That Dizzy Feeling: Feeling off-balance may indicate a health condition
10/1/2024
MOBERLY, Mo. – People use the word ‘dizzy’ to describe a variety of feelings or sensations. But ‘dizzy’ means different things to different people. The way you describe and how accurately you describe your dizziness to your doctor will provide valuable clues as to the underlying cause and will help with treatment.
“Dizziness occurs primarily in older adults, but can affect people of any age, and should be a red flag that something is out of sync,” said Dr. Gale Osgood, MRMC medical director of emergency services. “The way dizziness makes you feel — such as the sensation of the room spinning, feeling faint or as if you’ve lost your balance — provides clues for possible causes. Strokes are the underlying cause of ≈3% to 5% of such visits. Specific activities or positions that occur with your dizziness may also give insight as to the underlying cause, as can the duration of the dizzy episode.”
Vertigo
Vertigo feels as though your surroundings are moving when there is no actual movement. You may feel as though you’re tilting, spinning or falling. With severe vertigo, you may feel very nauseous or vomit and you may have trouble walking or standing, even to the point of losing your balance and falling.
Vertigo usually results from a sudden or temporary change in the activity of the balance sensors in the inner ear or in the balance sensors’ connections to the brain, both of which detect movement and changes in your head position. Common causes of vertigo include:
- Benign paroxysmal positional vertigo (BPPV) – intense, brief episodes of vertigo immediately following a change in the position of your head, such as when you turn over in bed or sit up in the morning.
- Inflammation in the inner ear – can cause a sudden onset of intense, constant vertigo that may persist for several days, along with nausea, vomiting and trouble with balance. When associated with sudden hearing loss, the condition is called labyrinthitis.
- Meniere’s disease – involves a buildup of fluid in the inner ear. It’s characterized by sudden episodes of vertigo lasting as long as several hours, accompanied by fluctuating hearing loss, ringing in the ear and a feeling of fullness in the affected ear.
- Acoustic neuroma – a noncancerous growth on the vestibular nerve, which connects the inner ear to your brain. Symptoms can include progressive hearing loss and ringing on swishing on one side accompanied by dizziness or imbalance.
Rarely, vertigo can be a symptom of a more serious neurological problem such as a stroke, brain hemorrhage or multiple sclerosis. In these cases, other neurological symptoms are usually present, such as double vision, facial weakness or numbness, coordination, slurred speech, and limb or severe balance problems. The good news is that vertigo generally doesn’t last more than a couple of weeks because the body usually adapts to the issue that’s causing the dizziness.
Feeling of Faintness
Dizziness can also be described as a feeling that you may faint or you feel lightheaded but don’t lose consciousness. Sometimes nausea and skin clamminess are present. Causes may include:
- Drop in blood pressure – which can occur after sitting up or standing too quickly, or could be a medication side effect.
- Inadequate output of blood from the heart – caused by various diseases of the heart muscle, an abnormal heart rhythm, or a decrease in blood volume which may cause inadequate blood flow from the heart.
- Loss of balance
Disequilibrium is the loss of balance or feeling unsteady when you walk. Causes may include:
- Sensory disorders – failing vision or nerve damage in the legs
- Joint and muscle problems – muscle weakness and osteoarthritis, which can wear and tear of the joints
- Neurological conditions – such as Parkinson's disease and cerebellar ataxia
- Medication side effects – such as with anti-seizure drugs, sedatives and tranquilizers
Other dizzy sensations
More difficult to describe “dizzy” sensations, including feeling “spaced out,” may be caused by:
- Anemia, or low iron level
- Allergies
- A cold or the flu
- Low blood sugar
- Ear infection or inner ear disorder
- Medications – especially blood pressure-lowering medications
- Vomiting, diarrhea, fever and other illnesses that cause dehydration
- Stress or anxiety
- Deep or rapid breathing (hyperventilation)
- The use of tobacco, alcohol or illegal drugs (overmedicating, alcohol and medicine interactions, misuse, intoxication or the effects of withdrawal)
- Fatigue
Bleeding, however, is a serious concern that can cause lightheadedness. Usually the location of the bleeding and the need to seek medical care is obvious. But if bleeding isn’t obvious, such as having small amounts of bleeding in the digestive tract, lightheadedness and fatigue may be the first noticeable signs there’s a problem. Heavy menstrual bleeding also can cause this type of lightheadedness.
When to see your doctor
If you have unexplained fainting, your doctor or an emergency room physician should evaluate you immediately. If your dizziness is accompanied by chest pain, a change in heart rate, or a severe headache, call 9-1-1 or have someone take you immediately to the ER. Also, any sensation of spinning, unsteadiness on your feet, or prolonged feeling of being off-balance should prompt a visit to your doctor.
“To help your doctor diagnose the problem, keep track of how long you have dizzy episodes, and try to be as exact as possible when describing the feeling,” Dr. Osgoood said. “Also, it is important to try to bring a list of any medications you’re taking.”
Moberly Regional Medical Center's emergency department is staffed by MU Health Care physicians. Together, these teams provide immediate access to care in a medical crisis. To learn more about emergency services at MRMC, visit moberlyregionalmedicalcenter.com.
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