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What causes dizziness and when should you worry?

The list of causes of dizziness is almost endless - but problems with your inner ear cause a special kind of dizziness called vertigo. If you have vertigo, you don't just feel dizzy - the world spins around you and makes you feel woozy or light-headed. Vertigo can affect your balance, make you unsteady on your feet, and feel generally unwell. You may also experience feelings of sickness or vomit.

Vertigo tends to be worse when you move your head. That's because it's caused by a problem with the balance mechanism in your inner ear. This balance mechanism - called the labyrinth - works through fluid which moves inside your inner ear, sending messages to your brain about your position.

There are several different causes for inner ear problems.

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'Itis' is the medical term for inflammation - just like tonsillitis and appendicitis. Labyrinthitis is an inflammation of the inner ear balance mechanism, which is often caused by a viral illness like a cold. It is a common cause of dizziness and vertigo, which gets worse when you move. You may also have nausea, vomiting or mild hearing loss. Sitting or lying in bed should ease the symptoms, and they usually settle within anything from a few days to a few weeks. If you have pain in your ear as well, you should see your doctor.

Ménière's disease

Ménière's disease also affects your inner ear. It is most common in people from 20-50 years of age. The symptoms tend to come in attacks which cause:

  • Some loss of hearing in one ear.

  • Vertigo.

  • Tinnitus - a buzzing, ringing or roaring sound, usually in the same ear with reduced hearing.

Most attacks last for a few hours but you may get clusters of attacks every day or two over a week or more. Once you have Ménière's disease, it's likely that you'll have more attacks in the future.

Fortunately, many people - up to 7 out of every 10 sufferers from Ménière's disease - go for months or years between attacks.

If you have symptoms like these, you should see your doctor. He or she may want to send you for ear tests or a scan of your ear. Although Ménière's disease can be unpleasant, it isn't cancerous and won't cause other problems with your nervous system.

Treatment for Ménière's disease depends on how bad your different symptoms are. For instance, if your attacks don't happen that often, your doctor may prescribe an anti-sickness tablet called cinnarizine or prochlorperazine to take just as an attack comes on. If your attacks are more frequent, your doctor may suggest a tablet called betahistine, which you take regularly to make the attacks less frequent. You may also find that reducing salt and caffeine in your diet, and avoiding smoking, will also help.

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Blood circulation

When not enough red blood cells reach your brain, you may feel light-headed and faint. This is more likely to be a problem if you stand up quickly or are feeling hot. Possible causes include:

  • Low blood pressure on changing position - this becomes more common as you age, are taking medication to lower your blood pressure, or if you have diabetes.

  • Anaemia - you're likely to feel very tired as well.

  • Anxiety - you may also feel breathless and anxious, and have chest pains or pins and needles.

  • Some medications.

  • Irregular heart rhythm - you may find you also have palpitations.

Problems with your balance

If this is the problem, you may not have vertigo or feel light-headed but you are likely to feel unsteady on your feet and may fall. Causes include:

  • Some kinds of stroke which can cause sudden vertigo - others will leave you unsteady.

  • Alcohol.

  • Nerve disorders that affect the nerves in your legs and feet.

  • Being generally weak and frail.

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Other causes of dizziness

How do I help myself?

If you have any prolonged or repeated episodes of dizziness, the best way to help yourself is to see your doctor.

Call for an emergency ambulance (999 in the UK) if you have any of the below symptoms:

  • Chest pain and palpitations.

  • Problems with your speech, vision or hearing.

  • Weakness in your arms or legs, or problems walking.

  • Numbness.

  • Loss of consciousness.

  • Sudden vertigo.

Explaining exactly what you mean by dizzy spells will help your doctor work out what the reason is, and the best treatment.

Some kinds of dizziness can be helped with tablets, and some will settle on their own. But you can also help yourself by:

  • Avoiding alcohol.

  • Sitting up slowly and resting on the edge of the bed for a few minutes before you stand up.

  • Asking your doctor about hand rails and other adaptations at home.

  • Making sure your home is well lit and there are no loose rugs or electrical wires on the floor.

  • Wearing well-fitting slippers with backs to them, to stop you tripping.

Bending your ear about tinnitus

Tinnitus - a buzzing, ringing or roaring sound in one or both ears - is a symptom of Ménière's disease. However, it's also a common problem on its own. If you have tinnitus, especially in one ear only - you must have it checked out by your doctor. That's because very rarely tinnitus on one side can be caused by a growth on the hearing nerve (acoustic neuroma).

Fortunately, the vast majority of people with tinnitus don't have any underlying condition, and it won't do you any serious harm. However, a constant ringing in your ears can be very distressing.

If your tinnitus is troublesome, your doctor can refer you to the hospital to see an ear specialist. They can often offer treatments which will help a lot with the symptoms - although they won't be able to cure them.

These treatments include tinnitus maskers - they are like hearing aids, but they produce a background noise (white noise) which helps to mask the tinnitus. Other noise generators - which you don't wear in your ear but have on in the background - can also help. For some people, relaxation techniques can make a real difference. So whatever you do - speak up and don't sit in silence.

With thanks to 'My Weekly' magazine where this article was originally published.

Article history

The information on this page is peer reviewed by qualified clinicians.

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