Benign paroxysmal positional vertigo (BPPV)
Tiny calcium crystals drift into the wrong part of the inner ear. Rolling over, sitting up or looking up then brings a brief, intense spin.
Vertigo and Balance Rehab in Rancho Santa Fe, CA
The room spins when you roll over, or the floor tilts in a busy store. We test how your balance system handles motion and build a plan around your physician's findings.
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- Care coordinated with your physician
The short answer
Vertigo is a false sense that you or the room is moving, most often caused by an inner-ear problem such as BPPV. At True Performance in Rancho Santa Fe, CA, we test balance, eye movement and motion tolerance once your physician has found the cause, then use GyroStim and TransLingual NeuroStimulation (TLNS) with guided balance work.
Overview
Why does the room keep spinning?
Rolling over in bed, looking up at a shelf or turning to check traffic can set it off. For a few seconds or a few hours, the world moves when it should stand still.
Vertigo is a symptom, not a condition in itself. It can start in the inner ear or in the parts of the brain that process balance, so the cause shapes the care.
Where do we fit in?
Your physician finds the cause first. We then test how your balance, vision and body sense work together.
When motion processing is part of the problem, we add computer-guided GyroStim sessions for dizziness, paced to what you tolerate and coordinated with your medical team.
Understanding
What is vertigo?
Vertigo is the feeling that you or your surroundings are spinning, tilting or swaying when nothing is moving. Most vertigo starts in the inner ear, the body's balance organ, or in the nerve that carries its signals. Less often it comes from the brain, such as after a stroke or head injury.
What is actually happening
The inner ear senses every head movement and reports it to the brain.
An ear or brain problem makes those signals wrong or mismatched.
The brain reads the mismatch as motion, so the room seems to spin.
Who this usually affects
- People who get dizzy when they roll over or look up
- Anyone recovering from an inner-ear infection
- People with a migraine history
- People recovering from a head injury
When it is something else
- Vertigo with weakness, slurred speech or a drooping face: call 911
- Plain lightheadedness or feeling faint, which has other causes
- Hearing loss or ear fullness that needs a hearing workup first
The re-check
We re-test your balance and motion tolerance as you go. If they stop improving, we change the plan or send you back to your physician.
What is the difference between peripheral and central vertigo?
Peripheral vertigo starts in the inner ear or the balance nerve, and it is the most common type. Central vertigo comes from the brain, for example after a stroke or a traumatic brain injury, and it often causes more severe unsteadiness.
Symptoms
Symptoms of vertigo
- A sense that you or the room is moving
- Tilting, rocking or being pulled to one side
- Unsteady standing or walking
- Nausea or vomiting
- Jumpy or unusual eye movements
- Blurred vision or trouble focusing
- Symptoms set off by head movement
- Sensitivity to light, noise or busy visuals
- Fatigue after an episode
Causes
Common causes
Vestibular neuritis and labyrinthitis
Inflammation of the balance nerve or the inner ear, often after a virus, causes sudden vertigo and unsteady walking. Labyrinthitis can also affect hearing.
Ménière's disease
This inner-ear disorder brings episodes of vertigo with ringing, hearing changes and a full feeling in one ear.
Vestibular migraine
Migraine can cause vertigo and motion sensitivity, sometimes with no headache at all.
Head injury or stroke
When the brain's balance pathways are affected, the vertigo is called central and needs medical care first.
Source: NIDCD overview of balance disorders.
Our approach
How our care works
Our balance rehab starts once the cause is known, testing how you respond to head position, visual targets and controlled motion. Care combines guided balance and eye-movement exercises with GyroStim and TransLingual NeuroStimulation (TLNS), paced to your tolerance and coordinated with your physician.
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GyroStim
Turning and acceleration often bring on vertigo, so a computer-controlled chair lets us add them in small, measured amounts while you aim at lit targets. Dr. McWhorter, a chiropractor, sets the protocol after a detailed evaluation, exam and review of your history, then adjusts it to your response. See how motion training in the GyroStim chair works.
TransLingual NeuroStimulation (TLNS)
A small device on the tongue delivers gentle pulses while you do balance and eye-movement exercises. It does not move inner-ear crystals, so it follows your physician's findings. Read about tongue stimulation paired with balance exercises.
Red flags
When to seek care
Most vertigo is not an emergency. Sometimes dizziness is a sign of a stroke or another serious problem.
- Weakness or numbness in an arm or leg
- Slurred speech or a drooping face
- A sudden, severe headache
- Sudden vision changes
- Trouble walking
- Chest pain or a racing heartbeat
- A fever over 100.4 degrees Fahrenheit
If vertigo comes with any of these, call 911 or go to the nearest emergency room before anything else.
Source: Cleveland Clinic's guide to vertigo.
Your clinician
Who plans your care
Your care is planned by Dr. Jeff McWhorter, D.C., a chiropractor whose practice focuses on functional neurology, concussion rehabilitation, and performance.
He looks at how your inner ear, eyes and body sense work together. Then he builds exercises around your physician's findings and the moments that set off your symptoms, and sends anything outside rehabilitation back to your physician.
Visit
Getting here
Our office is at 18029 Calle Ambiente, Suite 507, in Cielo Village, Rancho Santa Fe, about two miles from Lake Hodges. Patients come from across North County San Diego, and some fly in; see our guide for patients coming from out of town.
The first step
Schedule Your Vertigo Evaluation
- 01Start with a complimentary 15-minute intro call
- 02Your first visit takes about 90 minutes, plus data and history gathering
- 03We coordinate with your physician
How long does vertigo last?
It depends on the cause. BPPV usually brings brief spins after a change in head position, while vestibular migraine or Ménière's disease follow other patterns. Vertigo that keeps returning or changes should be checked.
What should I do during a vertigo attack?
Sit or lie down, avoid driving and move slowly until the spinning settles. If it comes with weakness, slurred speech or a severe headache, call 911.
Who should I see first for vertigo?
Start with your primary care physician, who may involve an ear, nose and throat doctor, an audiologist or a vestibular therapist. We add balance rehabilitation once the cause is known.
Can simple head movements help with vertigo?
For BPPV, yes, often. A provider can use repositioning moves, such as the Epley maneuver, to guide the crystals back into place. Other causes need other care.
Is vertigo the same as MdDS?
No. Vertigo usually feels like spinning, while the lasting rocking feeling after travel is a separate condition called Mal de Débarquement syndrome.
Does insurance cover vertigo care here?
We explain cost and payment options on your intro call, before you book an exam. The total depends on your exam and how many sessions your plan needs.
Journal
Read more about vertigo
Get a clear plan for vertigo that keeps coming back
Start with a complimentary 15-minute call with our team.