Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
An important part of being your physician is understanding who you are. That also means understanding how valuable your time is. My colleagues and I have developed My Doctor Online so you can e-mail me, check your lab results, make an appointment, access our many online programs or get information about a particular health topic – any time it’s convenient for you.
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Dizziness can occur at any age but is more common in older adults. There are many causes of dizziness. One way to understand causes is to divide your symptoms into two types of dizziness: vertigo and non-vertigo. Treatment options will depend on the cause, so we will ask you to provide a detailed history about your dizziness.
To begin, we will work with you to identify the type of dizziness you are experiencing in order to prescribe the right treatment. There are two types of dizziness:
We will ask you about when the dizziness occurs, the quality of the sensation that you experience, when you experience it, and what makes it better or worse. We will do a physical examination that is focused on the history that you provide.
There are many causes of dizziness and vertigo.
Motion sickness. Motion sickness occurs when the brain receives conflicting information from the eyes, skin pressure receptors, muscle and joint receptors, and inner ears. This can occur when you ride in a boat, airplane, car, or even on an amusement park ride. Nausea and vomiting are common with motion sickness.
Benign positional vertigo. Calcium deposits in the back part of the inner ear, also known as the semicircular canals, cause benign positional vertigo. It usually lasts less than one minute. It starts suddenly and is often first noticed in bed, when waking up from sleep. Any turn of the head brings on violent but brief bursts of a spinning sensation, especially when you tilt your head up or down or when you roll over in bed. In fact, any turn of your head can bring on this type of a spinning sensation. Nausea and vomiting may also occur. There is no hearing loss or severe ringing in the ears associated with this type of vertigo. It may take weeks or months to recover and it may recur.
Labyrinthitis. The labyrinth part of the inner ear helps control your balance and gait. If it gets swollen and inflamed, probably due to a virus, you can be diagnosed with labyrinthitis, also called vestibular neuronitis. The onset is rapid and the symptoms are severe. You will experience a spinning sensation that can last several days. Nausea, vomiting, and loss of balance are common.
Meniere’s disease. This spinning vertigo is caused by excess fluid in the inner ear. An episode can last minutes to hours, although the condition may last for months or years. The vertigo is usually severe. In addition, you may experience nausea, vomiting, and a ringing sound in the ears, typically only on one side. There can also be hearing loss and ear pressure. Symptoms may last months or years and may recur every few days.
Allergic reactions to food or airborne particles. Underlying allergy triggers can cause vertigo.
Other causes of vertigo:
Pre-syncope. Feeling lightheaded, as if you might faint, may occur when there is a sudden drop in blood pressure or blood flow to your brain. This sensation of almost losing consciousness may last seconds to minutes. You might have a feeling of warmth, sweatiness, nausea, or blurred vision, and you may appear pale to others. Pre-syncope usually occurs when you are sitting or standing, not when you are lying down. This has a number of causes. We will check medications that may be lowering your blood pressure, irregular heart rhythms, and other causes.
Disequilibrium. You may have a sense of imbalance when you walk, turn, or stand. Causes include damage to the nerves of the legs, joint problems, ear problems, neck problems, Parkinson’s disease, or vision problems. This is experienced more by the elderly. Falling is a major risk.
Nonspecific causes. The following things can cause lightheadedness, feeling giddy, or dizzy (not a spinning sensation like vertigo):
We recommend treatments based on the cause of your dizziness or vertigo.
Medication and exercise
Medications, such as meclizine, may be helpful if you have motion sickness. You can get a scopolamine patch to place behind your ear if you are going on a cruise.
Meclizine or Dramamine may help with symptoms of benign positional vertigo. The condition may also respond to various exercises or maneuvers that you can do at home or by seeing a physical therapist. These include Cawthorne head exercises or the Epley or Semont maneuver. These exercises move the calcium crystals that are causing the symptoms away from the nerve endings of the inner ear. These maneuvers are about 75 percent successful.
If medication is suspected to cause dizziness, we might stop the medication or prescribe an alternative.
If hyperventilation is diagnosed, you may be advised to get stress reduction training.
If you see a specialist, you may need other treatments based on the cause of the dizziness.
Home remedies for vertigo and lightheadedness
If you have symptoms of dizziness that concern you, please call our Appointment and Advice line, which is available 24 hours a day, 7 days a week.
Our advice nurses can give you immediate advice, and our telephone staff can send me a message or book an appointment with me or one of my colleagues, if I am not available.
Based on your symptoms, medical history, and any tests I may order, I will confirm your diagnosis. We will discuss potential lifestyle changes, therapies, and treatment options that are right for you.
If specialty care is needed, we will facilitate the process of scheduling an appointment with a specialist. If appropriate, I may call while you are in the office so we can all discuss your care together. If we decide you need a specialty appointment after that discussion, we can often schedule it the same day or soon thereafter.
You can connect with me in a variety of ways, depending on the situation and what is most convenient for you at the time. I am available online, by telephone, or in person.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system which allows all of the doctors and clinicians involved in your care to stay current on your health status and to collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments as needed. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures we will schedule an appointment with the radiology department. When the results are ready I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
My specialty colleagues are readily available to assist me if I need additional advice about your condition. In some cases, I may contact them during your visit, so we can discuss your care together. If we decide you need a specialty appointment after that discussion, we can often schedule it the same day or soon thereafter.
As part of our commitment to prevention, additional members of our health care team may contact you to come in for a visit or test. We will contact you if you are overdue for cancer screenings or conditions which may require monitoring.
As your personal physician my goal is to provide high quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available 24/7 so that you can access and manage your care where and when it is most convenient. From my home page you can:
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.