Vertigo and dizziness are symptoms that are common with a variety of conditions and disorders that can stem from issues with the inner ear and surrounding nerves. Many times these symptoms can derive from the brain having an issue integrating information from the outside world about our position in space and time. Our brain relies on input from our visual system (eyes and muscle of our neck and head), vestibular system (inner ear), and proprioceptive system (sensors that live in our joints and feet that communicate body positon), vertigo and dizziness can occur when there is a problem with one or more of these systems. 

Some causes of vertigo can be treated in a chiropractic, physical therapy or primary care setting, while others may need medication or further imaging/examination in order to treat. Here we are able to provide a comprehensive assessment to determine what is causing vertigo and dizziness symptoms; we are also able to provide treatment in office for causes of vertigo that respond well to manual therapies. 


The most important step when treating vertigo and dizziness is to determine what condition or underlying issue is generating the symptoms. Some common types of vertigo can be caused by movement of crystals within the inner ear, (benign positional paroxysmal vertigo, BPPV) or tension and restriction in the neck (cervicogenic vertigo), these can be treated in office with manual therapies. While some types of vertigo can be caused by infection or inflammation of the nerves within the inner ear, and may respond better to medications, as well as further examination or imaging.

Assessment in our office includes, in addition to a comprehensive history; balance testing, assessment of eye movements to look for weakness or abnormal movements, manual and orthopedic testing of the muscles and joints of the neck, sensory testing and vertigo specific examinations like the Dix-Hallpike Manuever. 

Treatment & Next Steps

Some types of vertigo can be treated in office while others may require a referral to an ENT (ear nose and throat provider), primary care provider, or neurologist. After the exam, Dr. Miller will determine what the appropriate next steps are, whether that is in office treatment co-treating with another provider, or referral to an appropriate provider to get you feeling better as quickly as possible. 

For types of vertigo that respond well to manual therapies, these are some of the treatment options that may be used at our office; 

  • Vertigo Repositioning Exercies (Epley's Manuever) 
  • Rehabilitive eye movement exercises
  • Functional Dry Needling 
  • Soft Tissue Mobilization / Active Release Technique