If you are experiencing lightheadedness, a sensation of losing your balance, or a sense of feeling unsteady, you may be one of the millions of Americans who experience dizziness (vertigo).

When your balance is impaired, you may feel unsteady, woozy, disoriented, have blurred vision, or have a sensation of movement. It may seem that the room is spinning. You may not be able to walk without staggering, or you may not even be able to get up. Sometimes nausea, vomiting, diarrhea, faintness, changes in heart rate and blood pressure, fear, anxiety, or panic accompany the dizziness and balance problems.

The organ of balance is located in the inner part of the ear close to the auditory nerve. Many times, but not always, the cause of dizziness is in this part of the ear. Consequently, individuals who are experiencing a balance disorder often have a hearing loss in one or both ears. Tinnitus, which is often described as "ringing in the ears" or "head noise," may also occur.

Dizziness can be associated with conditions that occur at all levels of the auditory system. Some of these conditions are swimmer's ear, insertion of foreign objects into the ear canal (external ear); ear infection, pressure changes, vascular problems, perilymph fistula (middle ear); Meniere's disease, ototoxic medicines, circulation disorders, labyrinthitis (inner ear); and, at the central level, tumors (especially of the vestibular portion of the eighth nerve) and head injury.

What should I do?

Dizziness and balance difficulties are symptoms of a problem. The first thing you should do is to try to find out the underlying cause. You should have a medical examination with special attention given to checking for factors associated with balance problems such as viral or bacterial infections, head injury, disorders of blood circulation affecting the inner ear or brain, visual disorders, medicines/drugs, tumors, and diseases involving the auditory system such as Meniere's Disease.

Should I see an audiologist?

Your hearing and balance should be evaluated by an audiologist certified by the American Speech-Language-Hearing Association to determine the cause and possible courses of actions to treat the balance disorder. Since balance disorders and/or vertigo can be associated with a number of conditions that may occur at any level of the auditory system, the audiologic evaluation will yield extensive information regarding cause and options for treatment.

Audiologists perform audiologic and balance assessment in order to gather information on your hearing and balance functioning. Test results help determine the possible causes of vertigo. Results of these assessments, in combination with medical findings, will provide diagnostic information on how to treat your dizziness and balance difficulties.

Audiologists can give you information that will increase your understanding of dizziness. Understanding what is happening is often relief in itself. Knowing the cause of your dizziness is also relief from having to live with the uncertainty of the condition.

How is dizziness treated?

The most effective treatment for vertigo is to eliminate the underlying cause, if possible. Because vertigo can be a symptom of a treatable disease or medical condition, medical or surgical treatment may be helpful. This is true for some cases of ear infection, stroke, or multiple sclerosis. For people with Meniere's disease, dietary changes such as reducing salt intake may help. For some people reducing alcohol or caffeine and avoiding nicotine have been found to be helpful.

Medical treatment varies and will be based on symptoms, medical history, general health, medical tests, and medical examination.

Unfortunately, in many cases, the vertigo and balance difficulties cannot be treated medically or surgically. In these cases, the vertigo itself may need to be treated.

What is vestibular rehabilitation?

Your audiologic, balance, and medical diagnostic tests help indicate whether you are a candidate for vestibular rehabilitation. Vestibular rehabilitation is an individualized balance retraining exercise program. The retraining teaches compensations that may decrease dizziness, improve balance, and improve general activity levels. Many audiologists provide limited vestibular rehabilitation; however, other clinicians such as physical therapists or occupational therapists are trained to provide more extensive vestibular rehabilitation. Rehabilitation with a clinician who specializes in vestibular rehabilitation may be effective in minimizing or relieving some of the symptoms, especially if the dizziness is caused by head movement, motion sensitivity, or certain positions. Rehabilitation is also excellent for recovery of balance and improving daily functional activities.

Find an ASHA-certified audiologist near you.