CONDITIONS • WESTMINSTER, ARVADA, BROOMFIELD, THORTON & DENVER METRO
Vertigo Treatment in Westminster, CO
Vertigo is not just dizziness. It is a specific sensation — the world spinning when it should not be — and it almost always has a specific, identifiable cause that responds rapidly to the right treatment.
The episode that came out of nowhere. The spinning that woke you in the middle of the night when you rolled over. The moment in the shower that sent you grabbing for the wall. Vertigo can be terrifying when you do not understand what is causing it — and surprisingly straightforward to treat once you do. Understanding what is actually happening inside your inner ear, and what else in your body may be contributing, changes the entire picture.
Same-Day & Same-Week Appointments Available
WE UNDERSTAND WHAT YOU'RE GOING THROUGH
Vertigo is frightening in a way that is hard to convey to anyone who has not experienced it. It is not just being a little dizzy. It is the world genuinely spinning, often violently, without any warning.
It might have started when you turned over in bed and the ceiling began rotating. Or you bent down to pick something up and straightened too quickly and the room spun so severely you had to sit on the floor. Perhaps it came on during a car ride, or in the shower, or looking up at a high shelf. Between episodes there can be a lingering sense of imbalance, a subtle unsteadiness that makes you cautious about your movements. The anxiety about the next episode can be as disabling as the vertigo itself. You may have seen a doctor who told you it is likely BPPV or an inner ear problem, gave you some exercises, and sent you on your way — leaving you to manage it alone with only a partial understanding of what is happening. We want to offer something more complete: a clear explanation of the mechanism, a comprehensive assessment of all the contributing factors, and a treatment plan that addresses all of them.
WHAT YOU MAY BE EXPERIENCING
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A clear sensation of spinning — either you are spinning or the room is spinning around you
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Episodes triggered by specific head positions — lying down, rolling over, tilting the head back, or bending forward
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Nausea, sometimes severe, accompanying the spinning episodes
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A sense of being "off" — unsteady and mildly dizzy between acute episodes
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Episodes that last seconds to minutes for BPPV, or hours for Ménière's disease
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Neck stiffness, jaw pain, or headaches alongside the vertigo episodes
IF THIS SOUNDS FAMILIAR
You have probably been told you have BPPV (benign paroxysmal positional vertigo), labyrinthitis, or an inner ear problem. You may have been given the Epley maneuver — a series of head movements — which may have helped temporarily. The vertigo may have returned.
What you almost certainly have not been told is that the cervical spine, the jaw joint, and the nervous system all have direct connections to the inner ear's balance system — and that addressing only the inner ear while these contributors continue is why vertigo so commonly recurs.
WHAT YOU PROBABLY HAVEN'T BEEN TOLD
The most common type of vertigo is caused by tiny crystals in your inner ear that have moved out of place. It can be resolved in a single session — but only if the right maneuver is performed correctly, and only if the other contributors to your balance system are also addressed.
Your inner ear contains a structure called the vestibular system — essentially a set of fluid-filled canals and chambers that detect the movement and position of your head in space. Inside one part of this system, there are tiny calcium carbonate crystals called otoliths — or informally, "ear rocks." These crystals normally sit in a specific spot where they detect gravity, helping your brain understand which way is up. When these crystals become dislodged and migrate into the fluid-filled canals of the inner ear, they trigger false movement signals with every head movement. The brain receives a message saying the head is spinning when it is not, and the result is vertigo. This is BPPV — benign paroxysmal positional vertigo — and it is by far the most common cause of true vertigo.
THE EPLEY MANEUVER — WHY IT WORKS, WHY IT SOMETIMES DOES NOT, AND WHAT IS USUALLY MISSING
The Epley maneuver is a carefully sequenced series of head position changes designed to guide the displaced crystals back to the part of the inner ear where they belong. When performed correctly, with the right sequence for the specific canal involved, it is remarkably effective — often producing complete resolution within one to three sessions. When it does not work, the most common reasons are that the wrong canal variant has been identified (there are several canals, and each requires a slightly different maneuver), that the technique was not performed precisely enough, or that there are additional contributors to the balance problem — most commonly the cervical spine and the jaw — that were never assessed or addressed.
The key insight most patients never receive is this: the inner ear does not work in isolation. Your brain's sense of balance is constructed from three sources simultaneously — the inner ear, the eyes, and the proprioceptive system (the position sensors in your joints, muscles, and connective tissue, particularly in the cervical spine). When the cervical spine is restricted or the jaw joint is dysfunctional, it sends conflicting or distorted position signals to the brain that can either produce vertigo independently or make BPPV significantly worse and harder to treat. Successful treatment addresses all three inputs to the balance system — not only the inner ear crystals.
The cervical spine — the most overlooked contributor to vertigo
The upper cervical spine — the top two vertebrae in the neck — contains some of the densest concentration of proprioceptive receptors in the entire body. These receptors constantly send information to the brain about the position and movement of the head. When the upper cervical joints are restricted — which is extremely common and can result from an old whiplash injury, prolonged desk posture, or accumulated stress — they send distorted or conflicting position signals to the brain. The brain, trying to make sense of conflicting signals from the inner ear and the cervical spine simultaneously, can generate a sense of dizziness, unsteadiness, or frank vertigo. This is called cervicogenic dizziness, and it closely mimics and commonly coexists with BPPV.
Many patients treated only with the Epley maneuver experience incomplete or short-lived resolution because the upper cervical contribution to their balance disruption was never assessed or treated.
The tmj connection — a cause of vertigo that almost no one is told about
The temporomandibular joint — your jaw joint — sits immediately in front of the ear canal. The inner ear structures and the TMJ share anatomical proximity, nerve supply, and even some structural connections. Research has established a clear association between TMJ dysfunction and vestibular symptoms including vertigo, tinnitus (ringing in the ears), ear fullness, and balance problems. When the jaw is misaligned, clenched, or inflamed, it can directly affect the tension in the ligaments adjacent to the inner ear, alter the fluid pressure in the vestibular structures, and produce dizziness and vertigo that resolves once the TMJ dysfunction is correctly treated. This connection is rarely discussed in standard vertigo management — and it is the explanation for a significant number of vertigo patients whose symptoms do not fully respond to inner ear treatment alone.
If you have jaw pain, clicking, teeth grinding, or ear symptoms alongside your vertigo, the TMJ may be a primary or contributing driver of your dizziness.
Other types of vertigo — what they are and how to recognize them
BPPV is the most common cause of true vertigo but it is not the only one. Vestibular neuritis — inflammation of the vestibular nerve following a viral illness — produces severe, prolonged vertigo without positional triggering. Ménière's disease involves fluid pressure changes in the inner ear and produces episodic vertigo lasting hours, often with hearing loss and tinnitus. Vestibular migraine produces vertigo as part of the migraine spectrum, sometimes without head pain. Each of these has a different mechanism, a different presentation, and a different treatment emphasis. Accurate differentiation is essential — the Epley maneuver is highly effective for BPPV and irrelevant for vestibular neuritis. Treatment must match the diagnosis.
Important: sudden severe vertigo with neurological symptoms — double vision, difficulty speaking or swallowing, limb weakness — requires immediate medical evaluation to rule out central nervous system causes.
What a complete vertigo assessment actually looks like
A thorough assessment identifies the specific vertigo type through careful history and clinical testing — including provocation tests that identify which canal variant is involved in BPPV. It assesses the upper cervical spine for restriction and for cervicogenic dizziness contribution. It evaluates the TMJ for dysfunction that may be contributing through the vestibulo-cochlear proximity. It considers the vestibular-visual system interaction and identifies any training that can improve the brain's ability to process conflicting signals. And for chronic or recurrent vertigo, it considers the systemic contributors — systemic inflammation, blood pressure dysregulation, and nutritional factors — that can increase vestibular reactivity. This is the comprehensive approach that produces lasting resolution rather than repeated Epley maneuvers that manage the symptom without addressing its full cause.
UNDERSTANDING YOUR PAIN
Why vertigo presents so differently from person to person — and why identifying the type is the most important first step
The specific character of the vertigo — how it starts, how long it lasts, what triggers it, whether it is accompanied by hearing changes, and what other symptoms are present — all point toward the underlying mechanism. Getting this right determines everything about the treatment approach.
BPPV and positional vertigo
WHAT'S HAPPENING
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Displaced calcium crystals in the inner ear canals generating false spinning signals with head movement
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Often compounded by upper cervical restriction sending conflicting position signals to the brain
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TMJ dysfunction may be contributing to vestibular fluid pressure changes and amplifying the episode severity
WHAT IT FEELS LIKE
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Intense brief spinning triggered by specific head positions — rolling over, lying down, or tilting the head back
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Episodes lasting seconds to about a minute before settling
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Fine rapid eye movements called nystagmus during the episode
Cervicogenic and cervico-vestibular dizziness
WHAT'S HAPPENING
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Upper cervical joint restrictions generating distorted or conflicting position signals to the brainstem
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The brain receives conflicting balance information from the neck versus the inner ear and eyes — and dizziness is the result
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Often follows a whiplash injury, a period of prolonged neck tension, or worsens with neck stiffness
WHAT IT FEELS LIKE
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A constant low-level unsteadiness or lightheadedness rather than dramatic spinning
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Dizziness clearly associated with head and neck movements
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Neck pain or stiffness accompanying and preceding the dizziness episodes
Ménière's, vestibular migraine, and chronic vestibular dysfunction
WHAT'S HAPPENING
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Ménière's: abnormal fluid pressure in the inner ear producing prolonged vertigo episodes with hearing changes
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Vestibular migraine: migraine-related vestibular network dysregulation producing vertigo as part of the migraine spectrum
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Chronic vestibular dysfunction: the brain has not successfully recalibrated after an acute event and maintains ongoing dizziness and imbalance
WHAT IT FEELS LIKE
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Ménière's: prolonged attacks lasting hours, ear fullness, tinnitus, and fluctuating hearing
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Vestibular migraine: vertigo associated with or preceding headache, light and sound sensitivity
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Chronic dysfunction: persistent imbalance and motion sensitivity that does not resolve between episodes
When vertigo requires immediate medical attention
Most vertigo has a benign cause and responds excellently to conservative care. However, certain presentations require immediate medical evaluation: sudden, severe vertigo accompanied by double vision, difficulty speaking or swallowing, weakness or numbness in the limbs, difficulty walking, or a severe headache unlike any you have had before. These symptoms may indicate a central nervous system event and should be evaluated urgently. If your vertigo fits this description, please seek immediate medical care before scheduling with us. If it does not — and for the vast majority of vertigo sufferers it will not — we can help you significantly and often very quickly.
THE BIGGER PICTURE
What you've probably already tried
Most vertigo patients have received some form of the Epley maneuver — the standard repositioning technique for BPPV. Some have been prescribed vestibular suppressant medications. A smaller number have been referred to vestibular rehabilitation. Very few have had the cervical spine, the TMJ, and the systemic contributors specifically assessed and treated as part of their care.
TREATMENTS PEOPLE TYPICALLY TRY
✓ Epley maneuver or Semont maneuver for BPPV
✓ Vestibular suppressant medications — meclizine, antihistamines
✓ Home Epley instructions to perform independently
✓ Vestibular rehabilitation exercises from a physiotherapist
✓ Low-sodium diet for Ménière's disease
✓ Steroid injections or surgery for refractory cases
None of these address the upper cervical spine's contribution to the balance system, the TMJ connection, or the systemic internal drivers of vestibular reactivity and fluid regulation.
THE EXPERIENCE MOST VERTIGO PATIENTS DESCRIBE
The Epley worked. For three weeks. Then you rolled over in bed one night and it was back. The doctor did it again. It resolved. Then it returned. This has now happened four times. You have been told this is just something that recurs with BPPV and you should do the exercises at home whenever it happens. This feels like managing a condition rather than resolving its underlying cause.
"The crystals keep coming back. I've had the Epley maneuver done five times now. The doctor says some people just have recurring BPPV. Is there nothing that actually prevents it from coming back?"
In many cases, yes — there are factors that predispose the crystals to repeatedly dislodge, and identifying and addressing them changes the recurrence pattern significantly. Restricted upper cervical joints that send abnormal signals to the balance center and increase its overall reactivity. Vitamin D deficiency, which is directly associated with higher rates of crystal dislodgement. Osteoporosis-related changes in crystal density. Systemic inflammation affecting vestibular fluid regulation. These are all identifiable and treatable.
OUR FRAMEWORK
What's actually driving your vertigo
Vertigo is rarely a simple inner ear problem in isolation. The cervical spine and jaw joint providing position information to the same brainstem center that processes inner ear signals, the nervous system's overall reactivity and adaptation capacity, and the internal biochemical environment that determines vestibular fluid regulation and crystal stability all contribute — and all can be meaningfully improved.
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The Physical System
The inner ear, the upper cervical spine, and the TMJ — the three anatomical regions whose position signals converge in the brainstem to create the brain's sense of balance
What goes wrong
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BPPV: displaced otolith crystals in the semicircular canals generate false movement signals with each head position change — the canal acts like a spirit level with a pebble in it, generating misleading readings whenever the head moves
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Cervical restriction: the upper cervical joints lose their normal mobility, degrading the quality of the position signals they send to the brainstem. The brainstem receives conflicting information from the inner ear and the neck and generates dizziness in an attempt to resolve the conflict
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TMJ dysfunction: the jaw joint shares its anatomical neighborhood with the inner ear — inflammation, misalignment, or muscle tension in the TMJ directly affects the vestibulo-cochlear structures and can alter inner ear fluid pressure
Why addressing all three matters
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Your brain constructs its sense of balance from three inputs simultaneously: the inner ear, the eyes, and the proprioceptive sensors in the joints and muscles — primarily the neck. When any one of these sends a distorted signal, the brain can generate dizziness while trying to reconcile the conflicting information
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Treating the inner ear alone while the cervical spine sends competing distorted signals leaves the balance system in a state of conflict — the crystals may be repositioned but the neck is still generating a contribution to dizziness that was never corrected
Patients with both BPPV and cervical restriction often see their vertigo frequency and severity reduce significantly after upper cervical treatment even before the BPPV itself is addressed — because the overall balance system disruption is reduced.
What this means
If your headaches begin at the base of the skull, travel over the top of the head, or are accompanied by neck stiffness, there is almost certainly a cervical structural component that has never been properly treated. This is not a secondary finding. It is likely the primary source of your headache pain — and it responds directly to treatment when correctly identified.
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The Nervous System
How the brain adapts to vestibular disruption — and why this adaptation capacity, when impaired, produces chronic dizziness that outlasts the original cause
What goes wrong
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The brain has a remarkable ability to compensate for vestibular disruption — given sufficient exposure to movement and appropriate challenges to the balance system, it will recalibrate and reduce dizziness over time. This process is called vestibular compensation. It requires movement to work — it is the reason people who become very still and avoidant after a vertigo episode often develop chronic dizziness long after the original inner ear event has resolved.
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The sympathetic nervous system — the stress response system — directly suppresses vestibular compensation. High stress, poor sleep, and chronic anxiety significantly impair the brain's ability to recalibrate its balance system. This is a major reason people under significant life stress have more frequent and more severe vertigo episodes.
Vestibular suppressant medications — while helpful in acute episodes — actually slow or block the brain's natural compensation process when used long-term. They need to be used judiciously and for the shortest necessary period.
What this feels like
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A persistent sense of unsteadiness, fogginess, or mild dizziness that lingers between acute vertigo episodes
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Significant motion sensitivity — crowded spaces, scrolling on screens, or moving vehicles producing discomfort
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Vertigo episodes clearly clustered around periods of high stress, poor sleep, or illness
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An anxiety about movement that leads to avoidance — which paradoxically slows the brain's ability to adapt and compensate
What this means
Vestibular rehabilitation exercises — specifically designed to challenge the balance system progressively — are a critical component of care, not only for chronic dizziness but for accelerating recovery from BPPV and reducing recurrence. Chiropractic care to the upper cervical spine directly improves the quality of proprioceptive input to the brainstem, supporting the compensation process from the structural side. Constitutional hydrotherapy and autonomic regulation reduce the sympathetic suppression of vestibular compensation, allowing the brain to adapt more quickly and more completely. Managing stress and sleep quality as part of the treatment plan directly reduces episode frequency and severity.
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The Biochemical System
The internal conditions that determine whether the inner ear crystals are stable, whether vestibular fluid regulation is normal, and whether the vestibular system is chronically reactive
What Goes Wrong
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Vitamin D deficiency is directly associated with higher rates of BPPV recurrence. The inner ear crystals are made of calcium carbonate — a calcium compound — and their stability is directly influenced by the body's calcium and vitamin D metabolism. Research has demonstrated that vitamin D supplementation in deficient BPPV patients significantly reduces recurrence rates. This is one of the most evidence-supported internal interventions in vertigo care and is almost never assessed.
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Ménière's disease involves abnormal regulation of the fluid pressure inside the inner ear. Systemic inflammation, dietary sodium intake, hormonal dysregulation, and gut health all influence this fluid regulation. Naturopathic approaches to reducing systemic inflammation and regulating fluid balance can significantly reduce Ménière's episode frequency.
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Blood pressure dysregulation — particularly postural hypotension where blood pressure drops when standing — produces dizziness that closely mimics vestibular vertigo and is completely missed when the inner ear is treated without blood pressure assessment
What this feels like
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Frequent BPPV recurrence — multiple episodes per year — when vitamin D status has never been assessed
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Ménière's-type vertigo varying with dietary changes, menstrual cycle, or hormonal treatment
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Dizziness specifically on standing from a seated or lying position — postural hypotension pattern
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Vertigo worsening significantly with illness, high-sodium diet, or periods of poor hydration
What this means
Naturopathic assessment of vitamin D status, calcium metabolism, systemic inflammation, blood pressure regulation, hormonal health, and gut function provides the internal picture that standard vertigo care completely omits. For patients with recurrent BPPV, vitamin D and calcium optimization can change the recurrence pattern profoundly — this is one of the highest-yield internal interventions in all of vertigo management. For Ménière's patients, the naturopathic approach to fluid regulation and inflammation management is as important as any local vestibular treatment. And for patients whose dizziness has a postural blood pressure component, identifying and correcting this changes the entire clinical picture.
OUR APPROACH
How we treat vertigo differently
We identify the specific vertigo type and canal involved, perform the appropriate repositioning maneuver with precision, correct the cervical spine and TMJ contributions to the balance system, support the brain's compensation process through vestibular rehabilitation, and address the internal biochemistry that either promotes crystal stability or predisposes recurrence. All simultaneously.
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Identify the specific type and reposition the inner ear, then address the cervical and TMJ contributors
The correct canal variant must be identified before the maneuver is selected. The cervical spine and TMJ assessment follows immediately.
Specific upper cervical mobilization — C1 and C2 in particular — to restore the quality of proprioceptive signals from the cervical spine to the brainstem and eliminate the cervicogenic dizziness component that may be contributing to or mimicking BPPV
Vestibular Assessment and Repositioning
Dix-Hallpike and roll tests identify the specific canal variant involved. The correct Epley, Semont, or Barbecue roll maneuver is selected and performed with precision. One to three sessions typically achieves resolution for BPPV when the correct variant is identified and the technique is applied correctly
Assess the jaw joint for dysfunction contributing to vestibular symptoms through vestibulo-cochlear proximity. Treat identified TMJ dysfunction through specific mobilization, dry needling of the masseter and pterygoids, and appropriate exercises. See our TMJ Treatment page for full details of this approach
Vestibular rehabilitation exercises including gaze stabilization, balance training, and progressive habituation exercises to accelerate the brain's recalibration after BPPV or vestibular neuritis and reduce the chronic dizziness that can outlast the acute event
WHAT THIS CORRECTS
Crystal repositioning · Cervicogenic dizziness · TMJ vestibular contribution · Brain recalibration
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Support the nervous system's compensation process and reduce the stress-driven component
The brain needs both the structural input corrected and the nervous system calmed for full vestibular compensation to occur — particularly in recurrent and chronic cases.
Regulate the autonomic nervous system to reduce the sympathetic suppression of vestibular compensation, directly supporting the brain's ability to recalibrate — one of the most underutilized interventions in chronic dizziness management
Consistent cervical mobilization progressively improves the quality of the proprioceptive input the brainstem is receiving, allowing the balance center to recalibrate against a cleaner set of inputs and reducing the overall dizziness burden
Applied to the cervical spine and, where appropriate, the periauricular region — reducing local neural inflammation that may be contributing to vestibular reactivity from the cervical and otolithic structures
Direct guidance on the sleep quality and stress reduction strategies that most significantly reduce vestibular episode frequency — given that sympathetic activation is a proven trigger for both BPPV recurrence and Ménière's episodes
WHAT THIS CORRECTS
Vestibular compensation capacity · Sympathetic suppression · Chronic dizziness · Recurrence prevention
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Optimize the internal environment for crystal stability and vestibular fluid regulation
Particularly important for recurrent BPPV, Ménière's disease, and any vertigo associated with hormonal or metabolic change.
Identify and treat vitamin D and calcium metabolism contributing to crystal instability, systemic inflammation affecting vestibular fluid regulation, hormonal drivers, blood pressure dysregulation, and gut health — the complete internal picture of vestibular health
Advanced lab Testing
Vitamin D levels, calcium and parathyroid function, inflammatory markers, hormonal status, blood pressure evaluation, and metabolic markers — the internal assessment that recurrent vertigo almost never receives in standard care
Vitamin D and calcium optimization for crystal stability, anti-inflammatory protocols for vestibular reactivity, and specific nutritional approaches for Ménière's fluid regulation — interventions directly supported by the vertigo research literature
Reduce systemic inflammation, support autonomic balance, improve the circulation and metabolic environment of the inner ear structures, and promote the deep recovery state that vestibular compensation requires
WHAT THIS CORRECTS
Crystal instability · Vestibular fluid dysregulation · Vitamin D status · Hormonal vestibular drivers
THE TMJ AND VERTIGO CONNECTION
Do you have jaw pain, clicking, teeth grinding, or a sense of ear fullness alongside your vertigo?
The temporomandibular joint sits millimeters from the inner ear canal. When the jaw is misaligned, inflamed, or under chronic muscular tension from clenching and grinding, it creates direct mechanical and neurological effects on the adjacent vestibular structures. TMJ-related vertigo, tinnitus, and ear pressure are among the most commonly misattributed vestibular symptoms — and the most reliably resolved when the jaw dysfunction is properly treated.
If your vertigo is accompanied by any jaw, ear, or facial symptoms, our TMJ evaluation should be part of your initial assessment. For many patients, treating the jaw is the most important intervention for their dizziness.
WHY THIS APPROACH WORKS
We treat the balance system as a whole — inner ear, cervical spine, jaw, nervous system, and internal biochemistry together
Your brain builds its sense of balance from three sources: the inner ear, the eyes, and the position sensors in the neck and body. Vertigo occurs when these sources conflict or when the inner ear itself generates false movement signals. Standard care addresses only the inner ear. We address all three inputs — and we address the internal conditions that determine whether the crystals are stable and the vestibular system is reactive or settled. This is why our patients achieve resolution where repeated Epley maneuvers alone could not.
✓ The inner ear crystals repositioned correctly for the specific canal involved
✓ The upper cervical spine and TMJ contributing conflicting signals to the brainstem
✓ The internal vitamin D status, inflammation, and fluid regulation driving crystal instability and vestibular reactivity
Vertigo is not something you just live with. It is something you resolve — once the complete picture of what is generating it is understood and addressed.
WHO THIS IS FOR
This approach is for people whose vertigo...
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Is new and they want it resolved quickly and completely rather than managed through repeated repositioning procedures
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Keeps recurring after the Epley maneuver — the recurrence driver has not been identified or addressed
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Is accompanied by neck pain, jaw symptoms, tinnitus, or ear pressure — suggesting cervical and TMJ contributions
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Is Ménière's-related and they want a comprehensive approach to fluid regulation and inflammation management alongside medical management
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Has left them with chronic dizziness and motion sensitivity between episodes — the nervous system compensation process needs direct support, not just more repositioning maneuvers
TAKE THE NEXT STEP
Vertigo has a cause. In most cases, it has several. We find all of them — and treat all of them.
We assess the inner ear, cervical spine, TMJ, and internal biochemistry together — and treat the whole picture.
Not sure where to begin? Give us a call and we'll help you choose the best first step.