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Why am I Dizzy?

In the physical therapy clinic we work with many individuals that report feeling dizzy. There can be many different causes of this feeling and assessments can be performed to confirm a diagnosis. One of the first steps is to ask what dizziness means to a person. For some people, dizziness may be a sense of lightheadedness, unsteadiness, fogginess, or a spinning sensation. The way that dizziness is described helps to identify the source of the sensation. For instance, lightheadedness may be caused by a significant drop in blood pressure when a person changes positions such as going from sit to stand. This is condition is called orthostatic hypotension and can cause an individual to report dizziness with transitional movements. Other common reports of dizziness can be attributed to changes in one or more of our balance systems and before describing those further, here is a quick review of our body’s balance systems.

Our body have 3 different systems that work together to maintain our balance: somatosensory, vision and vestibular. The somatosensory system refers to our joint receptors and sensation that provide information to our brain about where our bodies are in space. Vision allows us to see the environment around us as well as our position in relation to the environment. The third system, the vestibular system, is within the inner ear and provides your brain information about your head position and movement in space.

Our brains process the combined information from these systems and then provide input to our bodies to maintain our balance. When one of these systems is not working properly, a person may feel a sense of dizziness or unsteadiness. One common cause of an unsteady feeling is a change in the somatosensory system called peripheral neuropathy, a condition of the nerves. Peripheral neuropathy causes a change in sensation and may cause numbness and/or tingling in feet. When sensation is altered, this affects the information that is communicated to our brains about the position of our bodies and our ability to change that position is not as accurate. The sense of unsteadiness may also be attributed to changes in the vestibular system along with a common complaint of a spinning sensation. These two descriptions of dizziness can be caused by different conditions of the vestibular system. Two common conditions are vestibular hypofunction and BPPV, Benign Paroxysmal Positional Vertigo. Vestibular hypofunction occurs when there is a loss of function of one or both of the inner ear systems. This affects how information is processed regarding head position and movement and may cause a sense of imbalance or unsteadiness. BPPV refers to a condition when crystals within the vestibular system are displaced and a spinning sensation may occur with body and head movements as these crystals move.

While we have discussed some of the common causes of dizziness here, it is important to have dizziness assessed to determine the most probable origin as each cause of dizziness is treated differently. With proper treatment for the correct cause dizziness, you may reduce or eliminate your symptoms.

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11 Nov, 2015

Physical Therapy

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