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Dizziness and Vertigo:
Dizziness and vertigo can make even simple daily activities feel overwhelming. From BPPV and vestibular migraines to post-concussion dizziness, understanding the cause is the first step toward effective treatment. Learn when to seek help, what symptoms to watch for, and how physiotherapy can help you regain your balance.
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A spinning room, a sudden sway, a feeling that the floor isn’t quite where it should be. Dizziness and vertigo are some of the most disorienting symptoms a person can experience, and they’re far more common than most people realise. As PEAK notes on our Vertigo Treatment page, more than a third of Australians over 50 report having experienced vertigo, and the likelihood only increases with age.
The good news is that the most common causes of vertigo are also among the most treatable, often resolving in a single session with the right technique. Here’s what’s behind dizziness and vertigo, what we look for in clinic, and when it’s a sign to seek help quickly. (At PEAK, we call all our patients Athletes, not because of fitness level but because of mindset: our job is to help you reach your goal, whatever that is.)
Vertigo is a specific kind of dizziness: a false sensation of spinning or movement, even when you’re standing still. It’s typically split into two broad categories:
This is exactly why Running Gait Analysis is one of the first steps we take with patients who are injury-prone or building up their kilometres: a 60-minute assessment combining video gait capture, footwear review, and strength and mobility testing across the three phases of your running stride: initial contact, midstance, and propulsion.
Benign Paroxysmal Positional Vertigo (BPPV). The most common cause of vertigo by a wide margin, accounting for more than half of all peripheral vertigo cases. BPPV occurs when tiny calcium crystals in the inner ear become dislodged and disrupt normal balance signals, typically triggered by specific head movements like rolling over in bed or looking up.
Vestibular neuritis and labyrinthitis. Inflammation of the inner ear or vestibular nerve, often following a viral illness, causing more sustained dizziness than BPPV.
Meniere’s disease. A condition involving fluid build-up in the inner ear, often bringing episodes of vertigo alongside hearing changes and tinnitus.
Vestibular migraine. Migraine-related dizziness that can occur with or without a headache, and is more common than many people realise.
Persistent Postural-Perceptual Dizziness (PPPD). A chronic dizziness pattern that often develops after an initial vertigo episode, even once the original trigger has resolved.
Head injury and post-concussion syndrome. Dizziness is one of the most common lingering symptoms after a concussion.
Most vertigo is benign, but some presentations need urgent medical attention rather than a routine booking. Seek emergency care if dizziness is accompanied by:
These can be signs of a stroke or other serious neurological event, and time matters. If your dizziness is isolated, comes on with specific head movements, and isn’t accompanied by any of the above, it’s far more likely to be a benign vestibular issue that responds well to treatment.
For BPPV specifically, our Physiotherapy team commonly uses the Epley manoeuvre: a guided sequence of head and body positions that moves the dislodged inner ear crystals back to where they belong. Many patients feel significant relief after just one or two sessions.
For other vestibular conditions, our physiotherapists use vestibular rehabilitation: specific exercises that retrain the brain’s ability to process balance signals and compensate for inner ear dysfunction, particularly useful for vestibular neuritis, post-concussion dizziness, and PPPD.
BPPV in particular has a tendency to recur, especially in older patients or those with a history of head trauma or other inner ear conditions. If vertigo has come back before, it’s worth having a plan in place: knowing the early signs, having strategies for managing an episode, and getting back in for treatment quickly rather than waiting it out. That’s the pain, prevention, and performance approach in practice: treat the episode, put prevention strategies in place, then get back to performing without the fear of it returning.
It depends on the cause. BPPV episodes are often brief but can recur until properly treated, while conditions like vestibular neuritis can cause dizziness lasting days to weeks.
Stress doesn’t typically cause vertigo on its own, but it can worsen symptoms in existing vestibular conditions, particularly vestibular migraine and PPPD.
Some underlying causes, like Meniere’s disease and vestibular migraine, can have a genetic component, though BPPV (the most common cause) is generally linked to age and head trauma rather than heredity.
Dizziness is a broad term for feeling unsteady, light-headed, or off-balance. Vertigo is more specific: a false sensation of spinning or movement.
If you’re experiencing active vertigo symptoms, it’s safest to avoid driving until you’ve been assessed and the episode has settled.
If dizziness or vertigo has been affecting your day-to-day, it’s worth getting properly assessed rather than waiting it out. Book an appointment with our Hawthorne or New Farm team, or give us a call:
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