You don’t need to figure out why it’s happening. Two things give us surprisingly useful information: how long does it last, and what seems to set it off?
When the room suddenly spins or you feel as though you’re moving when you aren’t it can be frightening. And if you’re watching someone you love go through it, it can be frightening for you too. You don’t need to figure out why it’s happening. Two things can give us surprisingly useful information: how long does it last, and what seems to set it off?
You roll over in bed and suddenly the room moves.
You look up. Bend down. Turn your head.
For a few seconds, everything seems to spin.
You grab the wall. Close your eyes. Wait.
And afterward, you may be afraid to make the same movement again.
Or perhaps this isn’t happening to you at all. You’re reading this because someone you love is experiencing it, and you’re trying to figure out how to help.
“Dizzy” doesn’t tell us enough.
What Do You Mean by Dizzy?
People use dizzy to describe very different experiences.
Some feel as though the room is spinning around them. Others feel as though they are moving when they’re actually still. Some feel pulled to one side or unsteady on their feet.
Others mean lightheaded — as though they might faint — which is a different experience and deserves a different investigation.
When there is a false sensation of movement or spinning, we commonly call that vertigo.
Whether you say “the room is spinning” or “I am spinning” does not, by itself, tell us where the problem is coming from.
Modern approaches to dizziness place greater emphasis on when it happens, how long it lasts, what triggers it, and what we find on examination.
So you don’t have to find the perfect word. We need the pattern.
How Long and What Set It Off?
This is the useful thing to notice.
Did it last seconds, minutes, hours — or has it been continuous?
And what happened immediately before it began?
Did you roll over in bed? Look upward? Bend down? Turn your head? Did it begin without any obvious movement at all?
Those answers don’t diagnose you. But they help determine what should happen next.
Brief episodes of vertigo repeatedly triggered by changes in head position are characteristic of benign paroxysmal positional vertigo — BPPV — one of the most common causes of positional vertigo. Other timing and trigger patterns can point the examination in very different directions.
You don’t need to interpret any of it. That’s our job.
Sometimes We Can Actually Reproduce What You’re Feeling
BPPV occurs when tiny calcium-carbonate particles in the inner ear become displaced into one of the semicircular canals.
When your head moves into certain positions, those particles can create an abnormal signal of movement. That’s why someone can be perfectly still one moment, roll over in bed — and suddenly feel as though the room is moving.
If your history sounds like positional vertigo, we can test for it.
One of the primary tests is called the Dix-Hallpike maneuver.
We carefully position your head and body while watching your eyes. In posterior-canal BPPV, the maneuver can reproduce the vertigo along with a characteristic involuntary eye movement called nystagmus. Clinical guidelines recommend Dix-Hallpike testing for diagnosing posterior-canal BPPV.
Now we have more than the word dizzy. We have a finding.
Let’s Check You
At Ptak Family Chiropractic in Santa Monica, we start by listening to exactly what happened.
Depending on the pattern, the examination may include positional testing, eye movements, balance, gait, coordination and an appropriate neurological examination.
We’re trying to determine whether this behaves like BPPV, whether there is another vestibular pattern, and whether there are findings that suggest something neurological or otherwise outside what should be managed here.
And most importantly: what can we actually do about what we find?
If the examination demonstrates posterior-canal BPPV, a canalith-repositioning procedure such as the Epley maneuver may be appropriate. Rather than simply suppressing the sensation, the maneuver is designed to reposition the displaced particles. Clinical guidelines recommend canalith repositioning for posterior-canal BPPV.
If we find something else within our scope that can reasonably be addressed, we’ll explain what we found and what we recommend. And if the findings indicate that you need medical evaluation, imaging or another specialist, we’ll tell you.
What we find determines what we do.
When Vertigo Shouldn’t Wait
Most positional vertigo isn’t a medical emergency. But sudden dizziness or vertigo can occasionally accompany a neurological emergency, including stroke.
New spinning or severe dizziness accompanied by difficulty speaking, new facial or limb weakness or numbness, double vision, severe difficulty walking, loss of consciousness, or a sudden severe headache deserves urgent medical assessment.
Continuous new vertigo or dizziness — particularly when accompanied by neurological abnormalities or marked difficulty walking — also requires appropriate medical evaluation rather than assuming it is BPPV.
Let’s Find Out Why You’re Spinning
If the room has been spinning — or you feel as though you’re spinning — and you don’t understand why, let’s check you.
If you’re reading this because it’s happening to someone you love, bring them in.
We never charge you to sit down and talk about your needs. We’ll listen to what happened, examine the appropriate systems and determine what the findings tell us. If it’s something we can help, we’ll explain what we can do. If it belongs with another specialist, we’ll tell you that too. Call Ptak Family Chiropractic at 310.473.7991 and make an appointment.
You don’t have to figure out why the world is spinning before you come in. That’s what the examination is for.
Selected References
Bhattacharyya N, et al. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update). Otolaryngology–Head and Neck Surgery. 2017.
Rogers TS, Noel MA, Garcia B. Dizziness: Evaluation and Management. American Family Physician. 2023.
Edlow JA, et al. Guidelines for Reasonable and Appropriate Care in the Emergency Department 3 (GRACE-3): Acute Dizziness and Vertigo in the Emergency Department. Academic Emergency Medicine. 2023.
About the author. Dr. Jeffrey Ptak, DC, DSS, MSS, MA, is the founder of Ptak Family Chiropractic in Santa Monica, where he has practiced since 1986. His postgraduate study includes Chiropractic Functional Neurology through the Carrick Institute and advanced training through the International Association of Functional Neurology and Rehabilitation. He is the author of the forthcoming book It’s Like You Never Left, to be published by Indigo River Publishing.
Educational purposes only. This article does not diagnose any condition and is not a substitute for medical care. Seek urgent medical assessment for new severe dizziness or vertigo accompanied by difficulty speaking, new facial or limb weakness or numbness, double vision, severe difficulty walking, loss of consciousness, or a sudden severe headache. Individual results vary and no particular outcome is promised.
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