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  • Rudie

What is Dizziness? The Umbrella, and what it means...

Hello everybody!

What is Dizziness? This is the question I get probably more than anything else. It goes along with other questions like what does dizziness mean? What causes dizziness? And some people say they don’t know how to describe what they are feeling.

It’s such a common question, and so important to being able to assess your own health and communicate with your healthcare provider, that I thought I needed to make a video that was available to everyone.

How we communicate about dizziness is super important, because, when it comes to dizziness, a huge part of the diagnosis comes from the subjective history, or what you tell the doctor you are experiencing. One study found that the incremental value of the patient history had 76% sensitivity for correct diagnosis.[1] So, the communication factor is really important with dizziness, and it’s important that we’re all on the same page.

The first thing to understand is that the word dizzy is an umbrella term. It can describe several different sensations that can mean very different things. Kind of like how being happy or sad can mean many different kinds of happy or sad. Frankly, that’s why dizziness is such a tough thing to nail down, and why so many doctors and patients have difficulty with figuring it out. As a patient, it can be hard to know what to call it, which makes it hard for the healthcare provider to troubleshoot. So the first thing to do is to try to describe the sensation without using the word dizzy. Some common ways to describe dizziness in more detail are light-headed, heavy-headed, rocking, swaying, spinning, motion-sick, unsteady, even overwhelmed. The reason describing it is so important is because the description can indicate different problems that are causing it. For example, “light-headedness” is pretty vague, but usually associated with feeling faint, like you might pass out. That could indicate something to do with blood flow getting oxygen to your brain, and so implies the problem may have to do with your cardiovascular system. Of course, that is a very different sensation than dizziness where the room is spinning. We call this type of dizziness “vertigo”. Any type of dizziness where you are feeling movement that isn’t really there can be vertigo, such as rocking, or spinning. This type of dizziness is usually coming from a problem with your inner ear, because your inner ear and your vestibular system are in charge of sensing head movement. So when something in your vestibular system malfunctions, you can get incorrect movement signals being sent to your brain, and it feels like you are moving, even though you aren’t. OR when you do move around, your brain might not get the correct signal, so you might feel unsteady, wobbly, difficulty focusing your eyes, that sort of thing. So you can see how the “dizzy” that comes from something like a cardiovascular problem is very different than the

“dizzy” that comes from an inner ear problem. It depends on which system in your body is being affected. There are several different systems that can cause dizziness

when they malfunction, some more serious than others, and each system causes dizziness differently. Plus, each different type of malfunction within a system can cause dizziness differently! So the description really does follow the cause, and can help narrow things down.

There may be several different words that you can use to describe what you are experiencing. That’s OK! There’s no wrong way to describe your dizziness. It’s YOUR symptom, so you get to name it. Sometimes giving it a descriptive name helps to clarify and gives you some control over it. Just be ready to describe what you are feeling, and answer a bunch of questions.

In addition to the quality of the dizziness, and the words that you use to describe it, there are some other factors about the dizziness to consider.

One is other symptoms that go along with the dizziness. In our cardiovascular example, you might have other symptoms that have to do with blood flow and oxygen, like shortness of breath, numbness and tingling in your hands and feet, tunnel vision, weakness and fatigue. There are clues in these descriptions. Do you also get headaches? Pain anywhere? Slurred speech, coordination problems, balance problems, changes in your blood pressure or heart rate, anxiety, vision changes, fever, nausea? Dizziness usually does not happen by itself. It’s such a general term because it describes something that is happening to a system. These other concurrent symptoms can help figure out what is malfunctioning in your body if you know what the different body systems are supposed to do. Inner ear problems, for example, sometimes, not always, accompany changes in hearing, which makes sense because your inner ears also do hearing. Some people get migraines that cause their dizziness, and that can come with a headache, or visual auras. If you had a fever, or were sick, there could be an infection or inflammation going on. Everyone is different, so cataloging what you are feeling into categories, even writing it down, can go a long way to figuring out what is causing it, and hopefully how to fix it!

You also want to ask about patterns to the symptoms. Meaning: what makes it better and worse, and how does it act over time. Does the dizziness come and go, or is it getting gradually better or worse? When dizziness happens in spells, it can be hard to figure out any pattern, but you’ll at least want to ask yourself how long the spells last, and how often they happen. Aggravating and easing factors can be super important for diagnosis. Think back to when we talked about the cardiovascular system. If it is involved, anything that requires extra blood flow is going to be a problem, like exercise or walking up stairs. Then again, inner ear problems will be aggravated by something related to movement, like a change in position, or movement in your surroundings, like your peripheral vision. Maybe there are certain positions or activities that can trigger your symptoms. Or maybe it’s less concrete, like a certain food, medication, or life-stressor. What makes it better and worse, and how it acts over time should also fit with what system is involved, and can help narrow down what systems or structures in your body are being affected, so we can identify the problem.

This is where analyzing your dizziness can get complicated and sometimes overwhelming. You may have noticed that many of these patterns and descriptions of dizziness can overlap! Head movement and exercise kind of go together, right? Numbness and tingling, for example, can come from lack of blood flow and oxygen, nerve impingement, or even anxiety. So it gets tricky! There’s also no rule saying you can only have one kind of dizziness at a time! People very often have different types of dizziness at once. My advice is to try not to get overwhelmed, think about dizziness words that best describe what you are feeling, and write them down. Categorize your symptoms as best you can, but try not to get stressed out thinking about every little detail and over-analyzing. It’s important to have the three components to your description of your dizziness, quality, concurrent symptoms, and patterns, so that it paints a big picture of what could be happening. If you get dizzy when you stand up quickly, was it the drop in your blood pressure, the quick movement of your head, or unsteadiness on your feet? Only a doctor can make these decisions and diagnoses, because they are familiar with the systems in the body. This video does not constitute medical advice, so if you are experiencing any of these symptoms, please bring it up with your doctor as soon as possible.

What I do hope this video will do is give you a better idea of how dizziness is really an umbrella term, and can mean many different things, so that you have a better understanding of where to start, and how to communicate about dizziness, whether you’re a doctor or a patient. Like what to pay attention to, and how you might describe it without just using the word dizzy.

The good news is that many of these issues are treatable. Getting the correct diagnosis is half the battle, if not more! If medical professionals and patients can work together to problem-solve and figure out what the issue is, there are treatment options out there. They might be medical, surgical, diet, exercise or therapy-based, depending on the cause. At DizzyPhysio, we specialize in dizziness related to the inner ear, so anything that is movement-related. That can be sensing movement that isn’t really there, or sensing movement incorrectly, resulting in imbalance and disorientation. In addition to fixing the cause of this dizziness, or vertigo, sometimes people need a little help with their recovery, and vestibular therapy can help re-calibrate the brain and the inner ear after a vestibular problem.

So that’s what dizziness is. It’s not really one particular thing, but a category of things. Do you think this video was helpful? Like the video and subscribe to our channel if you thought so. And if you have dizziness, give DizzyPhysio a call! Thanks so much for watching!

1. Kroenke K. Causes of Persistent Dizziness. Annals of Internal Medicine 1992;117(11):898 doi: 10.7326/0003-4819-117-11-898.

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