Dizziness – Diagnosis and Treatment

Diagnosis

Doctors usually take a few steps to figure out what’s causing dizziness, vertigo, or balance issues. They’ll ask about symptoms—spinning, lightheadedness, feeling unsteady, nausea, or vomiting.

They want to know if you’ve lost hearing, had a recent infection, or if you struggle with depression, anxiety, or panic attacks.

Next, they’ll do a physical exam. They check your balance, the way you walk, and your nerve function. If your nerves or balance seem off, doctors often think about vestibular disorders like vestibular neuritis or labyrinthitis.

They also look for signs of central problems, such as neurological issues or even stroke.

Common tests used in diagnosis:

Test Name	What It Does	What It Finds
Eye Movement Test	Monitors eye tracking or reflexes, sometimes using water or air in the ear	Detects nystagmus, vestibular disorders, and abnormalities in the vestibular system
Head Movement Test (Dix-Hallpike)	Involves quick head movements to look for triggering of vertigo	Helps confirm benign paroxysmal positional vertigo (BPPV)
Posturography	Measures how well a person maintains balance in different settings	Shows which balance system part is not working right
Rotary Chair Test	Uses a chair that moves in circles or arcs	Examines how the inner ear and brain process movement

If doctors suspect a central problem like stroke, tumor, or acute vestibular syndrome, they might order imaging tests such as MRI or CT scans.

Blood tests can check for infections or other medical conditions. They may also measure your blood pressure while sitting and standing to see if orthostatic hypotension or presyncope is an issue.

Other evaluations might include:

• Hearing tests, especially if you have ear symptoms or possible Meniere’s disease
• A visit to an otolaryngologist (ENT doctor) for inner ear problems
• Tests for peripheral neuropathy if you notice numbness or tingling

Finding the root cause of dizziness usually takes a few steps and sometimes more than one test. This careful approach helps your doctor pick the right treatment for issues in the labyrinth, vestibule, semicircular canals, or other balance system parts.

Ways to Manage Dizziness

Medicines

Some people find that certain medicines help with dizziness. If you have Meniere’s disease, the doctor might prescribe diuretics (water pills), along with a lower salt diet, to cut down on dizzy spells.

Other medications can give quick relief from vertigo and nausea—these include prescription antihistamines and anticholinergics. Just know that these often cause drowsiness.

Sometimes, doctors prescribe benzodiazepines for anxiety that comes with dizziness. These meds can be addictive and make you sleepy, so doctors use them cautiously.

Medication Type	Use	Notes
Diuretics	Meniere’s disease	Often with a low-salt diet
Antihistamines	Quick relief for dizziness/vertigo	Can cause drowsiness
Anticholinergics	Nausea and dizziness relief	May make patients sleepy
Benzodiazepines	Anxiety-related dizziness	Risk of addiction, sedation
Migraine preventives	Dizziness from migraines	Taken regularly, not for quick relief

For migraine-related dizziness, doctors may recommend medicine you take regularly to prevent migraines.

Non-Drug Treatments

Physical movements and therapy can really help with dizziness or vertigo. For benign paroxysmal positional vertigo (BPPV), healthcare providers might use canalith repositioning procedures—the Epley maneuver is a common one.

This treatment helps move tiny calcium crystals (called otoconia) that have shifted out of place in the inner ear.

When these crystals end up in the wrong part of the ear, they can confuse the brain about your body’s position and cause dizziness. Repositioning them can stop these false signals and relieve symptoms.

Audiologists, doctors, or physical therapists usually guide you through these. Many people feel better after just one or two sessions.

Vestibular rehabilitation—a type of balance training—can make your inner ear and balance system less sensitive. These exercises work well for people with vestibular neuritis or benign positional vertigo.

If anxiety causes your dizziness, talk therapy with a counselor might help you manage symptoms by tackling stress or worries tied to dizziness.

Surgical and Other Procedures

If medicines and therapy don’t work, doctors may try other approaches. Sometimes, they inject the antibiotic aminoglycoside into the inner ear.

This stops balance signals from that ear, letting the other ear take over. It’s not for everyone, but it helps some.

Rarely, if nothing else works and there’s already serious hearing loss, a labyrinthectomy might be done. The surgeon removes parts of the inner ear that cause vertigo, which leads to total hearing loss in that ear but can end severe vertigo.

Doctors and patients might discuss other advanced options depending on what’s causing the dizziness and the person’s overall health.

Tips for Managing Dizziness at Home

If you often feel dizzy, you can make changes at home to reduce symptoms and stay safer. A few simple tweaks can make a big difference.

Helpful actions:

• Move slowly and avoid sudden position changes to keep your balance.
• Use a cane if you feel unsteady walking.
• Put non-slip mats in the bathroom and get rid of loose rugs or cords that could trip you up.
• Make sure rooms are well lit, especially at night.
• Sit or lie down right away during a dizzy spell. Sometimes closing your eyes and staying still in a dark room helps if vertigo is strong.
• Don’t drive or use heavy equipment if dizziness comes on suddenly or without warning.

Lifestyle matters, too:

• Cut back on caffeine, alcohol, salt, and tobacco—they can make dizziness worse.
• Drink plenty of water and aim for a balanced diet.
• Try to get good sleep every night.
• Manage stress with breathing exercises or gentle movement, like yoga.

Balance retraining exercises can help you get stronger and avoid falls. If dehydration triggers your dizziness, cool off and rehydrate with water or a sports drink.

For people with allergies, cutting down on exposures might reduce dizzy spells.
If medicine makes you dizzy, ask your healthcare provider about possible changes.

Tip	What to Do
Hydration	Drink plenty of fluids
Diet	Eat healthy, limit salt
Lighting	Keep rooms well-lit
Falls Prevention	Remove tripping hazards
Support	Use cane if needed

Over-the-counter antihistamines may help with nausea, but they can make you sleepy. Everyone’s different, so you might need to try a few things to see what helps most.

Getting Ready for Your Visit

Steps You Can Take Before Your Visit

A little prep goes a long way before your appointment. Bringing a friend or family member can help you remember what the doctor says and give you support.

Before your checkup:

• Check for Any Special Rules: Call the office to see if you need to follow any instructions before your visit. Sometimes you need to change your diet or pause certain meds, especially if you’ll have tests.

• Describe Your Symptoms Clearly: Write down details about your dizziness. Is it spinning or just lightheadedness? What were you doing when it started? How did it feel?

• List Your Other Health Issues: Tell your provider about all your health conditions, even ones that seem unrelated. Mention recent stress, anxiety, or mood changes.

• Gather Important Information: Make a list of major life events or changes that could be connected.

• Create a Complete Medicine List: Write down everything you take—prescriptions, over-the-counter meds, vitamins, and supplements.

• Prepare Your Questions: Bring a list.
  • What might be causing my symptoms?
  • Are there other possible reasons?
  • What types of tests do I need?
  • Is this a short-term or long-lasting issue?
  • Are there treatments that could help?
  • Do I need to avoid driving or other things?
  • Should I see a medical specialist?
  • Can I get generic versions of any medicines?

Having your notes and questions ready can save time and help you feel more confident during the appointment.

Questions Your Provider Might Ask

Your healthcare provider will probably ask about your symptoms and medical history. You’ll have an easier time if you’re ready for these.

• They might ask what you felt during your first dizzy spell.
• They’ll want to know if dizziness happens now and then or all the time.
• Details about how long dizziness lasts, how often it comes, and what triggers it matter.
• They may ask if it feels like spinning or just being off-balance.
• They could ask if you ever get faint, lose your balance, or notice things like ringing ears or blurry vision during dizzy spells.
• The provider may ask if moving your head makes things worse.
• Be ready to talk about all the medicines and supplements you use.

Here’s a sample chart of what you might be asked:

Sample Question	What to Think About
How did your first episode of dizziness feel?	Describe the sensation and situation
How often does dizziness happen?	Track frequency and duration
What sets off your dizzy spells?	Think about triggers like movement
Do you feel like fainting or just off-balance?	Distinguish between symptoms
Do you have ear symptoms or vision changes?	Note if you hear ringing or see blurry
What medicines and supplements do you take?	Bring a list if needed

Sharing these details helps your provider figure out what’s going on.

How to Stay Safe Before Your Checkup

Before your visit, you really need to look out for yourself—especially if dizziness sometimes throws you off balance.

• Be Careful When Changing Positions: If standing up makes you feel woozy, take your time and get up slowly.
• Plan Your Trips: If driving feels risky when you’re dizzy, try to find another way to get there. Maybe ask someone for a ride, grab a rideshare, or just take the bus.
• Make Your Home Safer:
  • Keep the lights on so you can see what’s around you.
  • Move anything you might trip over, like loose rugs or stray cords.
  • Shift furniture so you’ve got clear paths.
  • Toss some non-slip mats in the shower and tub.

These small changes can actually make a big difference and help you avoid accidents before your appointment. If you get things ready and jot down what you want to ask, your checkup will probably go a lot smoother.