Everyone experiences dizziness at some time. Whether it is from bending over and getting up too quickly or from feeling lightheaded after a long run, dizziness is a common phenomenon. Most of the time, the sensation lasts only a few minutes. For many people, however, it is a chronic problem that can adversely affect their relationships, work, and enjoyment of life.

The National Institutes of Health reports that dizziness is the top complaint of patients over age 70 and is the third most commonly reported complaint to physicians. (The top two medical complaints are headaches and lower back pain.) According to the NIH, 90 million Americans, or 42% of the population, will experience dizziness or vertigo at some time in their lives. The cost of medical care for patients with balance disorders has been estimated to exceed $1 billion a year in America. The odds of having dizziness or balance problems increase with age, but can strike at any age.

According to Dr. Jack Wazen, medical director of the Balance Management Center at Manhattan’s Lenox Hill Hospital, there are three categories of dizziness. One is vertigo. Patients with vertigo feel as if the world is spinning around them. The condition is usually caused by mineral deposits in the inner ear, but “it can also be caused by neurological problems, including migraines,” Dr. Wazen said.

The second category is diseases of “disequilibrium.” According to Dr. Wazen, these people feel off-balance. “They report feeling as if they are going to fall and that their feet are not touching the ground.” Among the causes of disequilibrium are neurological disorders, poor eyesight, and poor circulation in the feet.

The third type of dizziness is not marked by spinning or balance problems. The main symptom is lightheadedness, and the person feels as if he or she is about to faint. This is often caused by low blood pressure, low blood sugar, anemia, and even some medications.

What should you do if you are feeling dizzy? “Since dizziness is a symptom, not a disease, determining the cause is key,” Dr. Wazen said. Dizziness can be the sign of a serious neurological or a cardiovascular problem, but in most cases, it is the sign of an inner-ear problem, known as a vestibular disorder. These patients respond very well to the programs offered at vestibular disorder and balance centers.

Lea Mermelstein coordinates New York University Medical Center’s Balance Disorders Program. The program at NYU is the first and largest of its kind in the tri-state area. It has attracted health professionals from England and as far away as Japan, who come to observe the work of the center’s therapists. The center has 10 treating therapists and sees approximately 40 to 65 patients a day, according to Ms. Mermelstein. Patients need a referral for treatment, which they usually receive from a primary care physician, internist, neurologist, or ear, nose, and throat specialist.

One of the most common conditions treated at the center is Benign paroxysmal positional vertigo, a dizziness believed to be caused by debris that has collected in part of the inner ear. Therapists treat the condition by moving the head into standardized positions to displace any loose material in the canal. “Before these maneuvers were discovered, the standard treatment was surgery,” Ms. Mermelstein said. “This is just as effective and without the complications of surgery.”

At NYU, therapists also address the psychological aspects of dizziness. Dizziness “is a hidden illness,” Ms. Mermelstein said. “It is not visible, such as is the case with a person who is using a walker. Often, people with dizziness are thought to be lazy, in need of attention, or hypochondriacs. So they suffer even more. Dizziness and balance disorders put tremendous strains on relationships, which we help the patient address.”

Patients who visit the Balance Management Center are fully evaluated, beginning with a series of tests using state-of-the-art equipment designed to effectively determine each patient’s specific needs. Once testing is completed, the center’s team reviews the results and an individualized balance-management program is designed to meet the patient’s needs and help relieve his or her symptoms.

When there is a buildup of inner-ear fluid, treatment may involve drugs to reduce the inflammation. Because dizziness can be caused by physical problems, such as low blood sugar, and by some medications, a patient’s diet or medication may be adjusted. Treatments also include maneuvers of the patient’s head and traditional physical-therapy exercises to help patients regain their balance skills. In some cases, surgery is necessary.

In addition to Lenox Hill and NYU, several other hospitals in New York have dizziness or balance centers such as the New York Eye and Ear Infirmary’s Center for Hearing and Balance and Vestibular Rehabilitation Center.

For More Information

Lenox Hill Hospital Balance Management Center, 212-434-2224

New York University Medical Center Balance Disorders Program, 212-263-8466

New York Eye and Ear Infirmary Center for Hearing and Balance, 212-979-4340; Vestibular Center, 212-979-4699

The Web site of the Vestibular Disorders Association, www.vestibular.org, provides useful information about inner-ear balance disorders.