What causes dizziness?

A dizzy spell can be unnerving, but by looking at your dizziness symptoms and triggers, your doctor can usually pinpoint the cause of your light-headedness.

When she developed dizzy spells over several months, 45-year-old teacher Donna Taylor saw her GP, who conducted ear and movement checks, measured her blood pressure and tested her iron and blood sugar levels. The results were all normal and an eye check by her optometrist ruled out vision problems. But her dizzy spells continued. “Sometimes my giddiness was so bad I had to lie down,” Donna recalls. “I felt frustrated and worried.”

Dizziness – feeling light-headed, faint, woozy, weak or unsteady – is rarely caused by a serious disorder, but can be challenging, especially if severe and accompanied by nausea or ringing in the ears.

Why do I feel dizzy?

“Our central balance comes from multiple parts of the body; the eyes, inner ear, muscles and skeletal system, so any number of things that affect those systems can cause dizziness,” explains Dr Abhi Verma, Royal Australian College of General Practitioners spokesperson and GP.

For example, with vertigo, a severe form of dizziness that makes you feel as though your surroundings are spinning, tiny calcium carbonate crystals within the inner ear move out of position. This activates nerve cells that tell the brain your head’s moving, when it’s not. Causes can include head injury or inner ear problems.

Can neck problems cause dizzy spells?

“Your spine and peripheral joints help tell your brain your location in space,” says Ken Niere, spokesperson for the Australian Physiotherapy Association. Dizziness can occur if those messages become scrambled when poor posture and stress cause stiff neck and upper back muscles. “Physios treat this problem using massage to stretch and release tight muscles and increase mobility,” says Ken. “We also prescribe exercises to improve posture, reduce tension and strengthen weak muscles, increasing neck support.”

Within a couple of weeks of physio treatment, Donna’s dizzy spells became a lot better. “After 2 months of physio sessions, exercises and working on my laptop at a desk and not my couch, my dizziness was gone, which was an enormous relief,” Donna recalls.

When should I seek help?

If dizziness is prolonged, recurrent, severe, or causes ringing in the ears, headaches or vomiting, see your GP.

They may order a neurological examination, blood tests or brain imaging, or refer you to an ENT (ear, nose and throat) specialist or neurologist for further investigations.

What conditions can cause dizziness?

Age, medication side effects and some medical conditions can trigger dizziness. Other causes include dehydration, hypotension (low blood pressure), anaemia, anxiety, pregnancy, head injury. Neurological disorders like migraines and heart problems can also be responsible.

Inner ear disorders cause about half of all cases of persistent dizziness, reports Better Health Victoria. Some of these include:

• Meniere’s disease is a rare disorder that results in dizziness, vertigo and balance problems. Caused by an abnormal build-up of fluid in the inner ear, there is no cure but the symptoms can be managed
• benign paroxysmal positional vertigo (BPPV) causes sudden, intense, brief episodes of dizziness or vertigo when you move your head (for example, getting out of bed). Thought to be caused by calcium crystals coming loose in ear canals
• vestibular neuritis causes vertigo, dizziness, imbalance, unsteadiness and sometimes problems with vision or hearing, and is generally caused by a viral infection.

“BPPV is probably the most common cause of dizziness that we see, although hypotension [low blood pressure] is also fairly common,” says Dr Verma.

How is dizziness treated?

Dizziness often improves by itself, but if you need treatment, it’ll depend on the underlying cause and your symptoms. Medications, dietary changes or certain exercises may be part of your treatment plan.

“For example, BPPV responds favourably to the Epley manoeuvre (a series of exercises that help reposition ‘crystals’ in the ear), whereas there’s no cure for Meniere’s disease – it needs to be managed long-term by an ENT specialist,” says Professor Margie Sharpe, director of the Dizziness & Balance Disorders Centre.

“If you’re finding it difficult to get answers, the best thing to do is see a vestibular physiotherapist,” suggests Prof Sharpe. The physio will work on balancing exercises. You don’t need a referral, though your doctor may be able to help you find one.

Words by Bonnie Bayley and Stephanie Osfield
Updated April 2022