ENT CONCERN

Dizziness and Balance

Also called: dizzy, dizziness, vertigo, balance problems, spinning

Dizziness and balance problems can cause sensations of spinning, lightheadedness, unsteadiness or difficulty maintaining normal balance.

TYPICALLY OCCURS

Inner-ear problems, blood-pressure changes, medication and neurological conditions

TREATED BY

Surgery, vestibular rehabilitation, medication and underlying-cause management

ALSO LINKED TO

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Why it happens?

Maintaining balance requires several systems to work together. The inner ear contains the vestibular system, which detects movement and changes in head position, while the eyes provide visual information about the surrounding environment. The brain combines these signals with information from muscles and joints to maintain orientation and stability. If the information reaching the brain becomes disrupted or conflicting, dizziness, vertigo or unsteadiness can occur. Inner-ear conditions are therefore a common cause, including benign paroxysmal positional vertigo (BPPV), vestibular neuritis, labyrinthitis and Ménière’s disease.

Dizziness can also occur for reasons unrelated to the inner ear. A temporary fall in blood pressure when standing, dehydration, low blood sugar, anaemia, migraine and side effects from certain medications can all produce dizziness or lightheadedness. Vision problems and reduced sensation or strength in the legs can contribute to poor balance, particularly in older adults. Anxiety can also cause or intensify sensations of dizziness, although persistent symptoms should not automatically be attributed to anxiety without considering other possible causes.

Less commonly, dizziness and balance changes can be associated with conditions affecting the brain, nerves, heart or circulation. The exact sensation and accompanying symptoms can provide important clues: true vertigo often feels as though the person or surroundings are spinning, whereas lightheadedness may feel more like faintness. Balance problems may instead present as instability while standing or walking. Because these experiences can have very different causes, persistent, recurring, unexplained or suddenly developing dizziness should be appropriately assessed rather than treated as a single condition.

How far along is it?

Early

Brief episodes of dizziness, lightheadedness or mild unsteadiness occur occasionally, sometimes after standing quickly, moving the head or during illness.

Moderate

Dizziness or instability becomes more frequent and may interfere with walking, exercise, work or other everyday activities. Nausea or sensitivity to movement may also occur.

Advanced

Dizziness or loss of balance substantially affects mobility and everyday life, potentially increasing the risk of falls. Persistent symptoms may indicate an underlying condition requiring further investigation.

What addresses it?

Treatments that address this

Ear treatments→Ear, nose & throat→

Professional assessment is worthwhile when dizziness repeatedly returns, persists, becomes progressively worse or begins interfering with walking, work or everyday activities. Assessment is also important when dizziness occurs alongside hearing changes, tinnitus, repeated vomiting, fainting or frequent falls.

Sudden severe dizziness can sometimes indicate a medical emergency. Seek urgent medical attention when new dizziness or loss of balance occurs with facial drooping, weakness or numbness on one side, difficulty speaking, new severe headache, double vision, loss of consciousness, chest pain or an inability to stand or walk normally. These symptoms can indicate a serious neurological or cardiovascular problem.

Quick Questions:

What causes dizziness and loss of balance?

Possible causes include inner-ear disorders, dehydration, blood-pressure changes, migraine, medication side effects, vision problems and neurological or cardiovascular conditions. The underlying cause depends on the type and pattern of symptoms.

Is dizziness the same as vertigo?

No. Dizziness is a broad term describing several sensations. Vertigo specifically refers to a false sensation of movement or spinning, either of yourself or your surroundings.

Can inner-ear problems affect balance?

Yes. The vestibular system within the inner ear plays an essential role in balance. Conditions affecting this system can cause vertigo, dizziness, nausea and difficulty maintaining stability.

When should dizziness be considered serious?

Recurring or persistent dizziness should be professionally assessed. Sudden dizziness accompanied by weakness, facial drooping, speech difficulty, severe headache, double vision, fainting, chest pain or severe difficulty walking requires urgent medical attention.