Dizziness and Vertigo in Edmonton: How Vestibular Physiotherapy Works

Dizziness that changes when you move your head is usually a mechanical inner ear problem, and it often responds to a specific repositioning treatment rather than to medication. The most common cause, benign paroxysmal positional vertigo, is identified with positional testing and treated with a manoeuvre that many people respond to within one to three visits.

Dizziness that does not change with head position points elsewhere, and the assessment is built to tell those apart.

The three systems that keep you balanced

Balance depends on the inner ear, vision, and the position sense coming from joints and muscles. When those three inputs agree, you feel steady. When one is disrupted or they conflict, the result is dizziness, spinning, or unsteadiness.

This is why dizziness can arise from the inner ear, the neck, the visual system, blood pressure regulation, or a combination. The assessment works through those possibilities rather than assuming one.

BPPV: the most common and most treatable

In BPPV, small crystals normally embedded in one part of the inner ear become dislodged into a semicircular canal. Head movement then shifts fluid the canal was not designed to have moved, and the brain briefly receives a false signal of rotation.

The pattern is distinctive: intense spinning triggered by specific position changes such as rolling over in bed, lying back, or tipping the head up. Episodes usually last well under a minute and settle until the next trigger.

Diagnosis uses positional testing, most commonly the Dix-Hallpike. Treatment is a repositioning manoeuvre such as the Epley, which guides the crystals back to where they belong.

Other causes an assessment screens for

• Vestibular neuritis. Sudden onset, severe, lasting days, often after a viral illness, then weeks of residual unsteadiness that responds to graded retraining.
• Reduced vestibular function on one side. Difficulty focusing when the head moves, treated with gaze stability retraining.
• Cervicogenic dizziness. Arising from the neck, common after whiplash, needing neck and sensorimotor work rather than repositioning.
• Blood pressure related dizziness. Lightheadedness on standing, which is a different mechanism and sometimes a medication review.

When to seek medical care first

Get prompt medical assessment if dizziness comes with sudden severe headache, double vision, difficulty speaking or swallowing, one-sided weakness or numbness, new hearing loss, or fainting. Rehabilitation is not the first step for those presentations.

What to expect at an assessment

Around an hour. The history carries a lot of weight: duration of each episode, triggers, whether it spins or sways, hearing changes, and what you have stopped doing because of it. Testing then covers eye movement, positional tests, gaze stability, and balance on varied surfaces.

Some tests will briefly reproduce your symptoms, which is how the problem is located. You leave with findings, a plan, and usually a short home programme.

Frequently asked questions

Will it come back?

BPPV can recur, which is why people are usually taught to recognise the pattern early rather than losing weeks to it a second time.

Do the exercises make you feel worse?

Vestibular retraining commonly provokes mild symptoms during and after. The dose is set so they settle within a reasonable window, and adjusted if they do not.

Should I stop driving?

While you are having true vertigo episodes, yes. Return to driving is discussed as part of the plan.

Trust Care Physiotherapy, Edmonton, AB. Call (825) 525-2983 or book at trustcarephysio.ca.