Understanding Dizziness

Your sense of balance is controlled by vision, touch sensors located throughout the body and the vestibular system — a series of organs in the inner ear that send signals to the brain.

When something goes wrong with one of these systems, it can cause dizziness. The Handbook of Clinical Neurology states dizziness and vertigo affect up to 20% of adults annually. The main symptom is lightheadedness, including wobbliness, fainting or a spinning sensation. Dizziness is a common complaint during appointments with physicians, and studies show it impacts 70% of Americans at some point in their lifetimes—especially if they're over 65.

Dizziness is often due to:

• Cardiovascular disease – Arrhythmias, narrowed blood vessels and decreased blood volume can cause lightheadedness or feeling faint.
• Hypotension – Certain types of hypotension cause dizziness when you sit or stand too quickly.
• Labyrinthitis – An infection such as the flu causes inner ear inflammation and dizziness.
• Mal de Debarquement syndrome – Causes continual rocking, swaying or bobbing feelings. This often occurs after sea travel or prolonged treadmill running. Severe cases can last months or years.
• Ménière's disease – Episodes of vertigo, hearing loss and tinnitus. The cause is unknown.
• Migraine – Dizziness and motion sensitivity caused by a vestibular migraine.
• Perilymph fistula – A leakage of inner ear fluid into the middle ear. It is caused by head injury, air pressure changes and chronic ear infections.
• Positional vertigo – A brief, intense episode triggered by head position, such as dizziness when you bend down to look under the bed.
• Ramsay Hunt syndrome – A shingles-like infection that affects the face, hearing and nerves near the ear.
• Vestibular neuronitis – Nerve inflammation that maintains balance and eye movements.

Changes in vision, certain medications such as antibiotics or diuretics, neck problems, osteoarthritis, hyperventilation, stress or fatigue can also cause dizziness. Keeping a good record of your symptoms can help your doctor pinpoint the cause and ultimately guide you to relief.

While it's normal to feel dizzy on occasion, bouts of dizziness that occur regularly, have no explanation, are accompanied by hearing loss, happen after a fall or injury, or are accompanied by chest pain could be a sign of a more serious underlying problem.

Here are three ways to boost your balance:

1. Strengthen your core. Toning and strengthening the muscles that control movement, known as your core muscles, can help keep you steady while you walk, climb the stairs, or get in and out of the shower. Keeping these muscles in shape also helps prevent back pain and reduces your likelihood of injury while being active.
2. Choose appropriate footwear. Wearing flat, supportive shoes in the correct size can help keep you steady, even on uneven surfaces. If you have weak ankles, select a high-top athletic shoe for maximum support and lace it carefully so your foot does not slip out.
3. Perform progressive balance exercises. The National Institute on Aging recommends performing balance-boosting exercises, such as standing on one foot, at least twice a week. Start by holding onto a chair if necessary and then progress to standing with the chair in arm's reach, and progress to balancing on one foot without the support of a chair as you become steadier.

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