You get up in the morning and suddenly everything spins. The room seems to rotate, you reach for the wall. Or you turn over in bed and for a few seconds it feels as if everything is tipping.
Dizziness can be very unsettling. Many people affected have already been to several doctor's appointments, sometimes without a clear finding – and yet the feeling of unsteadiness, staggering or loss of control remains.
The good news: with many forms of dizziness, physiotherapy can help – provided the cause is carefully assessed and serious triggers have been ruled out by a doctor.
What actually is dizziness?
Dizziness is not a disease in its own right but a symptom. It shows that the processing of balance information may be disturbed or overloaded.
Our balance comes from the interplay of three systems:
- the inner ear with the balance organ
- the visual system
- deep sensation from muscles, joints and ligaments
If this information doesn't fit together well or isn't processed reliably by the brain, dizziness can result.
Common causes of dizziness
1. Benign paroxysmal positional vertigo – BPPV
Benign positional vertigo is a common cause of short attacks of spinning vertigo. Small calcium crystals, called otoconia (also otoliths or colloquially “ear stones”), come loose in the inner ear and get into a semicircular canal.
Typical are short, intense attacks of vertigo with certain changes of position, for example when turning over in bed, lying down, sitting up or looking up.
This form of vertigo can often be treated with special repositioning manoeuvres. Which technique makes sense depends on which canal is affected.
2. Neck pain in connection with dizziness
Many people with dizziness also develop neck tension or restricted movement of the cervical spine. That makes sense: if you feel unsteady, you often move your head less, hold your neck tight and avoid quick movements.
This can make neck pain, head pressure or unsteadiness worse.
Important: neck pain is not automatically the cause of the dizziness. That's why we see the cervical spine as part of the overall picture – not as the sole explanation.
Manual therapy and targeted exercises can help to reduce accompanying complaints and rebuild confidence in head movements.
3. Functional dizziness / PPPD
Sometimes dizziness persists even though no acute structural cause is found. Factors such as stress, anxiety, overload, visual stimuli or avoidance behaviour then often play a role.
This doesn't mean the dizziness is “imagined”. The symptoms are real. The nervous system simply reacts more sensitively to movements, situations or sensory impressions.
Physiotherapy can help here with education, gradual loading, balance training and strategies against avoidance behaviour.
4. Vestibular migraine
Dizziness can also occur in connection with migraine – sometimes even without severe headaches. Typical signs can be recurring dizzy spells, sensitivity to light or noise, nausea or a known history of migraine.
The medical assessment is done by a doctor. Physiotherapy can help in addition, for example with unsteadiness, avoidance of movement or accompanying neck pain.
How can physiotherapy help with dizziness?
Physiotherapy for dizziness is not a standard programme and not just massage. It begins with a detailed physiotherapy assessment: when does the dizziness occur? How long does it last? Which movements trigger it? Are there accompanying symptoms? How secure is your balance?
Depending on the findings, treatment may include:
- Vestibular rehabilitation: exercises for gaze stabilisation, balance reactions and safe movement
- Repositioning manoeuvres: for example with benign positional vertigo
- Education: a clear explanation of what is probably happening and what you can do yourself
- Balance and coordination training: especially important with unsteadiness, fear of falling or walking problems
- Training against avoidance behaviour: a gradual return to movements that you have been avoiding
- Treatment of accompanying neck pain: for example with manual therapy and active exercises
When should you see a physiotherapist about dizziness?
Physiotherapy can make sense if, for example:
- dizziness occurs with certain head movements or changes of position
- you feel unsteady when walking
- you avoid movements because you fear dizziness
- the dizziness persists after a vestibular illness
- you also have neck pain
- fear of falling or unsteadiness in everyday life increases
With sudden new, severe dizziness or neurological accompanying symptoms, you should first have a doctor or emergency service check whether there is a serious cause.
- paralysis, numbness or coordination problems
- speech, swallowing or vision problems
- double vision
- a new, very severe headache
- loss of consciousness
- chest pain, racing heart or marked shortness of breath
- dizziness after a fall or accident
Acute central causes such as brainstem or cerebellar strokes must be recognised and treated as emergencies.
Dizziness? We can help you in Rostock.
In our practices in the Altstadt and Südstadt we offer specialised physiotherapy assessment and treatment for dizziness. Because dizziness can have very different causes, we schedule appointments individually – please get in touch by phone, email or via our contact form.
Conclusion: take dizziness seriously – but often something can be done
Dizziness can severely restrict everyday life. A careful assessment is decisive: what type of dizziness is it? What are the triggers? Which warning signs need to be ruled out? And which exercises or measures really suit you?
With targeted physiotherapy, many patients can regain more security, mobility and confidence in their own body.
Note: this content is for general information and does not replace a medical diagnosis. With sudden new, severe or unusual dizziness and neurological accompanying symptoms, please see a doctor immediately.
