Sorting out dizziness and balance trouble after a car crash
A neurologist and a vestibular physical therapist on tracking down the cause
People use the word “dizzy” for very different feelings. The room may spin. You may feel faint when you stand up, or walking may feel shaky. Each of these can point to a different problem. After a crash, the cause could involve the head, inner ear, neck, vision or medicines. Start by describing exactly what happens instead of assuming it’s anxiety or a concussion. [1, 2]
Pin down when and how it happens
Tell your doctor when the feeling started. Say whether it’s there all the time or comes in spells. Does a short spin hit when you roll over in bed? Do you feel lightheaded when you stand? Does a crowded store leave you unsteady? [1, 2]
Mention any hearing changes, ringing, headache, nausea or neck pain. Note double vision or a recent change in your medicines too. Share the timing and what sets it off. A severity number by itself won’t tell the full story. [1, 2]
Brief spinning when you change position has one treatable cause, called benign paroxysmal positional vertigo. It can follow a head injury. Still, not every dizzy spell comes from this condition. A doctor needs to test for it and look at other causes too. [1]
Stay safe until you know the cause
Sit down as soon as the feeling starts. On stairs, hold a rail or have someone help you. Keep floors and paths clear. Don’t drive, climb ladders or work up high while you’re dizzy or your vision isn’t reliable. Ask whether a new pain or sleep medicine could be adding to the problem. If you also have a neck injury or other limits, get advice before trying a head movement treatment you find online. [1, 2]
What a focused exam can check
Your doctor may check your blood pressure as you change position. They may also test your eye movements, walking, hearing and nervous system. If a concussion is possible, mention headaches, changes in thinking, light sensitivity or poor sleep. Treatment depends on the cause. Some balance problems improve with specific repositioning moves or vestibular rehab, which retrains the balance system. Others need different medical care. [1, 2, 3]
Ask what the exam confirmed and what it hasn’t ruled out yet. Find out whether you need a hearing test, a vision check or a rehab evaluation. If the first treatment doesn’t help, tell your doctor. A repositioning move works for one specific diagnosis. It won’t cure every type of dizziness. [1]
- What is most likely causing this pattern?
- What should I avoid doing until we know more?
- If nothing changes, when should I come back?
Signs that call for emergency care
Get emergency care for a headache that keeps getting worse after a head injury. The same goes for repeated vomiting, seizures, weakness or numbness. Slurred speech, confusion and trouble waking up are emergencies too. New double vision after a possible concussion also needs urgent attention. Don’t drive yourself if any of these signs show up. [2, 3]
Milder symptoms can still matter. If dizziness keeps you from walking safely, working or leaving the house, set up a checkup. Don’t wait for it to fade on its own. [1, 3]
Dizziness can also leave people afraid of another fall or crash. Tell your doctor if you’ve started avoiding things you need to do. A plan can treat the physical cause while helping you ease back into daily tasks safely. Your symptom is still real when you need both kinds of support. [1]
Keep a two day dizziness log
For two days, write down what set off each spell, how long it lasted and what helped. Bring those notes and your medicine list to your appointment. They give your doctor a better place to start than the word “dizzy” alone. [1]
Sources and further reading
- 1NIDCD balance disorders
- 2CDC concussion symptoms and danger signs
- 3CDC concussion response and recovery
These are general tips for U.S. readers from the fields of neurology and vestibular rehab. Dizziness has more than one possible cause. A doctor’s exam is needed to pick the right treatment.
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