dizziness overview for patients

Overview

Dizziness is a term used to describe a range of sensations, such as feeling lightheaded, unsteady, faint, or as if you or the room around you is spinning.

Yes, it is very common. Around 1 in 4 people may experience dizziness at some point, and it becomes more common as you get older.

Dizziness can affect people of all ages, but it is more frequent in older adults. It also occurs in children, often after ear infections or migraines.

Symptoms

Common symptoms

• Lightheadedness or feeling faint
• A spinning sensation, also called vertigo
• Feeling unsteady on your feet
• A sense that you or the world is moving or swaying
• Nausea or vomiting
• Blurred vision or difficulty focusing

Symptoms in children

• Children may say they feel 'swirly' or 'woozy'
• They may hold onto furniture or appear clumsy
• They may have nausea or stomach ache
• They may be more fussy or scared than usual

Symptoms in older adults

• Feeling unsteady when walking or standing
• Difficulty keeping balance, especially on uneven surfaces
• Fainting or near-fainting
• Fear of falling, which may lead to being less active

Causes

Main causes

• Benign paroxysmal positional vertigo (BPPV) – tiny crystals in the inner ear move out of place
• Inflammation of the inner ear, called labyrinthitis
• Migraine, even without a headache
• A drop in blood pressure when you stand up (orthostatic hypotension)
• Dehydration or heat exhaustion
• Anemia or low blood sugar
• Anxiety or panic attacks
• Side effects of some medications
• Neurological conditions, such as stroke or multiple sclerosis (rare)

Risk factors

• Being aged 65 or older
• Having had a previous head injury or ear infection
• Having a history of migraines
• Taking certain medications
• Not drinking enough fluids
• Having diabetes, heart disease, or high blood pressure

When to see a doctor

See a doctor urgently if:

• Dizziness keeps coming back or lasts more than a few days
• Dizziness is severe and gets in the way of daily activities
• You have dizziness with hearing loss, severe headache, or vomiting
• You have fallen or feel very unsteady when walking

Book a routine appointment if:

• You have occasional mild lightheadedness, especially when standing up
• You want to find out why you feel dizzy
• You have other health conditions and would like advice on staying safe

Diagnosis

A healthcare provider will ask about your dizziness, when it happens, how long it lasts, and any other symptoms. They will also do a physical exam and may test your balance, vision, hearing, and reflexes.

Tests that may be done

• Blood pressure checks while sitting and standing
• Blood tests for anemia, blood sugar, or electrolyte problems
• Hearing tests
• Balance tests that track eye movements (such as VNG)
• MRI or CT scan of the brain, if needed

What to expect at your appointment

The visit may take 15 to 30 minutes. You may be asked to stand, sit, walk, or move your head. It can help to bring a family member or friend, and write down details about your dizziness before the visit.

Treatment

Treatment depends on the cause. For many people, symptoms improve on their own or with simple measures. If a specific cause is found, the care team will focus treatment on that cause.

Self-care at home

• Sit or lie down right away when you feel dizzy
• Stand up slowly, especially after lying down or sitting for a long time
• Drink enough water throughout the day
• Avoid caffeine, alcohol, and tobacco
• Keep rooms well lit and use a cane or walker if needed
• Use handrails on stairs and grab bars in the bathroom

Medical treatments

For certain inner ear conditions, a healthcare professional can perform a simple head movement procedure that helps move the crystals back into place. Other approaches may include vestibular rehabilitation, which is a set of exercises that train your brain to handle balance signals. Physical therapy, balance retraining, and falls risk assessment may also be recommended. For some causes, medicines that reduce nausea or calm the inner ear system may be prescribed.

When is surgery considered?

Surgery is rarely needed for dizziness. It might be an option for serious conditions such as a brain tumor or a severe inner ear disorder that does not improve with other treatments.

Living with this condition

Learn what triggers your dizziness, such as turning your head quickly or standing too fast. Plan ahead by looking before stepping down, carrying water, and holding onto stable objects when you feel unsteady. Tell family and friends what you are experiencing and how they can help.

Lifestyle tips

• Get enough sleep and rest
• Manage stress with relaxation exercises, breathing, or hobbies
• Limit alcohol and caffeine, and avoid smoking
• Keep your home free of clutter and loose rugs to prevent trips
• Add grab bars in the shower and near stairs

Diet and exercise

Eat a balanced diet with regular meals and drink plenty of fluids. Gentle exercises like walking, seated movements, or tai chi can improve balance. Ask your doctor or a physical therapist what activities are safest for you.

Mental health and emotional wellbeing

Dizziness can make you feel anxious, frustrated, or depressed, especially if it limits your activities. It is important to talk to your healthcare provider about these feelings. Counseling and cognitive behavioral therapy (CBT) may help you cope.

Prevention

Not all types of dizziness can be prevented, but you can reduce some risks. Stand up slowly, stay hydrated, and manage underlying conditions such as high blood pressure or diabetes. Avoiding sudden head movements and known triggers may also help.

Vaccines

There is no specific vaccine for dizziness. However, staying up to date on vaccines that prevent infections, such as flu or COVID-19, may lower your chance of inner ear infections that can cause dizziness.

Screening programmes

There is no routine screening test for dizziness, but regular blood pressure checks and medication reviews with your healthcare provider can help catch problems early.

Complications

If left untreated

• Falls and injuries, including broken bones
• Dehydration from nausea and not drinking enough fluids
• Anxiety and depression
• Difficulty driving, working, or doing everyday tasks
• A decline in physical fitness because of avoiding movement

Long-term outlook

For most people, dizziness improves or goes away completely once the cause is found and treated. Even if the cause cannot be fully identified, many people manage their symptoms well with support from healthcare providers, self-care, and time. You can take steps to stay safe and confident.

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