Vertigo

Spinning, tipping, or “the room is moving”? Let’s make sense of it—and fix what we can.

Vertigo is more than “just dizziness.” It’s that spinning, tilting, or floating feeling—like the room is moving when it isn’t. It can hit out of nowhere:

• Rolling over in bed
• Looking up or down
• Turning your head quickly
• Walking in a busy store or stepping off a curb

At Timpanogos Physical Therapy, we evaluate what’s causing that spinning feeling and build a plan to calm it down—often much faster than people expect.

Types of vertigo we commonly see

Vertigo usually falls into two big categories:

• Peripheral vertigo – from the inner ear/vestibular system (the most common type)
• Central vertigo – from the brain or brainstem (less common, but more serious)

Within those, we often see:

• Benign Paroxysmal Positional Vertigo (BPPV)
  
  • Brief spinning episodes triggered by changes in head position (rolling in bed, lying down, looking up)
  • Caused by tiny inner-ear crystals (otoconia) drifting into the balance canals where they don’t belong
• Vestibular neuritis/labyrinthitis
  
  • Sudden, intense vertigo that can last hours to days, often after a viral illness
  • Sometimes with hearing changes (labyrinthitis)
• Migraine-related vertigo
  
  • Dizziness or vertigo linked with migraine activity, with or without headache
• Post-concussion or post-traumatic vertigo
  
  • Dizziness and motion sensitivity after a head injury or whiplash

Some types of vertigo are very mechanical and fixable (like BPPV); others involve more long-term rehabilitation. Our job is to figure out which you have and treat it appropriately—or help you get to the right specialist if we’re seeing red flags.

BPPV: the “crystal problem” we treat all the time

Benign Paroxysmal Positional Vertigo (BPPV) is the single most common cause of vertigo and one we see very frequently.

In BPPV:

• Tiny calcium crystals (otoconia) in the inner ear get loose
• They drift into one of the semicircular canals, where they confuse your balance sensors
• Certain head positions make those crystals move—and your brain gets a strong, false “we’re spinning!” signal

Typical signs:

• Sudden spinning when you roll in bed, lie down, sit up, or look up/down
• Episodes that last seconds to a minute or so, then settle
• Often worse on one side

Special training in BPPV assessment & treatment

At Timpanogos PT, we are specially trained in vestibular assessment and BPPV treatment, including:

• Positional tests (like the Dix–Hallpike and roll tests) to identify which ear and canal are involved
• A variety of canalith repositioning maneuvers (Epley, Semont, and others) to guide crystals back where they belong

Clinical guidelines and randomized trials strongly support these maneuvers as highly effective first-line treatment for BPPV.

How fast can BPPV improve?

Research shows that many people with BPPV have significant improvement or complete resolution of vertigo after one or a small handful of repositioning treatments.

That matches what we see in the clinic:

A lot of BPPV patients walk in spinning and walk out saying, “I had no idea it could change that quickly.”

Some cases are more complex and require a few visits, but BPPV is one of the most treatable and rewarding vertigo diagnoses when it’s correctly identified and managed.

How we evaluate vertigo

Your first visit usually includes:

• A detailed history of when vertigo started, what triggers it, and how long it lasts
• Screening for red flags that might indicate a central (brain-related) problem needing urgent medical attention
• Positional testing for BPPV (Dix–Hallpike, roll tests, and variations)
• A check of eye movements and nystagmus (involuntary eye jerks)
• Assessment of balance, gait, and fall risk
• When appropriate, screening of the neck and visual systems, since they can interact with vertigo

If anything suggests a central vertigo cause or something more serious, we’ll advise immediate follow-up with your physician or emergency care. Otherwise, we usually begin treatment in that first visit—especially if BPPV is the likely culprit.

Treatment options: not one-size-fits-all

1. Canalith repositioning maneuvers (for BPPV)

For BPPV, the primary treatment is a series of precisely guided head and body positions that:

• Move the loose crystals out of the balance canal
• Return them to a part of the ear where they no longer trigger vertigo

These maneuvers are quick, hands-on, and often provide dramatic relief in a short time. They’re recommended as first-line care by major specialty guidelines.

We’ll also teach you:

• What to expect in the next 24–48 hours
• How to recognize signs of recurrence
• When simple home maneuvers might be appropriate vs. when to come back in

2. Vestibular rehab (for lingering dizziness and non-BPPV vertigo)

If your vertigo is not BPPV, or if you’re left with:

• Ongoing dizziness or motion sensitivity
• Unsteadiness or “floating” feelings
• Difficulty in busy visual environments

We may use vestibular rehabilitation, which can include:

• Habituation exercises to reduce sensitivity to motion or positions
• Gaze-stabilization (VOR) exercises to help your eyes stay focused while your head moves
• Balance and gait training so you feel safer and more stable in daily life

Vestibular rehab has solid evidence for improving dizziness and imbalance in a range of vestibular disorders, including post-concussion and vestibular neuritis.

3. Neck and vision contributions

Vertigo and dizziness can also be influenced by:

• Neck stiffness or dysfunction (cervicogenic dizziness)
• Visual problems or difficulty integrating visual and inner-ear input

We’ll address these with:

• Gentle manual therapy and exercise for the neck, when appropriate
• Basic oculomotor exercises and strategies for screen time or visually busy environments

How does this connect with our other dizziness services

Depending on what we find, your vertigo plan may overlap with:

• Balance & Fall Risk work (if unsteadiness or near-falls are significant concerns)
• Post-Concussion Rehab (if your vertigo started after a head injury)
• Nerve Conditions (if neuropathy and balance loss are part of your picture)

You won’t be bounced between providers—we integrate everything under one roof, with a clear plan.

FAQs

How do I know if my vertigo is BPPV?
 BPPV usually causes brief, intense spinning with specific head movements (rolling in bed, lying down, looking up). The diagnosis is confirmed with positional tests that provoke characteristic eye movements (nystagmus). We perform those tests in the clinic.

Can you fix my vertigo in one visit?
 If you have straightforward BPPV, you can get significant relief in 1 or a few visits with canalith repositioning maneuvers. More complex BPPV or other vertigo types may take longer, but we’ll give you a realistic expectation at your evaluation.

Is it safe to move my head if I’m dizzy?
 With the correct diagnosis and guidance, therapeutic movement is usually part of the process of getting better. We’ll never throw you into anything unsafe—we’ll explain each step, support you physically, and stop if something doesn’t feel right.

Ready to stop the spinning?

If you’re tired of the room spinning when you roll over, look up, or turn your head—and you’re ready for someone actually to test and treat the cause—

Schedule a vertigo evaluation at Timpanogos Physical Therapy, and we’ll:

• Figure out what type of vertigo you’re dealing with
• Use specialized BPPV maneuvers when appropriate
• Build a vestibular rehab plan to restore balance, confidence, and control

So you can go from “Don’t move, I’m spinning” to “I can roll over, look up, and walk without worrying what the room will do next.”