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How a physio can treat your vertigo, drug free!

Time and time again I hear people audibly surprised when I tell them that certain types of vertigo are very treatable by physiotherapy methods. In this blog I’ll briefly cover the three main types of vertigo and ways your physio can help reduce your symptoms and get you back to normal.


Inner ear dizziness – Benign Paroxysmal Positional Vertigo (BPPV)

BPPV is due to a dysfunction in the inner ear (vestibular system) where tiny crystals build up in the fluid inside your inner ear and disrupt the tiny hairs that communicate to the brain. The normal interaction of the fluid and the hairs helps your brain figure out how fast your head is moving and helps it to control your neck muscles and movement of your eyes in relation to the movement of your head. When the crystals hit the hairs, your brain gets a stack of mixed messages from the system and effectively freaks out.

Physios are perfectly placed to assess and treat these symptoms with a few groovy maneuvers ( [strongly advise to get an assessment before trying something like this by yourself at home] that can have up to a 90% success rate within the first 3 treatments.


Cervicogenic (from the neck) dizziness

Another common cause of dizziness is from the neck. Do you remember how the brain freaked out about weird messages from the inner ear with BPPV? Well now it’s the same thing but from the neck. In the neck, your joints, ligaments and other tissue are all responsible for telling your brain where your head is in relation to your body. The brain then puts this in with its signals from the inner ear and eyes (are you sensing the pattern here?) and spits out the image – right now the image is this very blog on your phone, tablet or computer.

After (most commonly) a neck trauma (think blunt force like a high tackle or punch or a whiplash based injury like a car accident) the damage to the soft tissue in the neck can throw these signals off. Physios can assess this through what’s called Joint Position Error (JPE) which involves firing a laser beam at a target with your eyes closed (watch the video, it’s only slightly less ridiculous than I’ve made it sound


Optic (from the eye) dizziness

The third way I’ve found a lot of dizziness comes about is – you may have guessed – faulty signals coming from the eyes, which when put together with the right signals from the inner ear and neck, goes and sends the brain into a literal spin. The brain does not compute!

There’s a range of optic tests covering tracking, focus and visual fields, along with cranial nerve testing that would need to be completed to give a full picture. Here’s one example of a test for horizontal tracking (


Keep in mind that it may be a combination of 2 or all 3 of these above issues that can drive vertigo to occur. And this is only 3 of the main physical issues I’ve found, other things like dehydration and low blood pressure or postural hypotension can also cause vertigo attacks. 

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