What Causes Dizziness? A Physiotherapist's Guide to Finding Answers
Dizziness is one of the most common reasons people seek medical attention — yet it remains one of the most misunderstood symptoms in healthcare. If you've ever wondered what causes dizziness, you're far from alone. The answer isn't always straightforward, because "dizziness" is actually an umbrella term that can describe several distinct sensations, each pointing toward different underlying causes. Understanding these differences is exactly where vestibular physiotherapy excels.
At Burlington Vestibular Therapy, our team works with patients from Burlington, Oakville, Hamilton, Milton, and Waterdown who are searching for answers about their dizziness — and, importantly, a clear path toward recovery.
Dizziness Isn't One Thing
Before exploring causes, it's worth clarifying what dizziness actually means clinically. Patients use the word to describe very different experiences:
- Vertigo — a sensation that you or your surroundings are spinning or moving
- Lightheadedness — a feeling of faintness or being "disconnected"
- Disequilibrium — a sense of unsteadiness or imbalance, particularly when walking
- Spatial disorientation — difficulty knowing where your body is in space
If you'd like a deeper look at how these sensations differ, our dizziness vs vertigo guide breaks this down in plain language. Understanding which type of dizziness you're experiencing is one of the first steps in our assessment process, because the sensation itself often points toward the underlying cause.
Common Causes of Dizziness: A Vestibular Perspective
Benign Paroxysmal Positional Vertigo (BPPV)
BPPV is among the most frequently encountered causes of dizziness seen in vestibular physiotherapy. It occurs when tiny calcium carbonate crystals in the inner ear — called otoconia — become dislodged and migrate into the fluid-filled canals, where they don't belong. The result is brief but often intense spinning triggered by specific head positions, such as rolling over in bed, looking up, or bending forward.
Many patients find that BPPV responds well to canalith repositioning procedures — a series of guided head movements designed to return those crystals to their proper location. You can learn more about one of the most well-known of these procedures in our Epley Manoeuvre guide, or visit our BPPV condition page for a comprehensive overview.
Vestibular Neuritis and Inner Ear Conditions
Vestibular neuritis involves inflammation of the vestibular nerve — typically following a viral illness — and may cause prolonged, intense dizziness and balance disturbance. Although the acute phase often resolves on its own, many patients are left with lingering imbalance and sensitivity to movement that benefits significantly from vestibular rehabilitation.
Other inner ear conditions, such as Ménière's Disease, involve fluid pressure changes that cause episodic vertigo, hearing changes, and ear fullness. These conditions require specialised management strategies that a vestibular physiotherapist can help coordinate alongside your medical team.
Cervicogenic Dizziness
One of the most underrecognised causes of dizziness is dysfunction originating from the neck. Cervicogenic dizziness may arise from tight muscles, joint restriction, or impaired proprioception — the body's sense of its own position in space. Patients often describe a vague unsteadiness or fogginess associated with neck movement or prolonged postures, such as working at a desk.
This is an area where physiotherapy is particularly well-suited to help. Our team can assess whether your neck is contributing to your symptoms and incorporate cervical mobility work, strengthening, and postural correction into your treatment plan.
Post-Concussion Dizziness
Dizziness following a head injury is common and can involve disruption to the vestibular system, visual processing, and the pathways between them. If you've experienced a concussion and continue to notice dizziness or balance difficulties, post-concussion dizziness deserves specific attention from a vestibular physiotherapist trained in this area.
Visual and Sensory Overload
Some patients experience dizziness primarily in visually complex environments — busy grocery stores, scrolling on screens, or moving traffic. This is sometimes referred to as visual vertigo and reflects a mismatch between what the eyes, inner ear, and body are communicating to the brain. Gaze stabilisation exercises — outlined in our gaze stabilisation guide — may help the brain recalibrate these signals over time.
Balance Disorders and Fall Risk
For older adults or those with neurological conditions, dizziness and balance difficulties often involve overlapping causes. Impaired sensation in the feet, reduced muscle strength, and vestibular dysfunction can all combine to increase fall risk. Our team offers a dedicated balance and fall prevention programme for patients in Burlington and the surrounding area.
Non-Vestibular Causes Worth Knowing
Not all dizziness originates from the vestibular system. Cardiovascular causes — such as a drop in blood pressure upon standing (orthostatic hypotension) — can produce lightheadedness that is easily confused with inner ear issues. Dehydration, certain medications, and metabolic changes may also contribute. While vestibular physiotherapy cannot address these causes directly, our thorough intake process helps identify when referral to another healthcare provider is appropriate.
When Dizziness Requires Urgent Medical Attention
Some symptoms alongside dizziness warrant immediate medical evaluation and should not be attributed to a vestibular condition without proper investigation. Seek emergency care if your dizziness is accompanied by:
- Facial drooping, slurred speech, or sudden weakness
- Severe, unusual headache
- Chest pain or shortness of breath
- Double vision or loss of consciousness
These may indicate a central neurological event that requires urgent assessment.
What Happens at a Vestibular Physiotherapy Assessment?
Our team uses a systematic approach to determine what causes dizziness in each individual patient — because no two presentations are the same. A thorough history explores the quality, timing, triggers, and duration of your symptoms. Clinical tests such as the Dix-Hallpike manoeuvre, head impulse test, and visual tracking assessments help differentiate between vestibular and non-vestibular origins.
From there, a personalised treatment plan may include canalith repositioning, habituation exercises, gaze stabilisation training, balance retraining, or cervical work — often in combination. Patient education is also a core part of our approach; understanding what's happening in your body can meaningfully reduce the anxiety that often accompanies persistent dizziness.
No referral is needed to see our team — you can access vestibular physiotherapy directly and begin finding answers sooner. If you'd like to understand more about what to expect, our first visit guide walks you through the process.
Practical Tips While You Wait for Your Appointment
- Keep a symptom diary. Record when dizziness occurs, what you were doing, how long it lasted, and what (if anything) helped. This information helps your physiotherapist identify patterns quickly.
- Move slowly and deliberately. Avoid rapid position changes — when rising from lying or sitting, take a moment before moving on. Many patients find this reduces lightheadedness considerably.
- Avoid relying on internet self-diagnosis. While educating yourself is valuable, online searches may inadvertently increase anxiety. A professional assessment provides clarity that symptom-matching online simply cannot.
Ready to Find Answers?
Dizziness can be disruptive, disorienting, and — understandably — worrying. But many causes are treatable, and evidence-based vestibular rehabilitation may help you regain your confidence, stability, and quality of life.
Our team at Burlington Vestibular Therapy is here to help patients throughout Burlington, Ontario and the surrounding communities get a clear picture of what's driving their symptoms — and a practical plan for moving forward.
Book your assessment today and take the first step toward understanding what causes your dizziness.
Educational Disclaimer: This blog post is intended for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. Individual symptoms vary and the information provided here may not apply to your specific situation. Always consult a qualified healthcare professional for an assessment tailored to your needs. If you are experiencing sudden or severe symptoms, seek immediate medical attention.
Reviewed by: Stephanie, Vestibular Physiotherapist
