Who Should I See For Dizziness?
Written by Dr. Tyler Steward, DC - 2-minute read
Dizziness is a term that encompasses sensations such as vertigo (a spinning sensation), lightheadedness, and imbalance. Each sensation helps the doctor determine the underlying cause and its location. Since there are many causes of dizziness, it is paramount that you receive a thorough examination and diagnosis. The aim of this article is to help you understand who to go to when you have dizziness.
Emergency Room / Urgent Care
Though rare, roughly 2.2% of isolated vertigo is from a stroke; therefore, any patient who has had a new and unexplained episode of vertigo should be evaluated urgently for a stroke. [1] This should be done at your nearest emergency room or urgent care center.
Once the ER rules out a stroke, they will likely evaluate for benign paroxysmal positional vertigo (BPPV). BPPV is one of the most common causes of vertigo and is very effectively treated with an Epley Maneuver. [2]
General Practitioner / Family Physician
Next, any patient who is dealing with dizziness should have updated blood work to rule in/out any metabolic, autoimmune, or infectious causes. [3] Typically, your general practitioner or family physician is the one you would go to for this. We have wonderful Family Physicians in the St Croix Valley, such as Allina Health and Hudson Physicians.
A Dizziness Specialist
Once the above steps are completed, and there is still no known cause, you should have a full vestibular workup from a dizziness specialist. Unfortunately, there is a lack of providers who specialize in dizziness. You should ask your Family Physician for a good referral, then verify that the specialist has training in dizziness. The specialist will conduct an examination to determine whether any further diagnostic testing is needed and which treatments will address the underlying cause. A regularly overlooked cause of dizziness is neck dysfunction. At The Steward Clinic, we specialize in treating patients with dizziness. With our cone-beam CT (CBCT) unit, we can view the upper neck in great detail, enabling precise treatment.
Dr. Tyler Steward has postdoctoral training in vestibular rehabilitation and has published practice-based research on improving dizziness outcomes in his patients. In fact, he published a study in the Journal of Contemporary Chiropractic on a series of patients that he treated. [4] The average objective improvement was ~70% within 30-days following an initial plan of care.
Contact us today to see if you are a candidate for our treatment.
When Should You Consider Upper Cervical Chiropractic Care?
We help people of all ages who are experiencing dizziness or other issues related to the upper cervical spine. We are located in River Falls, WI, and serve patients who travel from Hudson, Ellsworth, New Richmond, rural St. Croix and Pierce County, as well as the East Minneapolis Metro, including Woodbury and Stillwater.
When is Upper Cervical Evaluation and Treatment Appropriate?
Upper Cervical Care is likely to be effective in patients who have neck pain and/or restricted range of motion, along with their dizziness.
Upper Cervical Chiropractic evaluation may prove beneficial for patients who’ve had other imaging and tests that were normal.
When Is Upper Cervical Care Not Appropriate?
Anyone who has had an initial and new bout of vertigo without a prompt Emergency Care evaluation first.
Anyone who has classic BPPV symptoms and has not been evaluated and/or treated for BPPV (we can do this at The Steward Clinic)
Anyone who has untreated autoimmune, infectious, or metabolic conditions. Upper Cervical Care may be a great addition to their care routine, but the underlying physiology must be addressed first.
Citations:
Kerber KA, Zahuranec DB, Brown DL, Meurer WJ, Burke JF, Smith MA, Lisabeth LD, Fendrick AM, McLaughlin T, Morgenstern LB. Stroke risk after nonstroke emergency department dizziness presentations: a population-based cohort study. Ann Neurol. 2014 Jun;75(6):899-907. doi: 10.1002/ana.24172. Epub 2014 May 26. PMID: 24788511; PMCID: PMC4286199.
Bhattacharyya N, Gubbels SP, Schwartz SR, Edlow JA, El-Kashlan H, Fife T, Holmberg JM, Mahoney K, Hollingsworth DB, Roberts R, Seidman MD, Steiner RW, Do BT, Voelker CC, Waguespack RW, Corrigan MD. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update). Otolaryngol Head Neck Surg. 2017 Mar;156(3_suppl):S1-S47. doi: 10.1177/0194599816689667. PMID: 28248609.
Girasoli L, Cazzador D, Padoan R, Nardello E, Felicetti M, Zanoletti E, Schiavon F, Bovo R. Update on Vertigo in Autoimmune Disorders, from Diagnosis to Treatment. J Immunol Res. 2018 Sep 26;2018:5072582. doi: 10.1155/2018/5072582. PMID: 30356417; PMCID: PMC6178164.
