The Lowdown on Vertigo (And What PT Can Do About It)

Most people know that physical therapists treat pain and injuries—improving movement and strength. But did you know we also work wonders with balance and dizziness?

One of our clients had a sudden onset of vertigo on Christmas Eve. She was standing in the kitchen when the room began spinning. She had to lie down and couldn't get up without waves of dizziness and nausea. We got her in and calmed down most of her symptoms in the very first session. This is what we do.

Why Balance and Dizziness Are a Big Deal

Dizziness is one of the top reasons for medical visits in the US, affecting 15–20% of the population annually. About 40% of people will experience some form of vertigo during their lifetime. Beyond the misery of the symptoms themselves, dizziness is a leading contributor to falls—which can trigger a cascade of further injuries.

The Three Systems That Control Balance

Visual

Stand on one foot and notice how you balance—then try it with your eyes closed. Significantly harder, right? Our brains rely on visual input to detect subtle tilts and make micro-corrections to keep us upright. Lose that input, and balance becomes much more demanding.

Vestibular

When vision is unavailable, the vestibular system takes over. Deep in the inner ear lies a complex of bony canals that act like a gyroscope—sending signals to the brain about how your head is oriented in space. When this system malfunctions, simple head movements can trigger intense spinning, nausea, and loss of balance.

Medications can temporarily dull the neurological response, but we need those responses to function in the real world. Some people manage symptoms for months or years by limiting activity—which is not a solution.

Proprioceptive

Once vestibular dysfunction is addressed, we shift focus to proprioception—the network of sensors in every joint of your body (especially your feet, ankles, and hips) that help your brain orchestrate balance responses. The better these sensors function, the better your balance.

How We Treat It

The first step is always a thorough examination. We take a detailed history and run clinical tests to determine which system is involved.

If the onset was sudden and clinical tests show distinct responses, there's a good chance we can resolve the issue quickly with specific physical techniques that reset the crystals in the inner ear. Yes, this sounds unusual—but it's well-documented in the research and works remarkably well.

It's also worth noting that a more vague "foggy" or "fuzzy" dizziness is often rooted in dysfunction of the upper cervical spine. This presentation frequently goes unaddressed in traditional medicine. We've had great success identifying and treating these chronic dizziness patterns that have lingered for years.

Once vestibular function is restored, we build on it with progressive balance training—progressing from static to dynamic, stable to unstable, slow to fast. This becomes increasingly important as we age and stay active.