EXPERT VESTIBULAR REHABILITATION

Functional dizziness (also called Persistent Postural-Perceptual Dizziness or PPPD) refers to persistent feelings of unsteadiness, dizziness, or imbalance that are not caused by structural damage to the inner ear or brain, but rather by changes in how the nervous system processes balance and sensory information. These symptoms often develop after an initial vestibular event or may be triggered by anxiety, stress, or heightened sensory sensitivity. Although no structural damage is present, the symptoms are very real, can significantly affect daily life, and respond well to specialized rehabilitation.

Dizziness can originate from several different systems in the body, so one of our first goals is to identify the underlying cause through comprehensive assessment. A critical distinction is whether your symptoms stem from the peripheral vestibular system—the inner ear structures and vestibular nerve—or the central vestibular system within the brain and brainstem. Determining which system is involved guides our treatment approach and helps us target the specific area that needs rehabilitation for optimal recovery.

Vestibular migraine is a neurological condition where episodes of dizziness, vertigo, or balance problems occur in people with a history of migraines—even without a headache being present. The underlying issue is a disruption in how the brain processes balance, movement, and spatial information. Common symptoms include persistent imbalance, motion sensitivity (especially with head movement), dizziness triggered by visual stimuli (like scrolling screens, busy patterns, or moving through crowds), lightheadedness, a rocking or swaying sensation, and nausea. Vestibular migraine is one of the most common causes of episodic vertigo and responds well to targeted treatment.

Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of vertigo, creating brief episodes of spinning sensation triggered by specific head movements. BPPV occurs when tiny calcium crystals (called otoconia) within the inner ear become dislodged and move into the wrong canal, disrupting your sense of balance. While episodes can be unsettling and disruptive, BPPV itself is not dangerous—though it can increase fall risk if left untreated. Symptoms are typically brought on by changes in head position, such as looking up or down, lying back, rolling over in bed, or sitting up. Episodes usually last 30-60 seconds but can vary in intensity, from mild unsteadiness to severe spinning. The good news: BPPV often responds very well to specific repositioning maneuvers performed during treatment.

Cervicogenic dizziness is a type of dizziness and imbalance that originates from dysfunction in the neck. Unlike true vertigo (spinning), cervicogenic dizziness typically presents as unsteadiness, lightheadedness, or a sense of being off-balance that's directly related to neck problems or head position. This condition commonly develops after whiplash injuries, concussion, poor neck posture, cervical spine dysfunction, or degenerative changes that affect how the brain receives and interprets information from the neck. Treatment focuses on restoring proper neck function through manual therapy, exercises, and postural correction, often combined with vestibular rehabilitation to fully restore balance and stability. Common symptoms include dizziness or imbalance triggered by neck movement or sustained head positions, neck pain or stiffness accompanying the dizziness, headaches originating from the neck, and difficulty with balance—especially in busy visual environments or while walking.