Distinguishing Vertigo from Other Dizziness
Vertigo (a false sense of spinning) is different from lightheadedness (pre-syncope), disequilibrium (unsteadiness), and non-specific dizziness. Each has different causes and treatments.
When Physiotherapy Helps
BPPV responds to canalith repositioning manoeuvres. Vestibular neuritis responds to vestibular rehabilitation. Cervicogenic dizziness (from neck dysfunction) responds to cervical physiotherapy. Bilateral vestibulopathy responds to gaze stabilization and balance training.
Red Flags Requiring Medical Referral
New severe headache with vertigo, diplopia, facial numbness or weakness, sudden hearing loss, difficulty swallowing, or progressive worsening despite vestibular rehabilitation require urgent medical evaluation to exclude central causes (stroke, tumour).
The Assessment Protocol
A thorough physiotherapy assessment includes HINTS examination (Head Impulse, Nystagmus, Test of Skew), Dix-Hallpike testing, Romberg and tandem Romberg balance tests, and gait assessment to guide diagnosis and treatment selection.