What is Chronic Subjective Dizziness (CSD)? Ask a Singapore Chiropractor

The term chronic subjective dizziness refers to a unique type of persistent dizziness that is not easily categorised into other types of chronic dizziness.

The dizziness in CSD is called “subjective imbalance” as the person experiencing imbalance does not appear dizzy or off-balance to an observer. Moreover, physical examinations for chronic subjective dizziness typically comes back normal.

So, what exactly is this unique type of chronic dizziness?

Join Vitality as we explore this surprisingly common condition and how to possibly alleviate symptoms!

Common symptoms of Chronic Subjective Dizziness (CSD)

Although definitive diagnostic criteria for CSD are still being developed, the following are typical CSD symptoms:

  • A persistent dizziness that may vary in intensity, but is always felt

  • You feel dizzy for most days over a minimum of 3 months

  • Disequilibrium is most severe when standing or walking, but is completely absent or only mildly present when laying down

  • Symptoms are exacerbated by exposure complex visual stimuli or performing precision visual tasks

Causes of chronic subjective dizziness

The exact causes of CSD are still being worked out. However, the general theory is that CSD is caused by the brain’s inability to fix itself after damage to the vestibular system.

The vestibulocochlear nerve goes from the inner ears to the vestibular nuclei in the brainstem. Together with other parts of the brain, these nuclei combine information about posture and movement with information from other senses, such as vision.

When the vestibular system says something, like “we’re moving,” and the other systems say “no, we’re not,” dizziness is a common result.

Most of the time, the inner ears balance each other out. For example, when you turn your head to the right, one vestibulocochlear nerve is more active than the other. The brain interprets this difference in signal strength as a head turn.

So what happens if something, like inner ear disorders, makes the signal from one ear weaker? Even if the person is standing still, the vestibular nuclei tells the rest of the brain that the head is turning.

Brains are usually very flexible and can learn to change when neural signals change. When the vestibular nerve is damaged, the imbalanced electrical signals are eventually accepted as the new normal, and life goes on.

In CSD, the brain doesn’t adjust to a new normal.

Even if the original transient medical condition has healed, the brain is still very sensitive to anything that has to do with movement or balance.

Additionally, there is strong evidence that the common symptoms associated with CSD are influenced by anxiety disorders and other psychiatric disorders.

However, rather than being classified as a structural or psychological problem, CSD is categorised as a chronic functional vestibular disorder.

When to seek medical treatment

Immediately seek medical attention if you experience any severe or prolonged unexplained dizziness accompanied by:

  • Sudden, severe headache

  • Chest pain

  • Difficulty breathing

  • Numbness or paralysis of arms or legs

  • Fainting

  • Double vision

  • Rapid or irregular heartbeat

  • Confusion or slurred speech

  • Stumbling or difficulty walking

  • Ongoing vomiting

  • Seizures

  • A sudden change in hearing

  • Facial numbness or weakness

How do I get diagnosed with chronic subjective dizziness?

Diagnosing CSD can be hard because there isn’t a single test for it.

Instead, doctors use a series of tests to rule out other causes of chronic dizziness, such as benign paroxysmal positional vertigo, vestibular neuritis, low blood sugar or low blood pressure.

If all of the elimination tests come back normal and the symptoms match, CSD could be the cause.

Solve your chronic dizziness with Vitality Chiropractic Centres!

Take your health back into your hands by booking an appointment with Vitality!

As the first specialised Upper Cervical Chiropractic Care provider in Singapore, our professional Chiropractors are experienced in alleviating symptoms of dizziness related to the balance centres.

Whether your chronic dizziness is classified as CSD or is caused by other conditions, we are the best choice to help you take back your life.

At our centre, we perform unique nerve tests and are the first in Singapore to use this technique for the upper neck.

We take a holistic approach to our patients. Beyond alleviating your symptoms, our patient-centric approach takes you through active recovery to bring your life and spinal health back to functional wellness!

Under our careful treatment by our specialists in vertigo, Chiropractic patients experience less dizziness and are able to return to normal activities quicker!

Your health goals are ours too. We take your investment in your health seriously, providing you with the utmost care to restore vitality back into your life.

Written by

Shaan Rai (Chiropractic, Singapore)

Shaan (UK) is based in Singapore. He is a GCC registered Singapore Chiropractor, completing a 5 year course at AECC, attaining his Masters in Chiropractic. His career has been specialised in neurological cases, such as migraines and vertigo. He is the Chairman for Outreach and Charity for Alliance of Chiropractic (AoC) and is a founder of Vitality Chiropractic Singapore and the NeuroPro method, combining Upper Cervical techniques with Functional Neurology Rehab.

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