Not all dizziness is the same
“Dizziness” can describe different sensations: the room spinning, unsteadiness, a floating feeling, fogginess or difficulty focusing your vision during movement. Treatment therefore begins with a detailed conversation and examination designed to identify the symptom pattern and the system involved.
A common cause of positional dizziness is BPPV, in which a change in head position triggers brief episodes of vertigo. Other vestibular conditions also exist, and sometimes dizziness is not vestibular in origin. Assessment helps distinguish between them and determine whether physiotherapy is appropriate or further medical investigation is needed.
What does the assessment include?
- A detailed history of when the dizziness began, how long episodes last and what aggravates or relieves them.
- Assessment of eye movements, visual focus and responses to head movement.
- Specific positional tests when BPPV is suspected.
- Assessment of balance, walking and function when relevant.
- Identification of signs that require referral for further medical evaluation.
What does treatment look like?
Treatment is based on the assessment findings. When BPPV is identified, an appropriate repositioning manoeuvre may be performed. For other conditions, the plan may include gaze-stabilization exercises, gradual adaptation to movement, balance and walking exercises, together with a short and precise home programme.
The aim is to reduce the limitations caused by dizziness and support a gradual return to activities such as getting up, walking, driving, working or exercising, depending on your condition and response to treatment.
Important: New dizziness accompanied by weakness or numbness on one side, slurred speech, double vision, an unusual headache, loss of consciousness or a new and significant difficulty walking requires urgent medical assessment.
Useful questions
Should I stop medication before the assessment?
Do not change or stop medication without medical advice. When booking, mention which medicines you have taken and when, so this can be considered during the assessment.
How many sessions are needed?
The number varies with the diagnosis, duration of symptoms and response to treatment. Sometimes meaningful improvement occurs quickly; in other cases a gradual vestibular rehabilitation process is required.
What should I bring?
Emergency-department or physician summaries, hearing tests, imaging and a medication list if available and relevant. Please bring the glasses or hearing aids you normally use.