By: Lindsay Wilcox, PT, DPT, OCS; Spooner Coppell Clinic Director

Are you dizzy? Unsteady? Lightheaded? It’s easy to assume these symptoms mean vertigo—but that’s not always the case. True vertigo feels like you yourself are spinning, or the world around you is spinning, and you can’t make it stop. It is easy to get confused, so it is important to see a provider who knows the differences so you can be helped and diagnosed properly.

Vertigo can absolutely be treated, and although not every case is the same and timelines and outcomes can differ, in my experience, I have had vertigo patients feel better as fast as within one appointment with me at the clinic.

What causes vertigo?

One of the most common causes of vertigo treated in physical therapy is benign paroxysmal positional vertigo (BPPV). BPPV occurs when tiny calcium carbonate crystals—normally located in a specific part of the inner ear—become dislodged and migrate into one of the semicircular canals, which are responsible for detecting head motion.

When these crystals enter the wrong canal, they disrupt the normal flow of fluid within the inner ear and send inaccurate signals to the brain about head position and movement. This creates a mismatch between what the body feels, what the eyes see, and what the inner ear senses. For instance, when lying down, your body and vision recognize that you’re on your side, but the dislodged crystal may cause your inner ear to falsely signal that you’re still upright—resulting in the sensation of spinning or dizziness.

To diagnose BPPV, physical therapists use specific positional tests that help identify which of the semicircular canals is affected. These tests are crucial in guiding the appropriate treatment, often involving repositioning maneuvers to move the crystals back to their proper location.

How Physical Therapy Can Help

One of the reasons I enjoy treating vertigo, particularly BPPV, is that in many cases, I can help patients feel better in just one session. If BPPV is the culprit, a repositioning maneuver, such as the Epley maneuver, can move the crystals back where they belong, often resolving symptoms immediately.

That said, some cases can take multiple treatments, especially if patients have taken matters into their own hands by googling maneuvers, which can result in crystals moving out of place that were ok to begin with. So now, instead of one crystal or one canal having crystals out of place, there can be multiple!

Even in more serious cases of BPPV, improvement happens usually within a few sessions versus weeks or months of treatment. I had one patient in a motor vehicle accident with crystals dislodged in 3/6 canals. We had to treat them one at a time over each visit to fix the problem, so I saw him for about 6 sessions total over the course of about 2 weeks and then he was on his way and ok from there, so know there IS relief and help at the end of this road!

Another common mistake is ignoring vertigo and hoping it will go away. It’s easy to brush off vertigo and hope it will pass, but that can be risky. I once worked with a patient who struggled with dizziness and thought it was a concussion that would just pass, so put off getting help. Before he knew it, he had fallen and broken a rib—a painful and frightening experience that could have been avoided. Vertigo (and dizziness, too) can be dangerous and we want to eliminate any potential risk of getting injured further, so early care is essential!

Recognizing the Signs of Returning Vertigo

If you’ve had vertigo before, like an ankle sprain, you’re more likely to experience it again. That’s why I educate my patients on the early warning signs, which include:

  • A brief spinning sensation lasting less than 30 seconds
  • Symptoms triggered by head movements, like rolling over in bed or bending over
  • Feeling unsteady or off-balance without a clear reason

If these symptoms return, I encourage patients to come back in for treatment as soon as possible so we can address the problem the right way quickly.

Do I need a referral to get seen?

The good news is that you can seek care quickly and easily at a Spooner clinic near you if you are experiencing vertigo or dizziness.

In Arizona, you can see a physical therapist without a referral. In Texas, a referral is required after three weeks, but since vertigo treatment is often completed within that time, patients can usually get the care they need without extra steps.

If you or someone you know struggles with vertigo, dizziness, or just unsettled in their movement, don’t wait for it to go away on its own. Seek treatment so you can get back to moving and feeling better as quick as possible.

Ready to regain your balance and confidence? Schedule your appointment with a Spooner physical therapist today!