Vertigo, Dizziness or Feeling Off Balance?

Lightheadedness, feeling faint, disequilibrium, motion sensitivity, medication effects, blood-pressure changes, migraine, and other conditions may all be called “dizziness” without being true vertigo.

Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo in adults. It typically causes brief spinning episodes after changes in head position, such as rolling over in bed or looking upward.

The Epley maneuver is a canalith-repositioning technique commonly used for certain forms of BPPV. It is not appropriate for every type of dizziness or vertigo, so proper assessment matters before deciding whether a repositioning maneuver, another treatment, or referral is appropriate.

Cervicogenic dizziness may be considered when dizziness occurs with neck pain, limited movement, or after whiplash, but other important causes should be considered first.

It depends on the cause. Chiropractic care may fit some cervical musculoskeletal presentations, while many causes require vestibular, ENT, neurological, or other medical evaluation.

Not every patient needs imaging. X-rays may sometimes help evaluate a related neck injury, while MRI or specialized vestibular testing may be ordered by an appropriate medical provider when the history or examination suggests the need.

Referral may be appropriate for suspected inner-ear disease, BPPV, vestibular migraine, hearing changes, persistent imbalance, neurological findings, or a pattern that does not fit a musculoskeletal cause.