination, sometimes causing vertigo.

• How Physical Therapy Helps:
  Physical therapy is crucial for individuals experiencing dizziness due to neurological conditions. A physical therapist (PT) can help:
  - Improve balance and coordination through targeted exercises.
  - Reduce fall risk by strengthening muscles and refining postural control.
  - Enhance mobility and confidence in daily activities.

2. Peripheral Causes of Dizziness

Peripheral dizziness results from problems in the inner ear (vestibular system), which controls balance.

Benign Paroxysmal Positional Vertigo (BPPV)

BPPV occurs when tiny calcium crystals in the inner ear become dislodged and settle in the wrong area, stimulating balance nerves and causing intense vertigo.

• Symptoms often occur with specific head movements, such as rolling over in bed or sitting up from lying down.

How Physical Therapy Helps:
BPPV is highly treatable with the Epley Maneuver, a technique performed by physical therapists to reposition the dislodged crystals and relieve symptoms.

Vestibular Hypofunction

Vestibular hypofunction occurs when one inner ear nerve functions less effectively than the other, often following a viral infection or upper respiratory illness.

• Symptoms include dizziness, blurred vision, lightheadedness, and headaches, especially with activities like turning your head while driving or reading for long periods.

How Physical Therapy Helps:
Vestibular rehabilitation therapy (VRT) helps retrain the brain to interpret head and eye movements correctly, restoring balance.
- Eye gaze stabilization exercises improve vision clarity during movement.
- Balance training helps patients regain steadiness.
- Head motion exercises help recalibrate the vestibular system.

Other causes of vestibular hypofunction can include Meniere’s Disease, vestibular neuritis, labyrinthitis, and vestibular migraine.

3. External and Systemic Causes of Dizziness

Dizziness can also stem from external factors such as head injuries, medications, and systemic conditions.

Concussion & Post-Concussion Syndrome

Dizziness is a common symptom after a concussion, sometimes persisting for weeks or months if left untreated.
How Physical Therapy Helps:
- Vestibular rehabilitation therapy (VRT) can help retrain the brain to process motion correctly.
- Balance and coordination exercises assist in symptom recovery.

Medications & Systemic Conditions

Certain medications can cause dizziness, including:

• Blood pressure medications (causing lightheadedness due to low blood pressure).

• Antidepressants and sedatives (affecting the central nervous system).

Other systemic conditions that may cause dizziness include:

• Orthostatic hypotension (a sudden drop in blood pressure upon standing).

• Anemia (low red blood cell count, reducing oxygen to the brain).

• Low blood sugar (hypoglycemia), common in individuals with diabetes.

• Postural Orthostatic Tachycardia Syndrome (POTS), a disorder affecting blood circulation.

• Anxiety and hyperventilation, which can alter oxygen and carbon dioxide levels, leading to dizziness.

When to See a Physical Therapist for Dizziness

If dizziness is affecting your daily life, a physical therapist can help restore your balance and mobility. A skilled PT can:
- Ensure safety by using proper guarding techniques to prevent falls during balance exercises.
- Identify triggers of dizziness and develop a customized treatment plan.
- Rehabilitate your balance system, helping you return to normal activities with confidence.

Dizziness is not something you have to live with. A qualified physical therapist can provide effective treatments to help you regain control and improve your quality of life. If you experience persistent dizziness, consult a healthcare provider or physical therapist to explore treatment options.