Vertigo
Osteopathic Assessment & Supportive Management — Melbourne & Caroline Springs
Vertigo is a sensation of spinning or movement that can affect balance, confidence, and daily function. It is a symptom, not a diagnosis, and can arise from several different conditions — most commonly inner ear disorders.
At Live Well Health Centre, our osteopaths provide assessment and evidence-informed supportive management for people experiencing vertigo. Care focuses on identifying possible positional triggers, supporting safe movement, and guiding appropriate management strategies.
Management is individualised and may be provided alongside care from your GP or medical specialist where appropriate.
What is vertigo?
Vertigo is the sensation that you or your surroundings are moving or spinning when there is no actual movement.
It is commonly associated with disturbances in the vestibular system, which helps control balance and spatial orientation. This system involves:
- the inner ear
- the brain
- the visual system
- body position sensors
Vertigo can be brief or persistent, mild or severe, and may occur with movement or at rest depending on the cause.
Common symptoms
Vertigo may involve:
spinning sensation or movement illusion
dizziness triggered by head or body movement
balance problems or unsteadiness
nausea or vomiting
difficulty focusing visually
sensitivity to motion
feeling pulled or tilted
Symptoms can vary widely depending on the underlying condition.
Common causes of vertigo
Vertigo may be associated with several conditions, including:
- Benign Paroxysmal Positional Vertigo (BPPV) — most common
- vestibular neuritis or labyrinthitis
- inner ear disorders
- migraine-related vertigo
- cervicogenic (neck-related) dizziness
- medication or medical conditions
Accurate assessment is important because management depends on the cause.
BPPV-related vertigo and the Epley manoeuvre
One of the most common causes of vertigo is BPPV, which occurs when tiny calcium crystals in the inner ear move into areas that disrupt balance signalling.
BPPV typically causes brief spinning episodes triggered by head position changes, such as:
- rolling in bed
- looking up
- bending forward
- getting up quickly
When vertigo is confirmed to be consistent with BPPV, a specific positional technique called the Epley manoeuvre may be used as part of management.
The Epley manoeuvre is a sequence of guided head and body movements designed to help reposition displaced inner ear crystals. It is widely used in clinical practice for managing BPPV-related vertigo.
Your osteopath will only use repositioning manoeuvres where appropriate and safe based on assessment findings.
When is vertigo assessment important?
Assessment is recommended if you experience:
- spinning sensations triggered by movement
- balance problems or falls risk
- recurring dizziness
- uncertainty about the cause of symptoms
- symptoms affecting daily activity
Because vertigo has multiple possible causes, professional assessment helps determine appropriate management and whether medical referral is required.
Osteopathic assessment for vertigo
Assessment aims to identify likely contributing factors and determine whether symptoms are consistent with positional vertigo or another cause.
This may include:
- detailed symptom history
- identification of positional triggers
- observation of eye movement responses (where appropriate)
- balance and movement assessment
- neck movement evaluation
- screening for non-vestibular causes
If symptoms suggest a condition requiring medical investigation, referral to your GP or specialist will be recommended.
Osteopathic care does not replace medical diagnosis.
How osteopathy may support vertigo management
Osteopathic management aims to support safe movement, comfort, and functional balance. This may involve:
- positional assessment and movement guidance
- repositioning manoeuvres for BPPV where appropriate
- supporting neck comfort and mobility
- helping restore movement confidence
- education on symptom triggers and pacing
- gradual return to usual activity
Management is individualised and based on clinical findings.
Approaches that may be used
Depending on assessment findings, care may include:
- positional testing and movement guidance
- Epley manoeuvre for BPPV-related vertigo (when clinically appropriate)
- balance and movement support
- neck mobility and comfort strategies
- education on symptom management
- gradual movement re-exposure
Care is adapted to symptom sensitivity and safety.
Evidence and clinical guidelines
Vertigo and BPPV management are well established in clinical practice guidelines.
Key evidence sources:
American Academy of Otolaryngology — Head and Neck Surgery (AAO-HNS)
Clinical practice guideline: benign paroxysmal positional vertigo
National Institute for Health and Care Excellence (NICE)
Vertigo and vestibular disorders
Cochrane Review — Canalith repositioning procedures for BPPV
Vestibular Disorders Association (VeDA)
Vestibular disorder information
These sources support positional assessment and repositioning manoeuvres as standard management for many cases of BPPV.
What to expect from management
Experiences vary depending on the underlying cause. Progress may depend on:
- type of vertigo
- duration of symptoms
- sensitivity to movement
- adherence to management strategies
Some positional vertigo improves quickly, while other forms require gradual rehabilitation.
Self-management strategies your osteopath may discuss
- safe movement techniques
- pacing head movements
- sleep position guidance
- balance confidence strategies
- gradual return to activity
When to seek urgent medical review
Seek immediate medical attention if dizziness occurs with:
- severe sudden headache
- double vision
- slurred speech
- weakness or numbness
- difficulty walking
- chest pain
- fainting or loss of consciousness
These symptoms are not typical of simple positional vertigo.
Frequently asked questions
Is vertigo the same as dizziness?
Vertigo specifically refers to a spinning or movement sensation.
Is the Epley manoeuvre suitable for all vertigo?
No. It is used when vertigo is consistent with BPPV. Assessment determines suitability.
Is osteopathy a replacement for medical care?
No. Osteopathic care is supportive and may be used alongside medical assessment and management.
Related conditions
- Benign paroxysmal positional vertigo (BPPV)
- Vestibular dysfunction
- Cervicogenic dizziness
- Neck pain
- Balance disorders
Book an assessment
If you are experiencing vertigo or movement-related dizziness, our osteopaths can assess your symptoms and discuss appropriate supportive management.
Book an appointment to discuss your vertigo symptoms.
Health information disclaimer
This information is general education and is not a substitute for personalised medical advice. Individual assessment is required to determine appropriate care. Diagnosis and medical management should be guided by a qualified health professional.