What We Treat
Rolling over in bed should not send the ceiling spinning. Dizziness has causes, and they are testable. Start with an evaluation that looks for the cause, one-on-one with a licensed physical therapist, and a plan with an endpoint.
Sound Familiar?
Two or more? Keep reading.
Why It Happens
Deep in your inner ear sit three fluid-filled canals that tell your brain which way your head just moved. In BPPV, tiny calcium crystals come loose and drift into one of those canals. Now a position change, rolling over, looking up, bending down, sends a false signal about motion, and the room spins for a few seconds. Other causes look different. Vestibular neuritis inflames the balance nerve and brings days of constant dizziness. Meniere’s disease pairs vertigo with ear fullness or hearing changes. Vestibular migraine brings episodes with headache and light sensitivity. A stiff, injured neck can do it too. Lightheaded on standing is usually blood pressure or medication, and that one belongs to your physician.
They do not sort themselves out, and that is why yours has not. Medication like meclizine turns down the alarm, it does not move a crystal out of a canal. And after an inner ear illness, the brain needs specific head and eye movement to recalibrate. Avoiding every trigger, which is the sane thing to do, is exactly what stalls that process. Testing is what separates them: positional testing and watching your eye movement tell a licensed physical therapist which canal or which system is involved, and the plan follows from that.
The Honest Truth
Nobody regrets starting too early.
How We Fix It
Every plan has an endpoint. Here’s what the four phases look like for dizziness and vertigo.
Visit one
Pain
Positional testing and eye movement tell us which canal or which system is behind it. When the answer is BPPV, canalith repositioning moves the loose crystals out of the canal, and that treatment starts the same visit.
Early weeks
Prime
Gaze stabilization work rebuilds the link between your inner ear and your eyes, so the world holds still when your head turns. Doses are small and specific, enough to teach your brain, not enough to wreck your afternoon.
As tolerance builds
Perform
Walking while you turn your head. Standing on softer ground. Busy visual places like a full grocery aisle. The movements you have been avoiding get reintroduced on purpose, in an order you can handle.
Before discharge
Prevent
BPPV can return, so you leave knowing the early signs and what to do about them instead of starting from scratch. Balance and leg strength get shored up too, because the fear of falling usually outlives the spinning.
Questions, Answered
Honest answer: the positional tests can bring on a short bout of spinning, and that is the point. Your eyes tell us which canal is involved while it happens. You are lying down and supported, we tell you exactly what we are about to do, and BPPV spinning is brief. Nothing gets done to you by surprise, and you can stop at any point.
It depends entirely on the cause, which is why the testing comes first. BPPV has a mechanical problem and a mechanical treatment: repositioning the crystals. After an inner ear illness, gaze and balance retraining help the brain recalibrate. Meniere’s disease and vestibular migraine are managed with a physician, and therapy supports that rather than replacing it. We will tell you which one this looks like, and we will not promise you a cure we cannot deliver.
Medication has a real job, especially early on when the nausea is severe. What it cannot do is move a crystal out of a canal. And relying on a vestibular suppressant for a long stretch can slow the recalibration your brain needs to do. Keep taking what you were prescribed, talk to the prescriber about changes, and let the testing find out what is actually happening.
You do not need a physician referral in Louisiana, so you can start with an evaluation here. Part of that evaluation is screening for the things that are not ours to treat: hearing loss, new neurological symptoms, blood pressure drops when you stand. If we see any of those, we say so and tell you who should look at it. Medicare and the major plans are accepted, and the benefits check happens before your first visit.
It can contribute, and it often gets missed. Your neck feeds position information into the same balance system, so a stiff or injured neck can leave you feeling off, especially after a car accident or a fall. That is a different feeling from true spinning, and the exam checks both. If your neck is part of it, hands-on work on the neck becomes part of the plan.
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