What Causes Dizziness? Root Cause Evaluation is Key

Often times, dizziness can have more than one cause. This blog discusses what causes dizziness, specifically in the head and neck area.

The Inner Ear

The first thing I do when I evaluate people for vertigo or dizziness is I check out all of the nearby structures to the inner ear, which is our vestibular balance system.

There are many vestibular causes of dizziness, but BPPV is the most common.

After that, I also examine other areas of the body, especially the structure of the head and neck.

The Eyes

One area that may cause dizziness or vertigo is the eyes, so it is important to look at your vision.

Old glasses prescriptions that are out-of-date may cause dizziness. Sometimes what causes dizziness is as simple as new bifocals, trifocals, or progressive lenses.

Someone experiencing dizziness or vertigo might need their eyes checked to ensure proper lenses, or to detect a possible eye disease that nobody has picked up on yet.

Everyone’s eyes have normal changes with aging, even in the absence of eye diseases. An example of an age-related change to vision include reduced depth perception.

Some people need to see an optometrist or ophthalmologist. Other people need vision therapy if their eyes are what causes dizziness.

I also ask if bright indoor lights, or complex visual environments like supermarkets or crowds, cause dizziness or vertigo. I also want to know if outdoor sunlight or riding in the car makes symptoms feel worse.

That is important information to determine the root cause of dizziness symptoms related to vision as well.

If people complain that stationary objects appear to be moving, or straight lines appear wavy, or their vision gets blurry for a few seconds when they turn quickly, then they may have “oscillopsia.” This complaint is best treated by Vestibular Rehabilitation.

Now you are beginning to understand why I am so focused on analyzing symptoms in detail!

The Nose and Sinuses

Another area that may contribute to dizziness or vertigo is the nose and sinus.

Dizziness or vertigo may be related to a sinus problem or a sinus infection. It may be important to see an ear, nose, and throat doctor (ENT MD) to diagnose further.

Some people feel pressure in their ear when their nose or sinus is clogged, correlating with dizziness.

Other people may feel dizzy after a sinus infection or during allergy season every year. Those are some of the clues I look for when I am evaluating what causes dizziness in each case.

Over the years, I have developed specific tips and treatments for my patents with symptoms related to their nose and sinus.

The Brain

The brain is also an important factor. Problems with blood flow through the neck to the brain, migraines, and concussions are examples of brain problems that can cause dizziness or vertigo.

I screen everybody to see if they have signs of neurological disease in their brain. Maybe they will need to be referred to a neurologist for an MRI or other diagnostic testing if we want to investigate the brain further.

The Teeth and Jaw

The teeth can be part of dizziness and vertigo for people, and may even occur after major dental work.

You may need to see a dentist or an orthodontist if you are having issues with their teeth. Some people need a night guard for sleeping.

The jaw joint is another major factor. The vestibular system is housed very closely to the jaw joint, so issues with the jaw joint may affect with the vestibular system.

People with symptoms of dizziness related to their teeth, their jaw, chewing, and things like that, can affect the inner ear and may cause dizziness.

The Lips

I usually ask people if they had a cold sore break out around their mouth or lips prior to the initial onset of vertigo.

A commonly overlooked cause of vertigo is a viral attack of the cold sore virus (herpes) on the inner ear.

The Ear

Hearing loss, ringing in the ears (tinnitus), and chronic ear infections can be related to dizziness and vertigo.

Middle ear infections can cause damage to the inner ear as well, if the bacteria or virus migrate inward towards the inner ear.

That’s what I had as a child also: chronic ear infections from swimmer’s ear, that left me with permanent vestibular problems in my inner ear.

The Neck and Headaches

One last thing that can cause dizziness is the entirety of the neck. This includes motion, muscle tenderness, and headaches.

If people get headaches, I want to know what part of their head hurts, and if lights or sounds make their head hurt worse.

Migraines are an often overlooked cause of dizziness and vertigo.

A Perfect Storm

All of those things really need to be looked at if we are going to figure out what causes dizziness. It is typically not just one reason.

Often it is many reasons, but a lot of times all of these aspects can all be addressed in different ways.

What I tell people when they come to me to be evaluated for their dizziness and vertigo is:

“I am confident we can reduce, if not completely eliminate your vertigo.”

With all of the different factors that can contribute, we have to determine root cause to develop a targeted treatment plan.

If you have symptoms of dizziness and vertigo, it may be best to seek help from a vertigo professional to get to the bottom of what causes your dizziness.


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.

Accessibility Toolbar