We have all experienced being dizzy, off balance, spinning or feeling lightheaded. Often people categorize these symptoms as vertigo when, in fact, there are several reasons one may be experiencing these symptoms.

Dizzy. Off balance. Spinning. Lightheaded. Ear pressure. Nausea. At one point or another, we have all experienced at least one of these symptoms.


People often categorize these symptoms as vertigo when, in fact, there are several reasons one may be experiencing these symptoms.


Vertigo refers to the feeling that you or your environment is moving or spinning when your body is stationary. This is different from the symptoms just mentioned and can occur for a variety of reasons.


Benign paroxysmal positional vertigo, more commonly known as BPPV, is one of the most common conditions that can cause these symptoms. About 20 percent of all reported dizziness is due to BPPV.


The part of your brain responsible for the coordination of your vision, balance and postural responses is known as the vestibular system. Within this system are the fluid-filled semicircular canals in the inner ear. When your head moves around, the liquid inside the semicircular canals also moves.


Dizziness and other symptoms that stem from BPPV are thought to be due to the debris, known as otoconia, which have built up, broken off into particles and moved into fluid-filled canals of the inner ear. As your head position changes –– like when you lie down, bend over or roll in bed –– the debris moves in the semicircular canals and sends the message to your brain that you are moving. This is why many people experience the sensation that they are dizzy or spinning when they change position.


BPPV can often be managed by performing specific repositioning maneuvers to move the debris back where it belongs. A certified vestibular physical therapist or your doctor can assist in this process.


Another common reason many of us experience some of these symptoms is due to what is known as orthostatic or postural hypotension. This is a form of low blood pressure that occurs when you stand from a sitting position or sit up from a lying down position. Orthostatic hypotension can make you feel dizzy, lightheaded and even faint. These symptoms can last from seconds to minutes.


Some of the causes of orthostatic hypotension may include low blood sugar, mild dehydration or medication side effects. In a mild form, treatment is usually not indicated and slow changes in position are recommended to help regulate these symptoms. Long-lasting hypotension may be indicative of something more serious, and speaking to your doctor would be appropriate to help determine the cause.


Migraines are another common source of symptoms, including nausea, vomiting, auras, sensitivity to light and even difficulty with speech and alertness. Migraines affect more than 32 million people in the United States. They are caused by vasodilation (expansion) of the blood vessels in the head –– headaches are just the opposite, causing vasoconstriction (narrowing) of blood vessels.


Recent research suggests that migraines are a genetically based illness. People with a single parent having migraines have approximately a 50 percent chance of having migraines as well.


It is important to be aware that headaches are not always present with a migraine. One single migraine attack may last for hours, days and even weeks. The best course of action is to speak with your doctor so they can guide you in the right direction, as there are many treatment approaches.


Although there are many more causes of dizziness and similar symptoms, it is extremely important to be specific when describing your symptoms to your doctor. This will help to ensure you are treated accurately. Think about the conditions in which these symptoms occur. Are they when you are sitting still? Changing position? What exact symptoms are you feeling? How long do the symptoms last? Do you notice any triggers?


It is often suggested to keep a journal or a daily log of what symptoms you are experiencing and with what activities they occur. This can significantly assist your health care provider in figuring out how to most effectively treat you.


Ashley Saulnier PT, DPT, is a physical therapist at Spaulding Outpatient Center Framingham, Mass. She is certified in vestibular rehabilitation.