Dizziness - causes and therapy

Dizziness (vertigo) and balance problems

When people are plagued by dizziness, they feel that the floor is swaying, everything is turning, or the floor is sagging under them. According to the descriptions of those affected, dizziness usually goes hand in hand with the sensation of disturbed balance and insecurity and can be perceived, for example, as swaying vertigo or rather diffuse. The causes and accompanying symptoms of vertigo are varied. The spontaneous onset, seizure-like or permanent dizziness does not always have its cause in the sense of balance. Other causes of dizziness are usually benign and easily accessible to various forms of therapy.

The most important facts about dizziness

  • Besides dizziness, dizziness can have many other causes.
  • The feeling of dizziness can occur spontaneously, like a fit or permanently.
  • Dizziness is the second most commonly reported symptom in patients.
  • There are different types of dizziness.
  • Avoiding or treating the causes can make dizziness go away.

Forms of vertigo

Dizziness is usually classified according to different criteria, for example

  • after subjective perception,
  • by duration,
  • after trigger
  • or according to the origin of the complaint.

Of course, the symptoms are not always so clearly differentiated in practice, mixed forms and transitions do occur. The various forms of vertigo are defined by their causes and the specific way in which they manifest themselves in those affected.

Systematic dizziness

The following forms of vertigo are called systematic vertigo. The cause of the systematic dizziness is usually a disturbance or irritation of the sense of balance:

  • Spinning sensation
    Do you know the feeling you have when you get off after a quick carousel ride, for example? This is what the spinning sensation feels like.
  • Dizziness
    One speaks of vertigo when the ground seems to move underfoot, as happens physiologically after long boat trips.
  • Elevator dizziness
    Those affected have the feeling of an upward and downward movement of the surroundings, as is known from trips with elevators.

Unsystematic dizziness

With unsystematic dizziness, the apparent movements of the surroundings are less clear. Various sensations are summarized under the generic term diffuse vertigo, such as:

  • Feeling empty and turning in the head,
  • Blurred vision,
  • Flickering and turning black
  • Nausea attacks,
  • Gait insecurity,
  • Attacks of weakness,
  • impending fainting or lightheadedness
  • and a feeling of unreality.

It usually occurs with dizziness that occurs outside of the balance organ.

In addition to the perceptions described, there is often a tendency to fall in one direction, tremors in the eyes (nystagmus) and a number of vegetative symptoms such as nausea and vomiting, sweating, palpitations and anxiety. Due to the large number of additional symptoms, dizziness syndrome is mentioned.

Causes and triggers

In order to orientate ourselves with our body in space, the central nervous system must constantly process and coordinate sensory stimuli that come from the balance organ (vestibular apparatus) in the inner ear, from the eyes and receptors of the muscles and tendons and the respective requirements (rest, movement, change of position) be adjusted. Many people are well aware of the effects of irritation of this processing as motion sickness (motion sickness) or vertigo. The symptoms can also arise as a side effect of medication, alcohol or drug use. Last but not least, organic and functional disorders in defined areas lead to dizziness as well as stress, fear and psychological imbalance.

Cause in the equilibrium apparatus

The equilibrium organ in the inner ear consists of the atrial labyrinth, arch apparatus and the vestibular part of the VIII cranial nerve (equilibrium nerve). The cause of a series of vertigo syndromes is considered to be a disturbed sense of balance. If peripheral parts of the labyrinth or a nerve are damaged and the dizziness is triggered by head movements or changes in position, the symptoms can be a sign of frequent but benign positional vertigo (BPPV) or a symptom of Menière's disease, a disease associated with dizziness and Buzzing in the ears (tinnitus). But bacterial or viral inflammation, for example the structures of the inner ear (labyrinthitis) or the equilibrium nerve (neuritis), herpes zoster infection in the ear and an infarction in the labyrinth are also possible causes. Lesions in the central nerve tracts or the cerebral cortex can also lead to (especially systematic) dizziness. Furthermore, this can sometimes be identified in the context of migraines, multiple sclerosis, acute circulatory disorders in the brain (TIA), poisoning or tumor diseases (acoustic neuroma).

VR disease

A special form of motion sickness is VR illness or VR motion sickness. There are modern PC, console and cell phone games, but there are also professional applications in which the action is not perceived on a conventional monitor, but by means of virtual reality glasses, or VR glasses for short. With this, it is possible for users to act virtually in a 3D environment. As a result, some people experience symptoms such as dizziness, nausea, and disorientation. These symptoms go away on their own after a short time.

It is thought that these symptoms are caused by the discrepancy between the movements that are visually conveyed to the brain, but not by the sense of balance. As a result, VR disease plays a special role. The sense of balance is partly responsible for the symptoms, but there is no disturbance of the same. Many get used to the VR world after a while and the symptoms of VR disease subside. In others, these symptoms arise anew each time they are used.

Cause out of balance

In dizziness with a cause outside the sense of balance (non-vestibular dizziness), the origin can lie in different organs and functional areas. With anemia, for example, there is an undersupply of oxygen, which can lead to dizziness. In addition, vitamin deficiency, hypoglycaemia, hyperventilation and low blood pressure with dizziness symptoms immediately after getting up and possible weather sensitivity must be taken into account.

In the area of ​​the head, vision disorders such as latent squinting, reduced blood flow to the brain due to calcification processes, epilepsy or head injuries are also possible. Cervical dizziness, whose origin can be found in the area of ​​the cervical spine, certainly plays an important role.

Dizziness and cervical spine

In so-called cervical dizziness, there is a presumption of a connection between dizziness and the cervical spine. If other structural causes are ruled out, other methods such as osteopathy, chiropractic or Rolfing are often referred to in conventional medical practice, which include tissue quality and the use of the body in everyday life in diagnosis and treatment.

It is assumed in osteopathy that equilibrium receptors could sit in the muscles at the back of the head, which can be pinched off if these muscles are tight and can cause dizziness. Rolfing takes the statics of the entire organism into account in order to ensure adequate, symptom-free function without dizziness. These concepts are based on the fact that balance for the human organism can also be the relationship between the head and the body. If this is disturbed or inharmonic, complaints can arise. Therefore, in the diagnoses, symptoms that are not necessarily related to vertigo, such as:

  • Neck tension,
  • stiff neck,
  • Pain on the shoulder blade,
  • Stinging
  • or headache asked at the back of the head.

Structural representatives from the medical industry assume that the connection between the cervical spine and vertigo is more likely to be caused by degenerative processes in the cervical vertebrae. These are said to result in restricted movement, undersupply of blood and nerve conduction problems and thus functional restrictions in the organs of balance.

Dizziness due to head movement

According to statistics, dizziness occurs most often in the context of a so-called benign paroxysmal positional vertigo (BPPV). Here, certain movements or changes in position can lead to spontaneous vertigo attacks, which are very unpleasant but harmless in themselves. The reason for this are small stones that are in the inner ear and sometimes clump together to form larger structures. With certain movements, especially the head, these can now reach unfavorable positions with the lymph fluid and lead to dizziness. Various positioning exercises help to prevent the symptoms or to stop them early after they start. Alternative doctors see a possible connection with the diet of those affected. More on this in the section on nutrition as a trigger.

Psychogenic dizziness

Dizziness can occur in the context of many mental disorders, for example with depressive syndrome, pyschoses and especially with anxiety disorders. Vertigo and other specific phobias such as agoraphobia with or without panic attacks are often accompanied by dizziness, which is usually described as diffuse and unsystematic dizziness. It often takes a long time for a psychogenic cause to be accepted by those affected. After all organic causes have been excluded, the recommendation for psychotherapy is often made with the medical diagnosis of "phobic dizziness".

Age fraud

The likelihood of dizziness increases significantly with age. There is information that between 40 and 50 percent of those over the age of 75 should be affected. Very often, no clear organic cause for dizziness in old age is found. Various age-related factors presumably come together that favor vertigo symptoms. These include, for example

  • Heart failure,
  • Stumbling and irregular heartbeat,
  • Blood pressure fluctuations,
  • Circulatory disorders (especially of the brain and ears),
  • Vision disorders,
  • Ear disorders,
  • Anemia,
  • strong fluctuations in blood sugar levels
  • and desiccation.

Older people generally feel less and less thirsty, drink too little and are at risk of internal dehydration. Aging takes place in a process-oriented manner so that older people do not want to ignore their restrictions, for example due to dizziness. In order to avoid falls, a suitable aid, such as a rollator, is therefore useful. Regular balance exercises, a vitamin-rich basic diet and adequate hydration can stop the dizziness. Preparations from Ginkgo biloba and physical water applications, such as facial castings, are recommended for naturopathy.

Nutrition as a trigger

In alternative medicine, nutrition is also discussed as a trigger or an important factor in the development of dizziness syndromes. Electrolytes, in particular table salt, potassium, calcium, magnesium and phosphate, should play a role here. The mineral composition of the endolymph, a liquid that takes on important tasks in the ear canals, can be changed through nutrition and may impair the function of the sense of balance. In addition, food intolerances and food allergies are suspected of causing dizziness, because the symptoms improved with individual attempts to omit or omit the suspected allergens. As a preventive measure, basic food should always be preferred, especially if symptoms already exist.


Complaints that persist for a long time or recur should first be clarified by a doctor - and specifying specialist, for example in a practice for ear, nose and throat (ENT), neurology or cardiology. In the event of a severe vertigo attack, emergency medical help makes sense - not least because of the possibility of a stroke.

Conventionally, based on the patient's medical history and findings, drug treatment for the therapy of the underlying disease and for symptomatic relief of vertigo, for example with dimenhydrinate or pentoxyfellin, is in the foreground. In case of postural vertigo, various posture exercises, such as the posture maneuvers according to Epley and Semont, show better results. Psychotherapy is usually initially used with behavioral therapy or deep psychological procedures, but these can be supplemented by alternative procedures after consultation.

Self help through avoidance

If the cause of the dizziness is known, such as a food allergen, alcohol or drugs, you should avoid these substances. Those who tend to feel dizzy for a long time on carousel rides should not use such rides. The use of VR glasses should also be restricted if this causes dizziness.


Especially with chronic complaints, naturopathic treatments can improve things. Depending on the cause of the dizziness, acupuncture, ear candles (which also help with colds and stress) and Kneipp procedures are used. If the cervical spine is involved, manual therapies, Rolfing, osteopathy or craniosacral therapy are suitable.

In the case of stress and a psychogenic cause, for example:

  • Yoga,
  • Meditation,
  • Progressive Muscle Relaxation,
  • Hypnotherapy,
  • Psychokinesiology,
  • Acupressure
  • or autogenic training

Take remedial action so that those affected can regain "firm ground under their feet" and "find support" again.

Especially with age fraud, phytotherapy drugs with ginkgo extracts are often used.

Homeopathic methods

Dizziness from motion sickness can be treated with ear acupuncture and homeopathically prepared coconut grains (Coccolus). Bach flowers can also be used and other homeopathic medicinal products are also in use, such as Aurum, Viscum album and Tabaccume, which should ideally have been preceded by an individual professional medical history. (jvs, ok; updated 12/28/2018)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.


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  • Larysa Sokolova, Robert Hoerr, Tamara Mishchenko: Treatment of Vertigo: A Randomized, Double-Blind Trial Comparing Efficacy and Safety of Ginkgo biloba Extract EGb 761 and Betahistine, International Journal of Otolaryngology, (accessed August 5, 2019), PubMed
  • Thomas Brandt, Marianne Dieterich, Michael Strupp: Vertigo - Leitzymptom Schwindel, Springer Verlag, 2nd edition, 2012
  • Debara L. Tucci: Tinnitus, MSD Manual, (accessed August 5, 2019), MSD
  • HansChristoph Diener, Christian Weimar: Guidelines for Diagnostics and Therapy in Neurology, German Society for Neurology (DGN), Chapter Cranial Nerve Syndromes and Dizziness, (accessed August 5, 2019), DGN

Video: Vertigo: causes, symptoms, and treatments (October 2021).