Chiropractor for Dizziness and Vertigo in Fremantle
Dizziness is unsettling. Whether the room spins, you feel light-headed, or you simply do not trust your balance, it changes how you move through your day.
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Dizziness has many possible causes, and the neck is only one of them. At North Fremantle Chiropractic, our first job is working out which kind you have. When your neck is part of the picture, known as cervicogenic dizziness, we assess and manage it. When it is not, we tell you and refer you to the right practitioner.
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No referral needed. Book online or call 0414 316 261.
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When dizziness is an emergency
Call 000 now if dizziness comes on suddenly with any of these:
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A sudden, severe headache
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Double vision or loss of vision
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Slurred speech or trouble understanding speech
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Facial droop
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Weakness, numbness or clumsiness in an arm or leg
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Trouble swallowing or walking, or falling to one side
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Fainting
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Chest pain, a racing or irregular heartbeat, or shortness of breath
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New, unusual neck pain or headache that came on together with the dizziness, particularly after a neck injury or a sudden neck movement
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These can be signs of a stroke or a heart problem. Do not drive yourself and do not wait for a chiropractic appointment. Remember the Stroke Foundation’s F.A.S.T. test: Face, Arms, Speech, Time.
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See your GP promptly if:
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Your dizziness started after a knock to the head, a fall or a concussion
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You have new hearing loss, ringing in one ear or a blocked feeling in one ear
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It started after a new medication or a change in dose
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You keep nearly fainting when you stand up
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You are vomiting repeatedly or cannot keep fluids down
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It is getting steadily worse, or comes with unexplained weight loss
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If we find any of these during your assessment, we stop, explain why, and help you get to the right care.
What is cervicogenic dizziness?
"Cervicogenic" means coming from the neck. Cervicogenic dizziness is a feeling of unsteadiness, imbalance or light-headedness that is linked to neck pain or stiffness.
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The joints and muscles of your upper neck are packed with position sensors that tell your brain where your head is in relation to your body. Your brain blends that information with signals from your eyes and inner ears to keep you balanced. When your neck is painful, stiff or injured, that position information can become less accurate, and the mismatch can feel like dizziness.
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Typical features include:
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Unsteadiness or a floating, off-balance feeling, more than a true spinning
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Neck pain, stiffness or reduced neck movement at the same time
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Symptoms that come on with neck movement or sustained postures, such as long stretches at a desk
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A history of neck injury such as whiplash, or ongoing neck pain
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Headaches at the base of the skull
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Cervicogenic dizziness is what clinicians call a diagnosis of exclusion. Other causes, particularly inner ear and more serious causes, need to be considered and ruled out first. That is the core of our assessment.
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How cervicogenic dizziness differs from other causes
Dizziness is a symptom, not a diagnosis. Here is how some common causes tend to differ. This is a general guide, not a way to diagnose yourself.
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BPPV (benign paroxysmal positional vertigo). Brief spells of spinning, usually lasting less than a minute, set off by changing your head position relative to gravity: rolling over in bed, lying down, looking up or bending forward. It happens when tiny crystals in the inner ear move into the wrong canal. The neck is not the source. BPPV is identified with positional tests such as the Dix-Hallpike.
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Vestibular migraine. Episodes of dizziness or vertigo lasting from minutes to days, often in people with a history of migraine. Episodes may come with headache, sensitivity to light or sound, or visual aura, though not always. This is diagnosed and managed with your GP or a neurologist.
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Inner ear conditions. Vestibular neuritis usually causes sudden, severe, constant vertigo lasting days, often after a viral illness. Labyrinthitis is similar but comes with hearing loss. Ménière’s disease causes episodes of vertigo with fluctuating hearing loss, ringing and a full feeling in one ear. These need medical assessment, often with an ENT or audiologist. Sudden, constant vertigo always needs same-day medical assessment, because some strokes look very similar.
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Cardiovascular and other medical causes. Light-headedness or feeling like you are about to faint, especially when you stand up, can relate to blood pressure, heart rhythm, dehydration, low blood sugar, anaemia or medications. These sit with your GP. We may check your blood pressure as part of your assessment and refer if anything suggests a medical cause.
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Cervicogenic dizziness. Unsteadiness rather than spinning, linked in time with neck pain or stiffness, and often brought on by neck movement or sustained postures. No hearing changes. Assessed with neck, joint position sense and balance testing, once other causes have been considered.
How we assess dizziness, step by step
1. A detailed history
What exactly do you feel: spinning, light-headedness or unsteadiness? How long does each episode last, what sets it off, and what else happens with it? We ask about neck pain, injuries, headaches, hearing, vision, medications and your general health. How you describe the dizziness is often the most useful information in the whole assessment, so jotting down your episodes before your visit helps.
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2. Neurological and cranial nerve screen
We check the nerves that control your eyes, face, hearing, swallowing and speech, along with eye movements, coordination, sensation, strength and reflexes. This screens for signs that point away from the neck and towards a medical cause.
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3. Blood pressure
Where relevant, we check your blood pressure, including lying and standing.
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4. Neck movement and joint position sense testing
We measure how your neck moves and which movements bring on your symptoms. Joint position sense testing checks how accurately you can return your head to centre with your eyes closed, which tells us how well your neck’s position sensors are working. We may also test your eye movements with your neck turned.
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5. Balance testing
Standing balance with your eyes open and closed, on firm and soft surfaces, with your feet together, heel to toe and on one leg, plus walking tests. This shows how much you rely on each part of your balance system.
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6. Positional testing for BPPV
Before any positional or neck testing, we screen for signs that would make those tests unsuitable for you. Where indicated, we then use the Dix-Hallpike test and related positional tests to screen for BPPV. If BPPV is identified, we explain what we found and can usually treat it in the same visit with a repositioning manoeuvre such as the Epley.
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7. Putting it together
You get a clear explanation of what we found, whether your neck appears to be contributing, and what happens next. Imaging is not a routine part of assessing dizziness. If your examination suggests a scan, blood test or another opinion will change the plan, we arrange the referral.
Care options for cervicogenic dizziness
If your assessment points to a neck contribution and there are no warning signs, care may include:
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Hands-on care for the neck
Gentle mobilisation of the upper neck and upper back, soft tissue therapy and, where appropriate after screening, chiropractic adjustment. Technique is chosen to suit you, and a gentler approach is used where that is the better fit. Learn more about neck pain and chiropractic care at NFC.
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Dry needling
Where suitable, dry needling for trigger points in the neck and upper shoulder muscles. Suitability is checked first. Learn more about dry needling.
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Joint position sense and eye-head exercises
Simple drills that retrain how accurately your neck reports head position, such as returning your head to a target with your eyes closed, and exercises that coordinate eye and head movement.
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Balance training
Progressive balance work matched to your test results, from steady standing to more challenging surfaces and movements, built into your day or your training.
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Posture, workstation and training advice
Desk setup, screen height, sleeping position and pacing. If you lift, run or play sport, we talk through sensible modifications so you can stay active while care progresses.
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BPPV treatment
If BPPV is identified, we use canalith repositioning manoeuvres such as the Epley to move the displaced crystals back where they belong. Many people feel the spinning settle quickly once the right canal is treated, and we show you what to do if it comes back.
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Referral and co-management
We work with local physiotherapists for vestibular rehab and refer to them when that is the better fit. Your GP, an ENT, audiologist or neurologist may also be the right next step, either instead of our care or alongside it. With your consent, we are happy to write to them.
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Dizziness, neck pain and headaches
Cervicogenic dizziness often travels with neck pain and headaches at the base of the skull. If that sounds familiar, our headaches and neck pain pages explain how those are assessed.
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What to expect at your first visit
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Your initial appointment runs for about 45 minutes.
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If your dizziness is significant, have someone drive you.
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Bring a list of your medications, any results from your GP, ENT or audiologist, any scans, and notes on your episodes: when they happen, how long they last and what sets them off.
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We take your history and work through the assessment steps above.
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Some tests can briefly bring on your symptoms. We warn you first, and you can ask us to stop at any time.
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We explain what we found in plain language.
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If care is appropriate, it can start on the same visit, and you go home with your first exercises.
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If something needs a GP or another practitioner, you hear that on the day.
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Why choose NFC for dizziness
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Assessment first. We work out what kind of dizziness you have before anything else happens.
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Warning signs screened every time. Neurological and cranial nerve checks are part of every dizziness assessment.
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Clear referral pathways. We work with local physiotherapists, and if your dizziness belongs with a GP, ENT or neurologist, we tell you and help you get there.
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Training is part of the conversation. Dr Nathan Bridger is a chiropractor and a strength and conditioning coach, so if you train or play sport, your plan considers how to keep you moving with sensible modifications.
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Plain-language explanations. You leave knowing what we found and what the plan is.
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Local since 2020. Based in North Fremantle since March 2020, seeing people from Fremantle, East Fremantle, Mosman Park, Bicton, Palmyra and Cottesloe.
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No referral needed. Book directly online or by phone.
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Dizziness FAQs
Q: Can a chiropractor help with dizziness?
A: Chiropractors can assess dizziness and provide care where the neck is contributing, known as cervicogenic dizziness. Assessment comes first, because dizziness has many causes, including inner ear problems, migraine, blood pressure and heart conditions. Where your presentation points elsewhere, we refer you to the right practitioner.
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Q: What is cervicogenic dizziness?
A: Cervicogenic dizziness is unsteadiness or light-headedness linked to neck pain or stiffness. The upper neck sends your brain information about head position, and when the neck is painful or injured that information can become less accurate. It is a diagnosis of exclusion, so other causes need to be considered first.
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Q: How do I know if my dizziness is BPPV or coming from my neck?
A: BPPV usually causes brief spinning, lasting less than a minute, triggered by changing head position relative to gravity, such as rolling over in bed or looking up. Cervicogenic dizziness is more often unsteadiness linked with neck pain or stiffness and brought on by neck movement or sustained postures. Positional testing such as the Dix-Hallpike helps tell them apart, and some people have both.
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Q: Is dizziness the same as vertigo?
A: Not quite. Vertigo describes a spinning sensation, while dizziness is a broader term that includes light-headedness and unsteadiness. The distinction helps direct the examination, so describing exactly what you feel is genuinely useful.
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Q: Is it safe to have my neck treated if I am dizzy?
A: Every patient with dizziness is screened for warning signs before any neck treatment, including signs that point to a problem with the blood vessels or the brain. If those are present, we do not treat your neck and you are referred for medical assessment. Where neck care is appropriate, technique is chosen to suit you, and gentle mobilisation is used where that is the better fit.
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Q: When is dizziness an emergency?
A: Call 000 if dizziness comes on suddenly with a severe headache, double vision, slurred speech, facial droop, weakness or numbness in an arm or leg, fainting or chest pain. These can be signs of a stroke or a heart problem. Dizziness after a head injury also needs medical assessment before chiropractic care.
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Q: Will I need a scan for dizziness?
A: Not usually. Imaging is not a routine part of assessing dizziness. If your examination suggests a scan or blood test will change what happens next, we refer you to your GP or arrange the appropriate referral.
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Q: Do I need a referral to be assessed for dizziness?
A: No referral is needed. Book online or call 0414 316 261, and allow about 45 minutes for your initial appointment. If you have results from your GP, ENT or audiologist, bring them along.
