Dizziness while standing can have various root causes. The key information that will help your healthcare providers determine the root cause is the duration of the symptoms.

When you stand up, how long does the dizziness last?

In this article, I will share ten possible causes of dizziness while standing and what to do about it.

Medication Side Effects

Side effects from medications or possible drug interactions can cause or worsen dizziness while standing.

What to Do

You can ask your doctor or pharmacist if any of your medications might be causing your symptoms. They will review your medications for possible side effects and check for drug interactions.

Then they advise you on how to best move forward to minimize any dizziness caused by medication side effects.

Alcohol Intoxication

Alcohol intoxication can cause dizziness while standing. If you notice that you are feeling dizzy when you stand up while under the influence of alcohol, take caution because you could fall.

Alcohol may also have heightened effects on patients with vestibular disorders, like BPPV or vestibular neuritis.

What to Do

If you didn’t drink that much, beware that your medications could be interacting with alcohol. You can ask your doctor or pharmacist if any medications that you take interact with alcohol.

Getting a good night’s sleep and rehydrating can help you recover. Additionally, you may want to limit your future alcohol intake to prevent falls with injury.

Dehydration

Dehydration can cause dizziness while standing. This is typically a lightheaded feeling and may even lead to fainting in severe cases.

What to Do

Be sure to stay hydrated daily. Drinks that contain alcohol or caffeine do not count towards your daily fluid intake, since they can contribute to dehydration. Talk to your doctor or a nutritionist about your goal for daily fluid intake.

Low Blood Pressure

If your blood pressure drops when you stand up, that can cause dizziness while standing.

If the BP drops low enough, that is a medical condition called orthostatic hypotension.

Common causes of orthostatic hypotension (OH) include dehydration, medication side effects, and prolonged bed rest.

What to Do

I wrote a detailed article on orthostatic hypotension along with specific causes and what to do, which you can find here.

This article discusses how to manage low blood pressure with standing up.

To learn about other cardiovascular conditions that can contribute the dizziness when standing, click here.

Dysautonomia

In addition to OH, there are many other ways that your blood pressure and/or heart rate can respond abnormally when you stand up.

If your blood pressure and/or heart rate do not respond appropriately when standing up, then you may have some form of dysautonomia.

I wrote an article on the most common forms of dysautonomia and emerging treatment recommendations, which you can find here.

What to Do

Ask your doctor if your heart rate and blood pressure are responding normally when you are standing. If not, your doctor may refer you to a cardiologist or other specialist.

Carotid Occlusion

If the carotid arteries on the front of your neck are getting clogged, that can contribute to dizziness while standing. This may occur in patients with atherosclerosis, which is plaque buildup within arteries.

What to Do

Especially if you have high cholesterol, you can ask your doctor to check your carotid arteries for reduced blood flow.

If your doctor is concerned, they may order a carotid ultrasound or some other vascular imaging study.

A surgery called a carotid endarterectomy may help relieve dizziness while standing for patients who are diagnosed with carotid occlusion.

Foot Neuropathy

Foot neuropathy is usually caused by poor blood flow and/or nerve damage in the feet or lower legs. This condition can contribute to dizziness while standing.

What to Do

Ask your doctor to check if your feet and lower legs have good blood flow and nerve function. If your doctor is concerned, they may order tests to measure the blood flow or nerve function in your legs.

If you are diagnosed with foot neuropathy, your doctor will guide you on the next steps for your medical care.

Learn More about Foot Neuropathy

For tips on how to identify foot neuropathy, click here.

To learn about the causes of foot neuropathy, click here.

For safety tips for people diagnosed with foot neuropathy, click here.

To learn about treatment options, click here.

In this article, I share about how foot neuropathy links to low blood pressure with standing.

BPPV

The most common inner ear disorder is called BPPV. This condition occurs when crystals in your inner ear dislodge from their position and become displaced into another part of the inner ear.

BPPV can cause dizziness while standing in some cases, but not in all cases. If you also feel a stronger wave of dizziness when you look up, bend over, lie down, roll over in bed, sit up in bed, or get out of bed, then you may have BPPV.

What to Do

Contact a qualified specialist. To find a vestibular specialist who can diagnose and treat BPPV, use this article.

To learn more about how BPPV treatment works, click here.

Post-Concussion Syndrome

Concussions can cause dizziness with standing for some patients. Typically, these symptoms will resolve within two weeks of a new concussion.

For patients with post-concussion syndrome, concussion-related dizziness can last for weeks, months, or even years.

What to Do

If you have a history of trauma or recall hitting your head hard in the past, you may have dizziness while standing due to post-concussion syndrome. You should mention that history of head trauma to your healthcare providers.

Post-concussion syndrome can easily be missed without a proper history because it often does not show up on a brain CT scan or MRI.

I discuss post-concussion syndrome in more depth in this article.

Forward Head Posture

When you stand up, your head is supposed to be stacked directly above your spinal column. That is the ideal posture, with naturally occurring spinal curves.

If someone looks at you from the side and sees that your head is jutting forward in front of your trunk, then you may have a forward head posture.

A posture assessment used to check for forward head posture is called the “plumb line.”

If you have a forward head posture, it can contribute to dizziness while standing.

The lower cervical spine moves into excessive flexion, while the upper cervical spine is hyperextended. Blood flow to the brain and ears through the vertebral arteries in the neck may be affected, especially over time.

Forward head posture can also affect proprioception, which is the sensory input from the cervical spine. This can create a feeling of disequilibrium, which may be experienced as “dizziness while standing” by some patients.

What to Do

Forward head posture can improve with physical therapy or chiropractic care for the spine. I suggest you find a physical therapist or chiropractor with experience resolving forward head posture through manual therapy, postural training, and exercise.

If the patient’s forward head posture goes away when they lie down, then the prognosis for correcting forward head posture is much better.

Stretching the chest area and strengthening the upper back muscles may be necessary for long-term improvement.

Training in postural awareness while standing can also help as you learn how to properly align your head.

A highly skilled personal trainer or fitness professional may also be able to help with the exercise program for correcting forward head posture.

The older you are, the more challenging is this task – so don’t delay!

Some older patients have a fixed forward head posture regardless of whether they are sitting, standing, or lying down, due to thoracic kyphosis. In those cases, a doctor may recommend a kyphoplasty, which is a spinal surgery to repair any compression fractures that have been found in the thoracic spine.

Learn More

To find an article on lightheadedness and pre-syncope (near-fainting spells), click here.

This article discusses respiratory issues that can affect the oxygen level while standing up.

To learn about COVID-related dizziness, check out this article. This may be a deeper root cause of dysautonomia in some cases.

This article discusses the link between forward head posture and dizziness in more depth.

For more discussion on the medical causes of dizziness, click here.

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.

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