Vertigo and Inner Ear Issues such as BPPV and vestibular neuritis

Symptoms: dizziness, spinning sensation, nausea, can be constant or episodic in nature depending on the cause
Cause: BPPV associated with age >50, linked with osteopenia, vestibular neuritis caused by an inner ear infection
Treatment: manual therapy techniques such as the Epley Maneuver or BBQ Roll, therapeutic exercise for adaptation and habituation of the vestibular apparatus, patient education
Other Interventions: SERC or antiemetic medication for dizziness or nausea, consult with an ENT, otologist, or neurologist to rule out other more serious conditions that might require surgery


Symptoms: headache, dizziness, sensitivity to light and sound, difficulty thinking clearly, short term memory loss
Causes: direct blow to or rapid deceleration of head
Physiotherapy: Treatments: manual therapy to reduce headaches, patient education on the progression and prognosis of concussions as well as pacing and planning techniques, therapeutic exercise including both postural exercise as well as ‘brain gym’ exercises
Other Interventions: massage therapy, CT scan in some cases to rule out life-threatening brain injuries, pain or migraine medication, use of sunglasses or earplugs to reduce symptoms

Cervicogenic Headaches

Symptoms: pain in the base of the skull radiating over the top of the head
Causes: poor postural habits or strain to neck
Physiotherapy Treatments: manual therapy to reduce muscle tension in the suboccipital muscles, traditional physiotherapy modalities, therapeutic exercise, patient education to reduce the aggravation of symptoms related to poor ergonomic or postural habits, acupuncture, shockwave to resolve adjacent trigger points
Other Interventions: massage therapy, antiinflammatory or pain medication, migraine pill, botox injections, other investigations such as a CT scan to rule out serious problems of the brain