During my third UCSD Stein Public Lecture that I offered in January 2018, I had a chance to discuss the symptom of dizziness with head turns. This is a common complaint and can indicate a number of different root causes, all of which should be explored to reduce, if not completely eliminate this symptom of dizziness with head turns.
Dizziness with head turns can be caused by root causes involving the central nervous system (CNS), the neck bones, the neck muscles and/ or the inner ear, i.e. the vestibular system.
The management of dizziness with head turns depends on the root cause, so determining the root cause is critical to optimizing outcomes. It is important to remember that multiple root causes are often present and all root causes need to be addressed for the best results.
Some central nervous system disorders that can cause dizziness with head turns include migraines and multiple sclerosis. For this reason, consultation with a Vestibular Specialist is valuable for people who experience dizziness with head turns, to determine if a neurological root cause is contributing to the discomfort.
Migraines are the great mimicker of all causes of dizziness and can cause dizziness at rest, dizziness with motion and recurrent episodes of dizziness. Avoiding the triggers that cause migraines is a key to reducing the discomfort.
Sometimes the misalignment of neck bones, degeneration of intervertebral discs in the neck, or spasms in the neck muscles can cause dizziness with head turns. In these cases, people often feel some amount of neck pain, limited neck range of motion and may have tension in the muscles at the sides of the neck, the front of the neck and/ or the base of the skull.
Consulting with a physical therapist who specializes in manual therapy or a chiropractor who specializes in upper cervical adjustments may benefit someone who has dizziness with head turns and neck pain or muscle tension. In addition to manual therapy or upper cervical chiropractic care, people with muscle tension, neck pain and limited motion often benefit from soft tissue massage to loosen up and bring circulation to the fascia and soft tissues in the neck, head, jaw and shoulders.
Another common cause of dizziness with head turns is a vestibular problem, or inner ear issue. Typically, vestibular problems will cause dizziness with more rapid or quick head turns but they can also cause problems with head turns of any speed in some cases.
The most common inner ear condition is BPPV and a symptom of certain types of BPPV is dizziness with head turns. Another common inner ear condition is a vestibular hypofunction and that can cause dizziness with head turns.
All of the common inner ear conditions can be evaluated and treated by a Vestibular Specialist. The good news is that most causes of dizziness with head turns from the inner ear respond well to vestibular rehabilitation.
Consulting with a Vestibular Specialist for evaluation and treatment of the inner ear and neurological systems is an extremely important step in seeking specialty care for someone with dizziness with head turns, especially since most general practitioners do not know how to assess or treat dizziness symptoms related to the inner ear.
There is a lot more that I can share with you on all the conditions mentioned above, but to keep it simple, here is a summary of the steps I would suggest to someone who has dizziness with head turns:
- Notify your primary care physician of the dizziness with head turns.
- Consult with a Vestibular Specialist to determine any vestibular or neurological causes for your symptoms and follow up on their recommendations.
- Consult with a physical therapist who specializes in manual therapy, or a chiropractor who specializes in upper cervical adjustments, if neck pain is also present or if complete relief was not found with the Vestibular consultation.
- Consider getting a soft tissue massage for your head, neck and shoulders.
Disclaimer
This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.
I am seeing an ENT who purports to specialize in ears. They have given me a medication formerly used for blood pressure (Verapamil- no effects) and sent me for VNG testing, which detected inner ear hypofunction on both sides. I’ve had Epley maneuvers and other maneuvers. I was put on a muscle relaxer which made me feel even more drunk and affected my mental acuity and speech.
I’m wondering if these are common treatments, and if an antibiotic might be in order…
I know you are not seeing me, but is one sometimes used, and what symptoms might indicate it is appropriate.
Hi Bonnie,
My suggestion is for you to find a vestibular physical therapist who specializes in vestibular rehabilitation.
You can use this article to search for someone in your area.
The treatments you had so far are common for different types of dizziness and vertigo.
Yet none of the treatments you mentioned typically help with an inner ear (vestibular) hypofunction on both sides.
A specific vestibular rehab exercise program may be able to help.
Antibiotics are prescribed for a bacterial infection.
I hope you feel better soon!
I will try to best describe how I feel and what I’m feeling.
A few months ago I had an episode of Vertigo.
During this time, I vomited, with strong nauseousness and much spinning sensation.
Since then, I’ve been dealing with dizziness and nausea.
When I get up from my bed, couch or the car, I become dizzy..
Also, when I turn my head to the right, every thing moves like waves, gets blurry and I get nauseous.
(This is my own opinion, but I feel that vertigo has been lingering)
On another note, I had neck surgery on April 10, 2023.
I’ve had more of these episodes, more often than usually.
I can’t pinpoint it, what’s triggering these episodes of vertigo, dizzy spells with every else.
I’m concerned, something else is going on, I’ve made an appointment with my Doctor.
Hoping to get some help and answers.
Hi Yolie,
I think you are on the right track by making an appointment with your doctor, because it sounds like you need some individual medical advice.
You can use this blog to search for a vertigo doctor in your area.
You can use this blog to search for someone who can treat any cervical related dizziness or vertigo.
I hope you feel better soon!
I have no inner ear issues, however have degenerated discs in my lower spine. I stay hydrated, my blood pressure stays normal, and this has been going on for varying degrees over the years. For over two years now we very time I roll over or move my head to the rod I get so dizzy I have been known to fall. Several doctors, orthopedic specialist and spine specialists have ignored this and pushed muscle relaxers and physical therepy. I’m on Medicaid and often get the run around to specialists who may or may not take my Medicaid. I also have been told to get any further treatment if need an MRI which Medicaid will not cover even after being asked by a primary doctor, a pain specialist, and an orthopedic doctor. I will also have period of numbness in my limbs as well as severe static nerve pain and numbness. 3 friends have suggested I’m showing signs of MS but the doctors say there’s nothing in my blood work that makes them think that’s a problem.