Question 1

What is dizziness?

Accepted Answer

Dizziness is one of the most common symptoms in primary care, encompassing several distinct experiences: vertigo (a sensation of spinning, most commonly from the inner ear), presyncope (feeling faint, typically from cardiovascular causes), disequilibrium (imbalance without head sensation), and non-specific lightheadedness (often anxiety, hyperventilation, or dehydration). Distinguishing these types guides investigation appropriately. Benign paroxysmal positional vertigo (BPPV) — brief intense vertigo triggered by head position changes — is the most common cause and responds well to repositioning manoeuvres.

Question 2

What do people commonly experience with dizziness?

Accepted Answer

The experience of dizziness is universally unpleasant and often frightening — particularly vertigo, which can be severe enough to cause vomiting and inability to stand. Many people develop significant anxiety about recurrence after a distressing episode. BPPV sufferers often describe the sudden, intense vertigo triggered by lying down or rolling over as alarming until the benign diagnosis is made.

Question 3

What lifestyle changes can help with dizziness?

Accepted Answer

- Adequate hydration is the first intervention — dehydration is a common and easily correctable cause of dizziness.
- Rise slowly from lying or sitting to standing — allow 10–15 seconds before moving to reduce orthostatic dizziness.
- Reduce caffeine and alcohol, which worsen vestibular instability and increase fall risk.
- Identify and manage anxiety components — dizziness and anxiety form a bidirectional loop; addressing one reduces the other.
- Vestibular rehabilitation exercises (Epley manoeuvre for BPPV, Brandt-Daroff exercises) are highly effective when dizziness is positional.
- Maintain consistent meal timing to avoid hypoglycaemic dizziness — small, frequent meals with protein at each sitting.

Question 4

What integrative approaches support dizziness?

Accepted Answer

The Epley manoeuvre has strong evidence for BPPV. Vestibular rehabilitation physiotherapy is effective for persistent vestibular dizziness. Acupuncture has evidence for both vestibular and anxiety-related dizziness. Herbal medicine including ginger has evidence for nausea associated with vertigo. Stress management addresses anxiety-related dizziness.

Question 5

When should I seek professional support for dizziness?

Accepted Answer

- Seek emergency 999 care for sudden severe dizziness with headache, vision changes, speech difficulty, weakness, or facial asymmetry — these may indicate stroke.
- Seek same-day urgent assessment for new dizziness with hearing loss, tinnitus, or significant imbalance.
- See a doctor for dizziness causing falls, or for dizziness that has persisted more than two weeks.
- Seek review if dizziness developed after starting a new medication — many medications cause dizziness as a side effect.
- Seek vestibular physiotherapy referral if dizziness is positional (triggered by lying down or turning over) — BPPV responds well to specific repositioning manoeuvres.

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