Tinnitus and dizziness can occur together, but is there a connection between the two? Whereas tinnitus is defined as sound or noise that is perceived inside the head, dizziness is a broad term that can be used to describe a variety of complaints such the sensation that the room is spinning, feeling off-balance or unsteady, or light-headedness.
There are many reasons why someone with tinnitus may also experience dizziness. Here are important considerations regarding whether your tinnitus and dizziness may be related, and how to take action to get a diagnosis to improve your quality of life.
Types of Dizziness
"Dizziness" is a general term that may be used to describe different types of balance problems. There are actually more specific terms that can be used to describe different types of dizziness:
- Vertigo makes the person feel as though their surroundings or the room is spinning.
- Imbalance makes the person feel unsteady, "off-balance," or like they may fall toward one side more than others.
- Light-headedness refers to the feeling of floating or a disconnect between the head and the rest of the body.
Symptoms of Dizziness
People who experience forms of dizziness may notice these symptoms:
- Tripping or falling
- Feeling unsteady on unstable while walking or moving
- Feeling your surroundings or room spin
- Veering toward one side while intending to walk in a straight line
- Bumping into things such as furniture or counter tops
Causes of Dizziness
Some causes are referred to as otologic, e.g. a problem affecting the ear or vestibular organs, such as a weakness in the vestibular system.
Other causes are Non-otologic, e.g. not relating to the ear or vestibular system, such as a foot, ankle, or leg problem that affects balance.
Sometimes dizziness can be due to mix of both otologic and non-otologic causes, such as a person who has a numbness in one foot and also a vestibular weakness.
It's also possible for certain medications and substances to cause vertigo. Sometimes vertigo is permanent and sometimes it subsides when the medication is safely discontinued under the guidance of a physician. Some medications suppress the ability of the vestibular system to maintain balance, such as:
- Meclizine (which may be prescribed in order to suppress dizziness)
- Decongestants such as Pseudoephedrine or Sudafed
- Allery medications
- Certain intravenous antibiotics
- Certain chemotherapy drugs
- Alcohol
- Others
Read more about what causes tinnitus.
Tinnitus And Vertigo
It's important to consult a medical professional for proper evaluation and diagnosis if you have both tinnitus and vertigo. A few disorders that cause both tinnitus and vertigo include but are not limited to:
- Meniere's Disease - Usually patients report experiencing episodes of reduced hearing, increased tinnitus and dizziness, as well as a feeling of fullness in the ears. Of note, tinnitus tends to be "roaring" when it occurs due to Meniere's Disease.
- Acoustic Neuroma
- Otosclerosis
- Usher Syndrome
- Labyrinthitis
- Certain medications can affect both the inner ear and balance organs
- There are a number of rare conditions that are much less likely to be the cause
- Having two conditions that independently cause tinnitus and vertigo
Having both tinnitus and vertigo may make you feel anxious or depressed, and you may limit social interactions due to fear of exacerbating symptoms. It's important to find professional tinnitus help in order to optimise odds for success in treating both tinnitus and vertigo.
When to Consult a Professional
Tinnitus and dizziness can significantly interfere with living a safe and productive life, and it's important to be determine the diagnosis in order to treat an underlying problem. Here are some cues that it might be time to consult a professional such as a general practitioner, otolaryngologist (ear, nose, and throat surgeon), or audiologist:
- If tinnitus and dizziness are persistent
- If you have fallen or fear that you might fall
- If dizziness interferes with activities of daily living or working
- If the tinnitus and dizziness co-inside, it could be a cue that the two conditions may be related to a unifying diagnosis
Evaluating Tinnitus and Dizziness
Evaluation is the first step in determining if the tinnitus and dizziness are related. A case history will help guide the clinician in determining how to investigate the tinnitus and dizziness.
Evaluating Tinnitus
Tinnitus may be diagnosed based on the patient's subjective report but there are also pitch and loudness-matching tests that can be done to quantify tinnitus characteristics. Additionally, questionnaires such as the Tinnitus Functional Index (TFI) may help quantify tinnitus symptoms and their impact on quality of life. More specialised testing such as Magnetic Resonance Imaging (MRI) may be recommended for some people with tinnitus.
Evaluating Dizziness
Diagnosing dizziness usually entails a case history and potentially some of the following common balance tests. Of note, not everyone who has tinnitus and dizziness needs all of the following tests:
"Bedside" testing such as the Head Shake Test, Dix-Hallpike Test, Romberg Test, Fukuda Step Test, and Halmagyi Head Thrust Test may be done in the office or exam room.
Videonystagmography / Electronystagmography uses special goggles called Frenzel lenses or electrodes placed on the skin to track eye movement.
Caloric Irrigation entails placing air or water into the ear canals to test for a weakness of one or both sides of the vestibular system.
Rotary Chair Testing evaluates the Vestibular Ocular Reflex (VOR), a reflex that keeps vision clear and stable during head movement.
Vestibular Evoked Myogenic Potential (VEMP) tests the inferior vestibular nerve and saccular and utricular pathways.
Computerized Dynamic Posturography evaluates the vestibular, visual, and somatosensory abilities to maintain balance among different conditions (e.g. with and without vision).
Treatment for Tinnitus With Dizziness
The goal of any treatment is to reduce or eliminate symptoms. The good news is that with proper diagnosis and treatment, an improved quality of life is possible.
The particular treatment that is recommended for tinnitus and dizziness will depend on the diagnosis. Common treatments may include:
- Vestibular rehabilitation
- Lifestyle modifications and avoiding triggers
- Medication where indicated
- Surgery when necessary
Cognitive Behavioral Therapy for Tinnitus can be a helpful tool in reframing thoughts and emotions about tinnitus and improve your quality of life. It may also be useful for improving your ability to cope with dizziness symptoms.
Check out Oto's Complete Guide to Tinnitus Treatments as well as 7 Positive Lifestyle Tips That Will Help Relieve Tinnitus.
Join Oto
In addition to resources for reducing tinnitus intrusion, the Oto app offers techniques for physical wellbeing such as neck and shoulder stretches, neck and shoulder release, jaw release, arm swing, and gentle neck rotation.
Check out Oto's Tinnitus Support Group, a supportive community for individuals with tinnitus or related conditions to receive regular tips and tricks from the expert team at Oto!
References
2. Curthoys and Halmagyi Head Impulse test: An analytical device.
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