Why Do I Feel Dizzy? Vertigo and Poor Balance: Unraveling the Inner Ear’s Mysteries

Dizziness, vertigo, and poor balance are common complaints that affect millions of people worldwide. These symptoms can be unsettling and even debilitating, impacting one’s daily life and overall well-being. Understanding the underlying causes and seeking proper diagnosis and treatment are crucial steps towards finding relief and improving quality of life. 

Have you ever experienced a sudden sensation that the world is spinning around you or felt unsteady on your feet without any apparent reason? If so, you are not alone. Dizziness, vertigo, and poor balance are widespread complaints that can affect individuals of all ages and backgrounds. These symptoms can be caused by various factors, but a significant number of cases are attributed to issues with the inner ear, where the body’s vestibular system resides. While it can feel difficult to deal with, don’t let ongoing dizziness affect your social and work life

The Vestibular System: Our Sense of Balance

The vestibular system, located in the inner ear, is responsible for maintaining our sense of balance and spatial orientation. It works in conjunction with the visual system and proprioception (the sense of body position) to provide us with a stable perception of our surroundings. When this delicate system malfunctions, it can lead to dizziness and vertigo, often accompanied by a loss of balance.

The inner ear comprises three semicircular canals filled with fluid and tiny hair-like structures called cilia. These canals are responsible for detecting rotational movements of the head, allowing us to maintain our equilibrium during activities like walking, running, or even just turning our heads.

Common Causes of Dizziness and Vertigo

1. Benign Paroxysmal Positional Vertigo (BPPV): BPPV is one of the most prevalent causes of vertigo, particularly among older adults. It occurs when tiny calcium crystals (otoconia) within the inner ear become dislodged and enter the semicircular canals. This disrupts the normal flow of fluid, sending false signals to the brain about the head’s position, resulting in brief episodes of intense spinning sensations.
2. Meniere’s Disease: Meniere’s disease is a disorder of the inner ear characterized by recurrent episodes of vertigo, fluctuating hearing loss, tinnitus (ringing in the ears), and a feeling of fullness in the affected ear. It is believed to be caused by an abnormal buildup of fluid in the inner ear, leading to increased pressure and disruptions in the vestibular system.
3. Vestibular Neuritis: Vestibular neuritis is typically caused by a viral infection that inflames the vestibular nerve. This inflammation affects the transmission of signals from the inner ear to the brain, leading to sudden, severe vertigo, nausea, and difficulty maintaining balance.
4. Labyrinthitis: Similar to vestibular neuritis, labyrinthitis involves inflammation of both the vestibular nerve and the labyrinth, a structure in the inner ear responsible for hearing and balance. It is often associated with viral infections and can cause dizziness, hearing loss, and nausea.
5. Migraine-Associated Vertigo (MAV): Some individuals who suffer from migraines may experience episodes of vertigo as a part of their migraine attacks. This is known as migraine-associated vertigo or vestibular migraine. The exact mechanism behind this phenomenon is not fully understood, but it is believed to involve abnormal brain activity affecting the vestibular system.
6. Acoustic Neuroma: Acoustic neuroma is a non-cancerous tumor that develops on the vestibular nerve or nearby structures in the inner ear. As the tumor grows, it can interfere with the nerve’s function, causing dizziness, balance problems, and hearing loss.
7. Medication Side Effects: Certain medications, particularly those that affect the nervous system, can lead to dizziness and vertigo as side effects.

Poor Balance and Its Implications

Apart from vertigo and dizziness, some individuals may suffer from chronic poor balance, which can significantly impact their daily activities and quality of life. Poor balance is often associated with a higher risk of falls and injuries, especially in the elderly population. Falls can result in fractures, head injuries, and other serious consequences, leading to reduced mobility and independence.

Diagnosis and Treatment

Proper diagnosis is crucial for addressing dizziness, vertigo, and poor balance effectively. A thorough medical history, physical examination, and specific tests are typically conducted to identify the underlying cause. Some common diagnostic tests include:

1. Dix-Hallpike Maneuver: This test is used to diagnose BPPV. By placing the patient’s head in various positions, the healthcare provider can trigger vertigo and nystagmus (involuntary eye movements), indicating the affected semicircular canal.
2. Electronystagmography (ENG) and Videonystagmography (VNG): ENG and VNG are used to evaluate the vestibular system’s function by monitoring eye movements in response to specific stimuli.
3. Magnetic Resonance Imaging (MRI): An MRI may be performed to detect structural abnormalities in the inner ear, brain, or surrounding areas, such as acoustic neuroma.

Treatment approaches depend on the underlying cause. Some common strategies include:

1. Canalith Repositioning Procedures: These maneuvers, like the Epley maneuver, are used to reposition the displaced calcium crystals in BPPV to relieve vertigo.
2. Vestibular Rehabilitation: A specialized form of physical therapy that aims to improve balance and reduce dizziness through exercises that stimulate and train the vestibular system.
3. Medications: Medications may be prescribed to manage symptoms, such as anti-vertigo medications for acute episodes of vertigo or prophylactic medications for conditions like vestibular migraine.
4. Lifestyle Changes: Adopting a healthy lifestyle, including regular exercise, a balanced diet, and stress management, can have a positive impact on dizziness and overall well-being.
5. Surgery: In some cases, surgical intervention may be necessary to treat conditions like acoustic neuroma.

Dizziness, vertigo, and poor balance are complex symptoms that can arise from various underlying causes, with many cases attributed to dysfunction within the inner ear’s vestibular system. These symptoms can be distressing and significantly affect an individual’s daily life and overall quality of life. Seeking proper medical evaluation and diagnosis is essential for effective management and treatment. With advances in medical science and specialized therapies, many individuals find relief and regain control over their sense of balance, allowing them to lead fulfilling lives once again.

Concerned about your dizziness? Book an Appointment

Miami Physio has been providing professional physiotherapy treatment for vertigo and symptoms of vestibular migraines since opening in 2006, providing each valued client with customised treatments and recovery plans with highly effective results.

Contact Miami Physio today to book an appointment at the Lakelands or Falcon clinic, or with any queries about vertigo or dizzy spells.