Learn what steps to expect on your journey toward diagnosis, treatment, management and recovery from dizziness and imbalance.

Pre-diagnosis

• It is important to describe your symptoms to healthcare professionals with as much detail and accuracy as you can. They need this information to help figure out where your problem is coming from.
• Visit a primary care physician to talk about your symptoms and have a physical exam as well as basic tests for dizziness and imbalance. To fully understand your problem, the doctor will ask about your medical and family history.
• If your dizziness or imbalance lingers, further investigation by a specialist or other healthcare professional may be needed to complete a full evaluation. Diagnosis of balance and dizziness disorders can often be challenging. Patience and understanding is needed by both the doctor and patient.

• Wait times to see specialists may be long. In the meantime, some of these ideas may help you prepare for your appointment.
• Based on your history and physical exam, multiple diagnostic tests may be needed. Not all disorders can be identified by these tests.  They are done to pinpoint the exact site of your problem as well as rule out serious or life-threatening diseases.

Diagnosis

When you and your healthcare team know, or have a better idea, how and why your symptoms came to be (diagnosis), a treatment and management plan can be made. At this point, healthcare professionals will be in a better position to discuss what you might expect in terms of results (prognosis). Treatment and management will depend on whether you have a:

• vestibular (balance system) disorder
• condition not related to the balance system
• imbalance without dizziness

You may have more than one condition at the same time - this is an added challenge for diagnosis, treatment and management.

Treatment and management

Once you have a diagnosis, you and your healthcare team will need to decide what treatment and management approach is best for you. This is a matter of weighing the pros and cons of each choice. Factors include your hearing, age, general health, and the severity of the problem.

Stick with your treatment plan for a set amount of time. Six weeks is a reasonable time frame. Try your very best to follow the plan and stay positive. It can be helpful to keep a health diary to track how things go. At the end of your "trial" with the plan, reassess your symptoms and goals. You may find you were on the right track, or you may need to work with your healthcare team for reassessment.

Vestibular rehabilitation is a type of exercise therapy that will benefit most people with a balance or dizziness disorder. Its goal is to help your brain relearn how to balance and how to respond to signals from the balance and visual systems. If you are unable to access a vestibular therapist, home-based exercises or our Gaining Balance video may help.

Building your own wellness toolkit may help you make healthy lifestyle changes. As well as being good for your overall health, these changes are often the least expensive treatment for dizziness and imbalance.

Depending on your condition, some of the following may help:

• Medication may control symptoms for some people, even though there are none that can cure vestibular disorders. Your doctor needs to advise on the suitability of particular medications for your situation.
• Cognitive behavioural therapy (CBT) may provide relief if you are anxious about your condition. Anxiety is a common symptom of dizziness and imbalance.
• Treatment devices available in Canada may help people with some balance and dizziness disorders.
• Complementary and alternative treatments (CAM) are a grey area. Very few evidence-based scientific studies have been carried out to see how well they work specifically for people with balance and dizziness disorders. Inform yourself before trying any of these treatments.
• Surgery may be needed to treat some vestibular disorders if all other treatments do not work.

When no treatments are entirely effective, the focus is on learning to adapt and live well with chronic dizziness and imbalance.