Starts visit one
Pain
Settle the spinning.
Testing tells us where the signal is coming from. If it is BPPV, repositioning treatment starts here, and for many people the spinning settles fast.
What We Treat
The room tilts when you roll over in bed. You start planning your whole day around not turning your head. A lot of dizziness is treatable, and it starts with finding out which kind you have.
Sound Familiar?
Two or more? Keep reading.
Why It Happens
Your balance runs on three inputs: your inner ear, your eyes, and the sensation coming up from your feet and joints. Dizziness is what happens when those three stop agreeing. The most common reason for that disagreement has a name. BPPV, which is loose crystals sitting in the wrong part of your inner ear, sending a spin signal every time you move your head.
BPPV matters because it is fixable. A repositioning treatment moves those crystals back, and for a lot of people the spinning settles quickly. Not every kind of dizziness is BPPV, though. Blood pressure, medication, migraine, your neck, and an old concussion can all do it. Some causes are cardiac or neurological and belong with a physician, and a cause-first evaluation is how you find out which one you are dealing with. You have spent years driving other people to their appointments. Nobody has looked at yours yet.
The Honest Truth
Nobody regrets starting too early. Plenty of people regret waiting.
How We Fix It
Every plan has an endpoint. Here’s what the four phases look like for dizziness and vertigo.
Starts visit one
Pain
Testing tells us where the signal is coming from. If it is BPPV, repositioning treatment starts here, and for many people the spinning settles fast.
Once the spinning settles
Prime
Gaze and head movement drills teach your brain to trust your inner ear again, at a dose you can tolerate.
Once your gaze steadies
Perform
Busy aisles, quick turns, uneven ground, the back seat of a car. We add back the situations you have been avoiding.
Before we sign off
Prevent
BPPV can come back, so you leave knowing what to do if it does. Plus the balance work that keeps a stumble from turning into a fall.
I have had balance problems for years due to inner ear surgeries. I staggered and felt unbalanced when I walked, even with a cane.
Shared by Kate-Cliff B. · Balance and vertigo after inner ear surgery
Before: unbalanced and staggering when she walked, even with a cane
Now: improving, and looking forward to the sessions
Questions, Answered
Usually not, and a scan is rarely the thing that answers this one. Most dizziness is diagnosed by watching your eyes and your balance respond to specific movements, which is a hands-on test, not a picture. That evaluation also tells us when your dizziness is not ours to treat. New or severe symptoms with chest pain, fainting, sudden weakness or slurred speech need a physician, and that is a 911 call, not an appointment. If imaging or a specialist is the right next step, we say so and help you get there.
Some of it does stir up symptoms on purpose, and that is worth knowing before you come. Your balance system only recalibrates when it gets asked to work, so a little provoked dizziness is part of the retraining. The dose is the whole skill. A licensed physical therapist directs your care at every visit, so somebody is watching your response and adjusting it in real time. Nothing gets sprung on you.
You get an estimated number of visits at your evaluation, and a reason for the number. Your plan runs through all four phases, Pain, Prime, Perform, and Prevent, and you will always know which one you are in and what is left. BPPV often takes less than people expect. Dizziness with a long history usually takes more. Either way it is a plan with an endpoint, not an open tab of appointments.
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You don’t need to know which clinic or which service is right before you reach out. Start a request, or call the clinic closest to you, and we’ll help you sort out the rest.
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