Dizziness (Physiotherapy for Dizziness and Vertigo)

Dizziness can manifest in various ways. Part of our process is helping you describe and pinpoint the type of dizziness you have, as this gives clues to the cause. Common descriptions include:

• Vertigo: A false sensation of movement – either you feel like you are spinning/tilting or the environment around you is moving. This often points to an inner ear (vestibular) issue. For example, BPPV causes intense brief vertigo when you change head positions , while vestibular neuritis causes sustained vertigo with any movement in the acute stage. If you report true spinning vertigo, our physios will focus on vestibular tests.
• Lightheadedness: Feeling faint or like you might black out, similar to what you experience if you stand up too quickly. This can be due to blood pressure drops (orthostatic hypotension), dehydration, or circulatory issues. We might check your blood pressure in different positions and ask about medication or recent illness. If this seems to be the cause, we coordinate care with your GP, as physiotherapy might play a secondary role (like conditioning exercises) while medical management addresses the primary issue.
• Disequilibrium: A sense of imbalance or wobbliness without vertigo. You might say “I just feel off-balance” or like you’re walking on foam. This can occur with vestibular disorders, neuropathy in the feet, or even anxiety. We would do a balance assessment and vestibular screen to narrow it down.
• Floating or dissociated feeling: Some people, especially with anxiety-related dizziness or PPPD, describe it as a floating, rocking, or “inside of head” dizziness rather than external motion . We take this seriously as well; it often requires a combined approach of vestibular rehab and cognitive strategies.
• Visual vertigo: Feeling dizzy or disoriented in certain visual environments – like in a busy supermarket, scrolling on a computer, or driving past rows of trees (the flicker effect). This can happen with vestibular dysfunction (your brain is relying too much on visual cues) or PPPD. We have specific tests for this, like asking you to watch a moving pattern and seeing if it provokes symptoms.

By listening carefully to your symptoms, we can categorize your dizziness and design an exam plan. Often, people have multiple sensations (e.g., a mix of vertigo and lightheadedness), and we methodically rule in/out causes.

Anyone who’s experienced persistent dizziness knows how debilitating it can be:

• Daily activities become risky or difficult: Simple tasks like showering (closing your eyes with water running can trigger dizziness), cooking (looking up or bending down may set it off), or shopping (walking through aisles) can turn into challenges. You might start avoiding cleaning, driving, or taking walks if those bring on symptoms. This can lead to a less active lifestyle and dependence on others for chores or transport.
• Work impairment: Dizziness can significantly affect work – if you’re feeling unsteady or foggy, it’s hard to concentrate on tasks. For those in physical jobs, it raises safety concerns. Even desk job workers may struggle if screen use provokes dizziness or if they can’t drive to commute. As a result, many people with dizziness reduce hours or take sick leave.
• Social withdrawal: The fear of having a dizzy spell in public can be isolating. We’ve heard patients say they skip social outings, avoid busy environments like malls or cinemas, or even feel uncomfortable at family gatherings because of the noise and movement. Over time, this avoidance can contribute to feelings of loneliness or depression.
• Anxiety and quality of life: It’s very common and natural to develop anxiety around dizziness. You might constantly worry, “When will it hit me next? Will I be somewhere unsafe?” This anticipation anxiety can actually worsen dizziness, creating a vicious cycle. Sleep might suffer (either due to anxiety or if lying flat triggers symptoms), leading to fatigue which further lowers your threshold for dizziness. Overall quality of life can plummet; things that used to bring joy (playing with kids, exercising, travel) may have been sidelined.
• Physical deconditioning: Many vestibular patients drastically reduce movement to avoid symptoms – but this leads to loss of fitness, weaker muscles, and sometimes weight gain or joint stiffness. Unfortunately, being out of shape can exacerbate dizziness because your body isn’t as efficient. It’s a catch-22: you need to move to get better, but moving makes you dizzy. That’s where guided physiotherapy comes in – to break that loop in a safe way.

The toll of dizziness isn’t just physical; it’s emotional and psychological. Recognizing this, our clinic’s approach is as much about compassionate support and education as it is about exercises and treatments.

When you come to Peak Sports and Spine Centre with dizziness, you’re coming to a one-stop shop for comprehensive care. Our approach is systematic and empathetic: we aim to find the root cause and treat it, while giving you tools to manage symptoms and regain your confidence. Here’s what you can expect from our physiotherapy for dizziness service:

• Comprehensive Assessment: We will take a detailed history of your dizziness – when it started, how it feels, what triggers it, and any other related symptoms (headaches, hearing changes, neck pain, etc.). We’ll also review medical history and any tests done so far (like MRI or hearing tests). Then, we perform specific tests:
  • Vestibular tests: such as the Dix-Hallpike maneuver for BPPV, head impulse test for vestibular hypofunction, head shaking test, and observing for nystagmus in various positions . We might use Frenzel goggles to better see subtle eye movements.
  • Balance and gait assessment: can you stand on one foot, how you walk in a straight line, etc. We may do a Romberg test (standing with eyes closed) to see how you manage when visual input is removed.
  • Oculomotor exam: checking if your eyes can track targets smoothly or if certain eye movements provoke dizziness (for central causes vs. peripheral).
  • Neck assessment: Sometimes a stiff or dysfunctional cervical spine (neck) can contribute to dizziness (a condition known as cervicogenic dizziness). We’ll feel for tightness, check your neck range of motion, and maybe do positional tests that isolate neck vs. vestibular input.
  • Blood pressure/heart rate: If lightheadedness or faintness is a factor, we might measure orthostatic vitals (lying, sitting, standing) to catch any significant drops.
  • Functional tests: We might simulate a busy environment (have you walk while tossing a ball, or use a busy screensaver) to gauge your tolerance.

By the end of this evaluation, we’ll discuss our findings with you in plain language: e.g., “It looks like your dizziness is coming from an inner ear imbalance, specifically your left ear isn’t functioning as well – we call that vestibular hypofunction” or “Your tests for BPPV were positive, so that’s good news because it’s very treatable,” or “Your vestibular system seems fine; let’s consider if this might be related to neck tension or something like migraines.” We aim to give you a working diagnosis or at least a direction. If we suspect something outside our scope (say signs point to a neurological issue like a migraine or something cardiovascular), we’ll tell you and liaise with your doctor for further investigations, while still offering supportive care for symptom relief.

• Customized Treatment Plan: Based on the assessment, we craft a treatment plan. This could include:
  • Vestibular Rehabilitation: If you have a vestibular disorder (like neuritis, vestibular migraine, PPPD, or post acoustic neuroma, etc.), we’ll use targeted exercises as described in previous sections – gaze stabilization, habituation, balance training . We set achievable goals each week (e.g., improve balance time by X seconds, reduce dizziness score during head turns by X).
  • Canalith Repositioning Maneuvers: If BPPV is the cause, we can often fix it in one or a few sessions using maneuvers like the Epley maneuver . We’ll perform it and then give precautions (like how to sleep that night) and teach you possible self-maneuvers if appropriate.
  • Manual Therapy and Exercise for Neck (if cervicogenic dizziness): We might do gentle joint mobilizations to your cervical spine, soft tissue massage to tight neck muscles, and teach posture correction and neck strengthening exercises. Often, improving neck function decreases dizziness symptoms in cases where neck strain (like after a car accident or long-term poor posture) is a contributor.
  • Balance and Fall Prevention: Regardless of cause, if you’re having imbalance, we incorporate balance retraining. That might mean using parallel bars initially, then moving to free standing, balance boards, etc. Our clinic has various tools like foam pads, Bosu balls, agility ladders – we turn balance training into an engaging routine. This is critical not just to resolve dizziness but to restore your confidence in moving around safely.
  • Gradual exposure to activities: We won’t keep you in the clinic bubble – we’ll gradually simulate or have you practice the things that bother you. If you get dizzy in supermarkets, we might set up a mock aisle or even accompany you on a short walk outside as part of therapy. If scrolling a phone makes you dizzy, part of your exercise might literally be scrolling on a tablet in progressively more challenging positions. This way, you relearn to handle those stimuli.
  • Technology and Advanced Techniques: Our clinic uses advanced tech when beneficial. For example, we may use a computer-based balance trainer or virtual reality scenarios for visual vertigo. For biofeedback, we might use a force plate that gives you real-time info on your sway as you practice steadiness. These tools, combined with our expertise, accelerate progress.
• Education and Self-Management: We believe knowledge is power. We’ll teach you about the vestibular system and why certain exercises help. If your issue is chronic (like PPPD or a partially compensated vestibular loss), we coach you on managing flare-ups: e.g., which exercises to do if you have a bad day, how to breathe through anxiety to prevent a vicious cycle, and the importance of ongoing physical activity. We also discuss lifestyle factors: hydration, sleep, avoiding excessive caffeine or alcohol (which can exacerbate dizziness for some), and maybe diet changes if migraines are a trigger. We encourage questions – when you understand your condition, the fear often reduces, and you become an active participant in your recovery.
• Liaison with Other Healthcare Providers: We work closely with GPs, ENT specialists, and neurologists in Sydney and the greater region. If during our assessment we pick up something needing medical attention (say, a certain pattern of nystagmus that suggests a neurological cause, or hearing loss that hasn’t been evaluated), we will promptly communicate with your doctor and even help expedite referrals. Conversely, many doctors refer patients to us for vestibular rehab after ruling out serious causes. We keep them updated on your progress, which builds a circle of care around you. If needed, we’ll also advise on workplace ergonomics or liaise with occupational therapists, etc. – whatever it takes to help you get better.
• Empathy and Motivation: Dizziness can be invisible to others, but we see its impact on you. Our team is not only technically skilled but also supportive. We celebrate each improvement – perhaps your dizziness intensity went from 8/10 to 4/10 after a week of exercises, or you managed to walk 10 minutes outside for the first time in months. We recognize those wins. On tougher days, we’re here to encourage you and adjust the plan. We set a confident, optimistic tone: dizziness is treatable, you will improve, and we’ll guide you every step. That reassurance itself begins to break the fear-dizziness cycle.

Our goal with dizziness treatment is to not only eliminate or reduce the dizziness but also to address the fallout it has caused in your life. That means by the end of your program, you’re not only feeling steadier – you’re back to doing the things you need and love to do, whether that’s working, exercising, or enjoying a day out with family, without a second thought about dizziness.

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