Vestibular and Balance Clinic

DIZZINESS: Causes, Symptoms, Diagnosis and Treatment at Back in Motion

Rehab physiotherapy includes the treatment and management of dizziness, also referred to as vertigo, dizzy spells, spins, light headedness, unsteadiness, and motion sickness.

The most common causes for dizziness and vertigo are inner ear issues, sensory mismatch and side effects of medication:

·Inner ear or vestibular problems include viral causes such as vestibular neuritis or labyrinthitis, bacterial infection, Menieres Disease or BPPV (benign paroxysmal positional vertigo).

· Sensory mismatch occurs when the vestibular system, vision and muscles/joints are not relaying the same information to the brain. This variance in input causes symptoms such as balance issues, falls, nausea and blurred vision.

·Many heart and blood pressure medications, thyroid medications, diuretics and antihistamines can cause dizziness and lightheadedness. Other medications do not work well together and can cause symptoms. It pays to read the labels and discuss your medications with your doctor.

Dizziness and vertigo can be due to a medical condition such as stroke, concussion, brain injury, multiple sclerosis, cerebellar disease, a cardiovascular condition, chronic fatigue or even part of the aging process. People with migraines can also experience dizziness, especially at the time of menses or ovulation. Both low and high blood pressure can cause dizziness.

Dizziness and falls can be the result of one of the systems responsible for balance and clear vision not working well. Typical examples are poor circulation or numbness in feet; arthritis in hips, back or neck interfering with the messages from the leg muscles and joints reaching the brain; hip or knee joint replacement. Deterioration in vision, which we often rely on for spatial awareness can have a devastating effect on our balance and confidence.

Dizziness and dizzy spells can also be a symptom of hyperventilation, anxiety and shallow or poor upper chest breathing. It is usually accompanies by other symptoms which we can investigate using the BradCliff Method® for assessment.

At the Back in Motion Clinic, we are able to differentiate between all the above causes through specific assessment techniques and develop an individualised treatment programme to get you functioning again and relieve you of your symptoms.

Vestibular and Balance Clinic

There are a number of causes of dizziness which give different symptoms. Here are a number of examples:


  • The right or left inner ear structure or the nerve leading from it (vestibular nerve) can be affected by a virus, middle ear infection, concussion, whiplash, or uncommonly a brain tumour

  • The brain itself where the processing systems for balance and vision are situated can be affected through conditions that affect the brain such as stroke, concussion, cerebellar conditions, or side effects from medications

  • The aging process can affecting vision, balance and hearing through changes in the brain tissues, arthritis affecting the joints (hips, knees, back, neck), changes in the nerves affecting sensation in the feet. These can combine to limit your activity and confidence going out, in turn altering your responses to movement and balance;

  • Structural changes in the inner ear complex whereby bits of calcium crystals (otoconia) fall off the balance structures and flow freely through the canals causing disturbances in the balance messages to the brain. This is known as BPPV

  • Some people can be sensitive to motion (never liked playgrounds, funfairs etc) and over time it worsens so that they are seriously travel sick (car, plane, bus) and get symptoms with small movements

  • There are other causes of dizziness such as a heart condition, altering blood pressure, stress and anxiety, hyperventilation, altered breathing patterns from asthma, other lung conditions or even over-exercising. These too can be treated through individualised programmes targeting the cause.