Understanding It
What Vertigo and Dizziness Is
Vertigo is the sensation that you, the room or your surroundings are moving when they are not. People often describe spinning, tilting, rocking or being pulled to one side.
Dizziness is a broader term. It can describe light-headedness, feeling faint, being off balance, or having difficulty judging where your body is in space.
Your brain works out where you are and how you are moving by combining information from your eyes, muscles and joints, and the vestibular system in your inner ear. The vestibular system detects head movement and helps your brain maintain balance.
If these information sources disagree, your brain can receive conflicting signals. That mismatch can produce vertigo, nausea, unsteadiness or difficulty focusing.
One common cause is benign paroxysmal positional vertigo (BPPV). Small calcium carbonate crystals inside the inner ear can move into a part of the balance system where they do not belong. Certain head movements can then trigger a brief episode of a spinning sensation.
Other causes include vestibular migraine, inner-ear disorders, medication effects, dehydration, low blood pressure, and neurological conditions. Dizziness can also occur alongside anxiety, although that should not be assumed to be the cause without considering other possibilities.
How does it usually present?
People experience vertigo and dizziness differently, but common symptoms include:
- A spinning or turning sensation
- Feeling unsteady when standing or walking
- Feeling as though you are being pulled or pushed to one side
- Light-headedness or feeling faint
- Nausea or vomiting
- Symptoms triggered by rolling over in bed, looking up, bending down or turning the head
- Difficulty walking in busy environments or on uneven surfaces
- Blurred or jumping vision when moving the head
- Reduced confidence with walking or moving around
- Difficulty concentrating or feeling foggy
- Fear of falling because of poor balance
The timing and triggers are useful clues. Brief spinning brought on by a particular head position points towards a different problem from dizziness that is constant, worsening or associated with neurological symptoms.
When to Act
When to Seek Help
If your dizziness is new, persistent, recurrent or affecting your ability to walk safely, arrange an assessment with your GP or another appropriate health professional. You should not assume that recurring dizziness is harmless simply because previous episodes settled. If you are unsure whether your symptoms are urgent, seek medical advice rather than attempting to diagnose the cause yourself.
Call 000 immediately if you have sudden dizziness or vertigo with any of the following:
- Facial drooping, weakness or numbness on one side, difficulty speaking, new confusion, loss of vision, severe difficulty walking, or a sudden severe headache — these can be signs of stroke or another neurological emergency
- Chest pain, severe shortness of breath, collapse or loss of consciousness
Seek urgent medical assessment for:
- Sudden new hearing loss, particularly if it occurs with vertigo or tinnitus
- Significant head or neck trauma, or severe dizziness following recent neck injury
- Vertigo or dizziness that is constant and does not only occur with head movements
Causes & Risk
What Causes It and Who Is at Risk
Vertigo and dizziness can have many causes, so an assessment should look at the pattern rather than treating the word "dizziness" in isolation.
Common possibilities include:
- BPPV: episodes of spinning triggered by changes in head position.
- Vestibular neuritis or labyrinthitis: inflammation affecting the vestibular system, sometimes following a viral illness. Labyrinthitis may also involve hearing symptoms.
- Vestibular migraine: dizziness or vertigo associated with migraine, which may occur even when headache is not prominent.
- Ménière's disease: episodes of vertigo associated with hearing changes, tinnitus and a sensation of fullness in the ear.
- Medication or blood-pressure effects: some medicines and changes in blood pressure can contribute to light-headedness or imbalance.
- Reduced balance system function: vestibular problems can make walking and head movements more difficult, particularly as you get older.
- Neurological or cardiovascular causes: dizziness can sometimes be associated with conditions affecting the brain, circulation or heart and needs appropriate medical assessment.
Older adults are particularly vulnerable to the consequences of dizziness because reduced balance can contribute to falls. However, vertigo is not simply an age-related problem and should not automatically be dismissed as "just getting older".
How We Help
How Our Team Can Help
The limitation is important: physiotherapy is not appropriate for every cause of dizziness. If your symptoms suggest a medical, neurological, cardiovascular or ear-related problem requiring investigation, you may need medical assessment or referral before therapy proceeds.
Physiotherapy
Assessment of balance, movement, walking, eye and head movement responses, and the circumstances that bring symptoms on. Where appropriate: vestibular rehabilitation, balance exercises, graded exposure to movement, BPPV positional tests and repositioning maneuvers, and strategies for reducing falls risk.
Occupational Therapy
Where dizziness is affecting safety at home or making everyday activities difficult: how you manage showering, stairs, transfers and moving around your home, with practical changes or strategies to reduce falls risk.
Nursing
Monitoring and health assessment where nursing care is otherwise appropriate, and helping identify when symptoms require medical review.
Starting Out
What to Expect at Your First Appointment
Your first appointment should start with questions about the dizziness itself.
You may be asked:
- What does the sensation feel like?
- When did it start?
- How long does each episode last?
- What brings it on?
- Does moving your head or changing position make it worse?
- Have you experienced nausea, vomiting, hearing changes, tinnitus, headaches, or visual symptoms?
- Have you fallen or become unsteady?
- What medications and other health conditions may be relevant?
Your physiotherapist may assess your walking, balance, eye movements, head movements, and how your symptoms respond to different positions.
If a vestibular cause appears likely, the assessment findings can help determine whether physiotherapy is appropriate. You should leave with a clearer explanation of what has been identified, what can be addressed through physiotherapy and whether further medical assessment is recommended.
Ready to book?
Ready to get started?
Contact inOne Healthcare on 1300 765 456 or submit a referral online. Dizziness and Vertigo is most commonly managed by our Physiotherapy team.
info@inonehealthcare.com.au
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