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You Have Had All of the Tests, Blood Work, MRI's, CT's but No Results.

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Vertigo: Frequently Asked Questions

Understanding Vertigo

What is vertigo?
Vertigo is the false sensation that you or the world around you is spinning, tilting, or moving when nothing is actually in motion. It isn't a disease on its own — it's a symptom, and it points to a problem somewhere in the system your body uses to keep track of where it is in space.

That system draws on three inputs: the inner ear, your vision, and position sensors called proprioceptors, which are especially dense in the upper neck. Your brainstem takes all three signals and merges them into a single picture of your position. When one input disagrees with the others, the brainstem receives conflicting information, and the result is often the spinning sensation of vertigo.

Episodes can last seconds or hours. Many people also experience nausea, sweating, unsteadiness, or difficulty focusing their eyes during an attack.

What's the difference between vertigo and general dizziness?
"Dizziness" is a broad word people use for several different sensations, and telling them apart matters, because they point toward different causes.
-Vertigo — a spinning or rotational sensation, either of yourself or your surroundings. Usually points toward the inner ear, the upper neck, or the brainstem.
-Lightheadedness — feeling faint or like you might pass out. More often related to blood pressure, blood sugar, dehydration, or medication.
-Disequilibrium — unsteadiness on your feet without spinning. Often related to proprioception, muscle weakness, or neurological conditions.
-Brain fog or floating — a vague disconnected feeling, sometimes described as not being fully present.

When you describe your symptoms to any provider, be specific. "The room spins when I roll over in bed" tells us something very different than "I feel like I might faint when I stand up." That distinction often narrows the cause considerably.

What causes vertigo?
The most common causes include:
-BPPV (benign paroxysmal positional vertigo) — displaced calcium crystals in the inner ear, triggered by head position changes
-Vestibular neuritis or labyrinthitis — inflammation of the inner ear or vestibular nerve, often following a virus
-Ménière's disease — a disorder of inner ear fluid pressure
-Vestibular migraine — migraine that produces vertigo, sometimes without any headache at all
-Cervicogenic dizziness — dizziness originating from dysfunction in the upper neck
-Medication side effects — a frequently overlooked cause
-Head or neck trauma — including whiplash from a car accident, sometimes years earlier

More than one can be present at the same time, which is part of why vertigo is often difficult to pin down.

Specific Conditions

What is BPPV, and how is it treated?
BPPV is the single most common cause of vertigo. Small calcium carbonate crystals that normally sit in one part of the inner ear become displaced into the semicircular canals, where they disturb fluid movement and send false motion signals to the brain.

The hallmark is brief, intense spinning triggered by specific head positions — rolling over in bed, looking up at a shelf, lying back at the dentist. Episodes typically last under a minute.

BPPV responds well to canalith repositioning maneuvers, such as the Epley maneuver, which use gravity to guide the crystals back where they belong. If your presentation fits BPPV, that's the appropriate first-line treatment, and we'll tell you so directly. Some patients find their BPPV keeps recurring, and in those cases it's worth investigating whether upper cervical mechanics are a contributing factor.

Is Ménière's disease the same as vertigo?
No. Vertigo is a symptom; Ménière's disease is a specific inner ear disorder that produces vertigo as one of its features.

Ménière's is typically diagnosed by a cluster of four findings:
1.Episodes of vertigo lasting 20 minutes to several hours
2. Fluctuating hearing loss, usually in one ear
3. Tinnitus, often described as a low roar
4. A sensation of fullness or pressure in the affected ear

It's understood to involve excess fluid pressure in the inner ear, though why that happens isn't fully settled. Standard management includes dietary sodium reduction, diuretics, and in some cases procedures targeting the inner ear.

There's a longstanding clinical interest in the relationship between upper cervical alignment and Ménière's, based on case series suggesting some patients improve following atlas correction. The proposed mechanism involves the effect of upper cervical position on drainage and circulation near the ear. It's worth being straightforward: this research is preliminary, not conclusive. If you have diagnosed Ménière's, upper cervical care is reasonable to explore alongside your ENT's management, not as a replacement for it.

What is vestibular migraine?
Vestibular migraine causes vertigo, dizziness, and motion sensitivity as a migraine phenomenon — and confusingly, many people experience it without any head pain whatsoever. Patients often report sensitivity to light and sound, visual disturbance, or motion sickness during episodes.

It's one of the more commonly missed causes of recurring vertigo, particularly in patients with a personal or family history of migraine. If you have both headaches and vertigo, mention both, even if they never occur together.

Can neck problems cause vertigo?
Yes, and this is where our work is focused.The upper cervical spine — the atlas (C1) and axis (C2) — contains an unusually dense concentration of proprioceptors that report head position to the brainstem. When the atlas is misaligned, those receptors can send distorted positional information. Your brainstem then attempts to reconcile that faulty neck signal against what your eyes and inner ears are reporting, and the mismatch can produce dizziness, unsteadiness, or a spinning sensation.

This is called cervicogenic dizziness. Common features:
-Dizziness that worsens with neck movement or sustained postures
-Accompanying neck stiffness, tension, or headache
-Onset following a head or neck injury, including whiplash
-Unsteadiness more than true spinning, though both can occur
-Normal inner ear testing despite persistent symptoms

The upper cervical region also surrounds the vertebral arteries, which supply blood to the brainstem and inner ear structures, and sits adjacent to pathways affecting cerebrospinal fluid movement. Both are areas of active clinical interest in vertigo.

Upper Cervical Care and Vertigo
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How could an atlas misalignment cause dizziness?
The atlas is the top vertebra of the spine, and it sits directly beneath the skull, encircling the brainstem. It's the only vertebra with no disc above or below it, which allows remarkable range of motion — and also means it depends heavily on soft tissue for stability.

When the atlas shifts out of position, several things can follow:
-Distorted proprioceptive input — faulty position signals reaching the brainstem
-Altered autonomic regulation — the brainstem governs the autonomic nervous system, which influences blood pressure, heart rate, and inner ear fluid balance
-Vagus nerve irritation — contributing to nausea, which so often accompanies vertigo
-Changes in vertebral artery blood flow — affecting circulation to the brainstem and inner ear

Correcting the misalignment aims to remove that interference and let the system recalibrate.

How do you determine whether my atlas is misaligned?
We measure rather than guess. Your first visit at Atlas Specific Chiropractic includes:
-A thorough case history — including any head or neck trauma, even from years ago
-Tytron C5000 paraspinal infrared thermography — a non-contact scan detecting autonomic nervous system patterns along the spine, giving us an objective baseline
-Precision upper cervical X-rays — three specific views, measured to determine the exact direction and degree of misalignment in your particular anatomy

No two atlas misalignments are identical, so no two corrections should be. If your scans and history don't indicate an upper cervical problem, we'll tell you and point you toward the appropriate provider.

What is the correction like? Does it hurt?
We use the Advanced HIO Knee Chest technique — a precise, low-force correction delivered by hand while you rest in a knee-chest position. There's no twisting of the neck, no forceful thrust, and no popping or cracking sound.

Most patients are surprised by how little they feel. Because the adjustment is calculated from your own X-ray measurements, it uses only the force needed to move the atlas along its specific misalignment vector.

How quickly might I notice a change?
It varies considerably, and anyone promising you a specific timeline hasn't examined you yet.

Some patients notice a shift within minutes. Others improve gradually over days and weeks as the surrounding soft tissue adapts and holds the correction. Longstanding misalignments, particularly those tracing back to an old injury, generally take longer.

Some patients also experience a retracing response in the first days after correction — temporary tiredness, mild soreness, or brief symptom fluctuation as the nervous system adjusts. This is normal and short-lived, and we'll prepare you for it.

We track your progress with repeat Tytron scans rather than relying on impressions alone. If objective measures aren't moving, that's information, and we'll act on it.

Is upper cervical chiropractic safe if I have vertigo?
The technique we use involves no neck rotation and no high-velocity thrust, which addresses the primary safety concern people raise about neck adjustments.

That said, safety begins with an accurate diagnosis. Certain causes of vertigo require medical rather than chiropractic management, and part of our examination is determining whether you're in the right place. We refer out when that's the correct answer.

Tell us about any diagnosed vascular conditions, connective tissue disorders, recent trauma, or new neurological symptoms so we can factor them in.

When to Seek Immediate Care
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When is vertigo an emergency?
Certain symptoms alongside vertigo can indicate a stroke or another urgent condition. Seek emergency care immediately if vertigo occurs with:

Sudden severe headache unlike anything you've had before
-Double vision or loss of vision
-Slurred speech or difficulty finding words
-Weakness or numbness on one side of the body
-Facial drooping
-Difficulty walking or severe loss of coordination
-Sudden hearing loss
-High fever with neck stiffness

Vertigo caused by a problem in the brain can closely mimic inner ear vertigo. If something feels sharply different from your usual episodes, don't wait — get evaluated urgently.

Getting Started
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Do I need a referral to be seen?
No. You can schedule directly with our office.

Do you accept insurance?
We're out of network with insurance, which lets us build care around what your examination shows rather than what a policy will authorize. We accept HSA and FSA cards and provide detailed superbills you can submit to your insurer for potential reimbursement.

What if I've already tried everything?
Many of the patients we see have. They've been through ENT evaluations, MRIs, vestibular therapy, and medications, and they've been told their tests look normal — which is frustrating when you still can't turn your head without the room moving.

Normal inner ear testing doesn't mean nothing is wrong. It may mean the problem lies somewhere those tests don't examine. The upper cervical spine is one of those places, and it's rarely evaluated with the precision it requires.

Where are you located?
Atlas Specific Chiropractic is located in Hiawatha, serving patients throughout Cedar Rapids, Marion, Robins, North Liberty, Ely, and the wider Eastern Iowa area.

‍Atlas Specific Chiropractic
1350 Blairs Ferry Road, Suite B
Hiawatha, IA 52233
(319) 343-8540
iowaatlasspecific.com