Written by Dr Julian Simpson — Chiropractor with 15+ years of experience, Board Member of the Chiropractic Australia Research Foundation, and author/reviewer of 800+ health articles. Radial vs Focused Shockwave Therapy for Tendinopathy: What the Latest Research Says Tendon pain can be frustrating, persistent, and difficult to fully resolve — especially when it starts interfering with work, sport, gym training, or everyday movement. Whether you are dealing with tennis elbow from repetitive lifting, shoulder pain from tradie work, Achilles pain from running around Sunbury, or knee tendon pain from local sports competition across Melbourne, chronic tendinopathy can significantly impact your quality of life. At Health Wise Chiropractic, one of the most common questions we hear is: “What’s the difference between radial and focused shockwave therapy — and which one works better?” A major 2025 systematic review and meta-analysis examined exactly that question, comparing Radial Shockwave Therapy (RSWT) and Focused Shockwave Therapy (FSWT) across multiple tendon conditions. Here’s what the latest evidence means for patients looking for shockwave therapy treatment in Sunbury and surrounding Melbourne suburbs. What Is Tendinopathy? Tendinopathy refers to chronic tendon pain and dysfunction caused by repeated mechanical overload. Common examples include: Tennis elbow Golfer’s elbow Rotator cuff tendinopathy Achilles tendinopathy Patellar tendinopathy (jumper’s knee) Gluteal tendinopathy Shoulder calcification injuries Research shows tendinopathy commonly affects: Athletes Gym-goers Tradespeople Office workers Runners Active adults People performing repetitive lifting or gripping tasks Without proper treatment, tendon pain can become chronic and harder to resolve. What Is Shockwave Therapy? Shockwave therapy is a non-invasive treatment that uses acoustic pressure waves to stimulate healing within injured tissue. There are two primary types: Radial Shockwave Therapy (RSWT) Radial shockwave therapy disperses energy over a broader area and works more superficially within tissues. It is commonly used for: Tennis elbow Plantar fasciitis Achilles tendinopathy General muscular tightness Broad tendon irritation Focused Shockwave Therapy (FSWT) Focused shockwave therapy concentrates energy at a precise depth and focal point. This allows treatment of deeper tissue structures and more targeted tendon pathology. Focused shockwave is often used for: Deep tendon injuries Calcific shoulder tendinopathy Persistent chronic tendon pain More localised tissue degeneration Which Shockwave Therapy Worked Better? Focused Shockwave Therapy Showed Better Pain Reduction The pooled analysis found that Focused Shockwave Therapy (FSWT) demonstrated statistically superior pain reduction compared with radial shockwave therapy when used alone. Researchers reported: Statistically significant pain reduction favouring FSWT Stronger mid-term improvement beyond 12 weeks Better long-term outcomes in some shoulder tendinopathy studies One study involving non-calcific rotator cuff tendinopathy found: Both RSWT and FSWT improved symptoms However, FSWT showed superior long-term outcomes beyond 24 weeks Another study on tennis elbow found: Both treatments improved pain and function FSWT produced more sustained benefits over time Radial Shockwave Therapy May Improve Strength More Effectively Interestingly, the research also found that RSWT may provide greater improvements in wrist extensor strength, particularly in tennis elbow cases. The pooled analysis showed: A statistically significant improvement in wrist extensor strength favouring RSWT Benefits observed in both short-term and mid-term follow-up periods Researchers believe this may occur because radial shockwave treats a broader treatment area, including surrounding forearm muscles and tendon structures. This may make RSWT particularly useful for: Tennis elbow Forearm overuse injuries Grip-related dysfunction Occupational repetitive strain injuries Both Treatments Were Found to Be Safe Reported side effects included: Mild skin redness Temporary bruising Minor swelling Temporary discomfort during treatment Researchers noted that local anaesthetic was generally not required for low-energy shockwave therapy. Shockwave Therapy May Work Best Alongside Rehabilitation The review highlighted that shockwave therapy is often combined with: Strengthening exercises Eccentric loading programs Chiropractic care Manual therapy Mobility rehabilitation Sports rehabilitation At Health Wise Chiropractic, we commonly combine shockwave therapy with evidence-based rehabilitation approaches to improve long-term tendon recovery. This is particularly important because tendinopathy is no longer viewed as simply “inflammation.” Modern research shows tendon pain also involves: Collagen degeneration Reduced tendon healing capacity Altered pain processing Nervous system sensitisation Reduced tendon load tolerance Why Tendon Pain Can Become Chronic The review explained that chronic tendinopathy involves complex biological changes within the tendon. Shockwave therapy may help stimulate: New blood vessel formation Tendon regeneration Collagen production Fibroblast activity Tissue remodelling Cellular repair mechanisms Researchers also noted that chronic tendon pain may involve central sensitisation, where the nervous system becomes increasingly sensitive to pain signals over time. This helps explain why some tendon injuries persist for months — even when scans do not appear severely damaged. Which Shockwave Therapy Is Better Overall? The honest answer from the research is: There is currently no clear overall winner. The review concluded: FSWT may provide superior pain reduction in some tendon conditions RSWT may improve muscle strength more effectively in tennis elbow Both therapies appear safe and clinically useful More high-quality studies are still needed Researchers also noted that treatment protocols varied significantly between studies, including: Number of shocks Energy settings Session frequency Treatment duration Exercise integration This makes direct comparisons challenging. Who May Benefit From Shockwave Therapy? Shockwave therapy may help people suffering from: Tennis elbow Shoulder tendinopathy Achilles tendinopathy Jumper’s knee Rotator cuff pain Chronic tendon irritation Persistent sports injuries Repetitive strain injuries It may be particularly useful for patients who have: Ongoing tendon pain lasting longer than 3 months Failed to improve with rest alone Plateaued with standard physiotherapy Recurring flare-ups Difficulty exercising due to pain Shockwave Therapy in Sunbury & Melbourne At Health Wise Chiropractic, we provide shockwave therapy as part of an integrated treatment approach for chronic tendon and musculoskeletal injuries. We regularly help patients from: Sunbury Melton Craigieburn Gisborne Keilor Melbourne Whether your tendon pain is coming from sport, gym training, work demands, or everyday wear and tear, an accurate assessment is the first step toward recovery. Book a Shockwave Therapy Assessment If you are dealing with persistent tendon pain, our team can help determine whether radial or focused shockwave therapy may be appropriate for your condition. How Chiropractic Care May Help At Health Wise Chiropractic, we take a comprehensive approach to posture-related care. Treatment may include: Chiropractic adjustments Postural assessment Soft tissue therapy Corrective exercises Ergonomic advice Laser therapy Shockwave therapy Spinal decompression therapy We focus on addressing both the symptoms and the underlying biomechanical stress contributing to neck dysfunction. About the Author Dr Julian Simpson is an Australian chiropractor with over 15 years of experience in musculoskeletal healthcare and rehabilitation. He is a Board Member of the Chiropractic Australia Research Foundation and has reviewed and written more than 800 evidence-based health articles focused on spinal health, rehabilitation, sports injuries and conservative care approaches. His treatment focus includes: Chiropractic adjustments Sports chiropractic Massage therapy Shockwave therapy Laser therapy Non-surgical spinal decompression Dr Simpson provides patient care through Healthwise Chiropractic, serving communities including Sunbury, Melton, Diggers Rest and surrounding regions. Reference Stania M, Pawłowski M, Benduch M, Dudon A, Hirjaková Z, Bzdúšková D, Kimijanová J. Efficacy of radial and focused shockwave therapy for tendinopathy: a systematic review and meta-analysis. Sci Rep. 2026 Feb 6;16(1):7632. doi: 10.1038/s41598-026-37160-3. PMID: 41651897; PMCID: PMC12936064.

Written by Dr Julian Simpson — Chiropractor with 15+ years of experience, Board Member of the Chiropractic Australia Research Foundation, and author/reviewer of 800+ health articles. Focused Shockwave Therapy for Shoulder Pain: What the Research Says Shoulder pain can make everyday life frustrating — from lifting groceries at Sunbury Square Shopping Centre to reaching overhead at work or trying to get comfortable at night. For many people across Sunbury and Melbourne’s north-west, persistent shoulder pain can linger for months despite rest, medication, or exercise. One of the most common causes of ongoing shoulder pain is rotator cuff tendinopathy, a condition involving irritation and degeneration of the shoulder tendons. Recent research has shown promising results for focused extracorporeal shockwave therapy (F-SWT) as a non-invasive treatment option for chronic shoulder pain and rotator cuff injuries. At Health Wise Chiropractic, we regularly see patients struggling with stubborn shoulder pain caused by work, sport, gym training, poor posture, and repetitive overhead activity. This article breaks down the latest evidence in simple terms and explains how shockwave therapy may help. What Is Rotator Cuff Tendinopathy? The rotator cuff is a group of muscles and tendons that stabilise the shoulder joint and help with lifting and rotating the arm. When these tendons become overloaded or irritated over time, it can lead to: Persistent shoulder pain Pain lifting the arm overhead Weakness Difficulty reaching behind the back Pain sleeping on the affected side Reduced shoulder mobility Research shows shoulder pain affects between 7% and 27% of the general population, making it one of the most common musculoskeletal complaints seen in healthcare. For many office workers, tradies, gym-goers, and active adults around Sunbury, repetitive strain and poor shoulder mechanics can gradually contribute to tendon degeneration and chronic inflammation. Why Traditional Treatments Don’t Always Work Conservative treatments for shoulder tendinopathy often include: Anti-inflammatory medication Physiotherapy Cortisone injections Rest and activity modification While these approaches can help some people temporarily, research has shown that more than half of patients continue to experience recurring or persistent shoulder pain long term. That’s why interest has grown in newer regenerative therapies like shockwave therapy. What Is Shockwave Therapy? Shockwave therapy uses acoustic pressure waves to stimulate healing within injured tissues. The research identified several possible benefits of shockwave therapy, including: Increasing blood flow Stimulating tissue repair Promoting growth factors Reducing pain sensitivity Improving tendon healing There are two main types: Focused Shockwave Therapy (F-SWT) Focused shockwaves penetrate deeper and target damaged tissue more precisely. Radial Shockwave Therapy (R-SWT) Radial shockwaves spread more broadly and lose energy as they travel through tissue. The study specifically compared these two approaches for non-calcific rotator cuff tendinopathy. Key Research Findings Focused Shockwave Therapy Reduced Pain More Effectively Pain Scores at 48 Weeks At nearly one year after treatment: Focused shockwave patients averaged 1.4/10 pain Radial shockwave patients averaged 3.0/10 pain This suggests focused shockwave therapy may provide more sustained long-term relief. Shoulder Function Improved Significantly Patients receiving focused shockwave therapy reported better: Daily function Shoulder mobility Pain reduction Quality of life MRI Scans Showed Tendon Healing Improvements One of the most interesting findings was that MRI imaging showed measurable tendon improvement after focused shockwave therapy. At 24 Weeks 82% of focused shockwave patients showed MRI improvement Compared with only 23% in the radial shockwave group At 48 Weeks 100% of focused shockwave patients improved by at least one MRI grade Compared with 50% of radial shockwave patients This suggests the treatment may help support actual tendon healing — not just temporary pain relief. Why Focused Shockwave Therapy May Work Better Researchers believe focused shockwave therapy may provide superior results because it: Penetrates deeper into tendon tissue Delivers more concentrated energy Stimulates new blood vessel growth Promotes tissue regeneration Improves tendon-to-bone healing The study also discussed how focused shockwave therapy may encourage: Neovascularisation (formation of new blood vessels) Increased healing growth factors Improved tendon strength Reduced inflammatory pain chemicals These healing processes can take time, which may explain why the greatest improvements appeared after 24 to 48 weeks. Is Shockwave Therapy Safe? The study found shockwave therapy was generally safe and well tolerated. Reported side effects were mild and temporary, including: Temporary soreness Skin redness Mild discomfort during treatment Importantly: No serious complications were reported No surgery was required No injections or medications were needed during treatment Who May Benefit from Shockwave Therapy? Shockwave therapy may help people experiencing: Chronic shoulder pain Rotator cuff tendinopathy Shoulder impingement Tendon degeneration Pain with overhead movement Persistent symptoms despite physio or medication At Health Wise Chiropractic, we commonly see shoulder pain in: Office workers Tradespeople Gym enthusiasts Tennis and golf players Swimmers Parents lifting young children Drivers with repetitive shoulder strain How Chiropractic Care May Help At Health Wise Chiropractic, we take a comprehensive approach to posture-related care. Treatment may include: Chiropractic adjustments Postural assessment Soft tissue therapy Corrective exercises Ergonomic advice Laser therapy Shockwave therapy Spinal decompression therapy We focus on addressing both the symptoms and the underlying biomechanical stress contributing to neck dysfunction. About the Author Dr Julian Simpson is an Australian chiropractor with over 15 years of experience in musculoskeletal healthcare and rehabilitation. He is a Board Member of the Chiropractic Australia Research Foundation and has reviewed and written more than 800 evidence-based health articles focused on spinal health, rehabilitation, sports injuries and conservative care approaches. His treatment focus includes: Chiropractic adjustments Sports chiropractic Massage therapy Shockwave therapy Laser therapy Non-surgical spinal decompression Dr Simpson provides patient care through Healthwise Chiropractic, serving communities including Sunbury, Melton, Diggers Rest and surrounding regions. reference Li C, Li Z, Shi L, Wang P, Gao F, Sun W. Effectiveness of Focused Shockwave Therapy versus Radial Shockwave Therapy for Noncalcific Rotator Cuff Tendinopathies: A Randomized Clinical Trial. Biomed Res Int. 2021 Jan 9;2021:6687094. doi: 10.1155/2021/6687094. PMID: 33506031; PMCID: PMC7811429.

Written by Dr Julian Simpson — Chiropractor with 15+ years of experience, Board Member of the Chiropractic Australia Research Foundation, and author/reviewer of 800+ health articles. Focused Shockwave Therapy for Low Back Pain: What the Latest Research Means for Patients in Sunbury & Melbourne Low back pain is one of the most common musculoskeletal conditions worldwide, affecting up to 84% of people during their lifetime. Research also shows around 25–78% of patients experience recurring back pain within the first year, while chronic low back pain lasting longer than 12 weeks affects up to 7% of the population. At Health Wise Chiropractic, we regularly help patients across Sunbury, Melbourne, and surrounding suburbs who are struggling with ongoing back stiffness, disc-related pain, sciatica, muscle tension, and chronic flare-ups that have not fully responded to standard treatments. New research into Focused Extracorporeal Shockwave Therapy (Focused ESWT) is showing promising results for reducing chronic low back pain and improving movement without surgery or injections. What Is Focused Shockwave Therapy? Focused Shockwave Therapy (Focused ESWT) is a non-invasive treatment that uses targeted acoustic waves to stimulate healing deep within injured tissues. Unlike traditional radial shockwave devices that mainly treat superficial tissue, focused shockwave therapy can target deeper spinal and muscular structures more precisely. Research suggests focused shockwave therapy may help: Reduce chronic inflammation Improve blood flow and tissue healing Decrease muscle spasm and stiffness Stimulate cellular repair Reduce pain sensitivity in irritated nerves Improve mobility and function This makes it highly relevant for patients dealing with: Chronic low back pain Sciatica Sacroiliac joint pain Disc-related pain Lumbar stiffness Muscle guarding and spasm Persistent spinal inflammation What Did the Research Find? A 2024 systematic review examined randomised controlled trials involving focused shockwave therapy for chronic low back pain. Researchers reviewed studies published across major medical databases including PubMed, Scopus, Web of Science, and clinical trial registries. Out of 55 identified studies, only 3 high-quality randomized controlled trials specifically investigated focused shockwave therapy for low back pain. Despite the small number of focused ESWT studies available, the results were encouraging. Significant Pain Reduction Reported One study involving chronic low back pain patients found pain scores on the Visual Analogue Scale (VAS) improved dramatically: Baseline pain: 7.2/10 After treatment: 1.5/10 One month later: 1.7/10 The sham treatment group improved less significantly: Baseline pain: 7.3/10 After treatment: 2.9/10 One month later: 3.1/10 This suggests focused shockwave therapy may provide faster and more meaningful pain relief compared to placebo treatment. Improved Function & Daily Movement Researchers also measured disability using the Oswestry Disability Index (ODI), one of the most widely used back pain assessment tools. In one study: ODI disability scores improved from 41.1 down to 11.9 after one month By 3 months, scores further improved to 7.1 Lower ODI scores indicate better movement, reduced disability, and improved quality of life. For many chronic back pain sufferers, this means: Easier walking Better sitting tolerance Improved sleep Less stiffness getting out of bed Reduced reliance on pain medication Greater ability to work and exercise Why Shockwave Therapy Is Gaining Attention Many chronic low back pain patients become frustrated after trying multiple treatments with limited long-term success. The research highlighted that: Only 31–47% of chronic low back pain patients experience relief within 1 year using standard conservative care alone. Focused shockwave therapy may provide an additional option for patients who are not responding well to traditional approaches. Importantly, the reviewed studies reported minimal side effects, with no major complications observed. Compared with corticosteroid injections, focused shockwave therapy avoids risks such as: Infection Tissue damage Glucose intolerance Osteoporosis risk Vascular injury Combining Shockwave Therapy With Chiropractic Care Research suggests the best outcomes often occur when shockwave therapy is combined with: Exercise rehabilitation Core stabilisation Mobility work Manual therapy Postural correction Who May Benefit From Focused Shockwave Therapy? Focused ESWT may help patients experiencing: Chronic low back pain lasting longer than 3 months Recurrent back pain flare-ups Sciatica symptoms Sacroiliac joint dysfunction Muscle tightness and spasm Disc-related lumbar pain Reduced spinal mobility Persistent pain despite other treatments Every patient is different, which is why a proper assessment is essential before beginning treatment. How Chiropractic Care May Help At Health Wise Chiropractic, we take a comprehensive approach to posture-related care. Treatment may include: Chiropractic adjustments Postural assessment Soft tissue therapy Corrective exercises Ergonomic advice Laser therapy Shockwave therapy Spinal decompression therapy We focus on addressing both the symptoms and the underlying biomechanical stress contributing to neck dysfunction. About the Author Dr Julian Simpson is an Australian chiropractor with over 15 years of experience in musculoskeletal healthcare and rehabilitation. He is a Board Member of the Chiropractic Australia Research Foundation and has reviewed and written more than 800 evidence-based health articles focused on spinal health, rehabilitation, sports injuries and conservative care approaches. His treatment focus includes: Chiropractic adjustments Sports chiropractic Massage therapy Shockwave therapy Laser therapy Non-surgical spinal decompression Dr Simpson provides patient care through Healthwise Chiropractic, serving communities including Sunbury, Melton, Diggers Rest and surrounding regions. Reference Ferdinandov D. Focused extracorporeal shockwave therapy for the treatment of low back pain: a systematic review. Front Med (Lausanne). 2024 Aug 29;11:1435504. doi: 10.3389/fmed.2024.1435504. PMID: 39267973; PMCID: PMC11390445.

Written by Dr Julian Simpson — Chiropractor with 15+ years of experience, Board Member of the Chiropractic Australia Research Foundation, and author/reviewer of 800+ health articles. New Research Reveals a Potential Way to Reduce Vertigo Recurrence Can Combining Treatments Improve Outcomes for BPPV? If you've ever experienced sudden spinning sensations when rolling over in bed, looking up, or changing position, you may have experienced Benign Paroxysmal Positional Vertigo (BPPV). BPPV is one of the most common causes of vertigo and dizziness, affecting thousands of Australians every year. While it is considered a benign condition, the symptoms can significantly impact quality of life, confidence, mobility, and day-to-day activities. New research suggests that combining traditional repositioning manoeuvres with additional medical management may improve outcomes and reduce the likelihood of symptoms returning. What is BPPV? BPPV occurs when tiny calcium carbonate crystals, known as otoconia, become dislodged from their normal position within the inner ear. These crystals can migrate into one of the balance canals, where they interfere with the vestibular system's ability to accurately detect movement and position. Common symptoms include: Vertigo (spinning sensations) Dizziness when changing position Nausea Balance difficulties Unsteadiness when walking Motion sensitivity Fear of movement due to symptom flare-ups Although BPPV is usually not dangerous, it can significantly affect a person's confidence, independence, and ability to perform everyday activities. Why Does BPPV Keep Coming Back? One of the biggest frustrations for many sufferers is recurrence. Research suggests that up to one-third of people with BPPV may experience another episode within 12 months. Several factors appear to increase recurrence risk, including: Female gender Migraine history Osteoporosis Vitamin D deficiency Diabetes High cholesterol High blood pressure Increasing age Because of this, healthcare providers continue searching for ways to reduce relapse rates and improve long-term outcomes. The Epley Manoeuvre: The Gold Standard Treatment The Epley manoeuvre remains one of the most effective treatments for posterior canal BPPV. The procedure involves a series of carefully guided head and body movements designed to return displaced crystals back to their proper location within the inner ear. Numerous studies have shown the Epley manoeuvre can: Reduce vertigo symptoms Improve balance Eliminate positional dizziness Decrease abnormal eye movements (nystagmus) Improve quality of life For many patients, significant improvement can occur after only one or two treatments. What Did the New Research Discover? Researchers followed 80 patients diagnosed with BPPV and compared two treatment approaches: Group One Received the Epley manoeuvre alone. Group Two Received the Epley manoeuvre plus a medication called flunarizine for two weeks. After treatment, the combined treatment group demonstrated: Higher overall treatment success rates Greater improvements in dizziness symptoms Better balance performance Reduced disability from vertigo Improved blood flow measurements Lower recurrence rates over the following 12 months Most notably, recurrence rates were significantly lower in the combined treatment group. Only 5% of patients experienced symptom recurrence compared to 20% of those who received the Epley manoeuvre alone. Why Might Blood Flow Matter? Researchers are increasingly exploring the connection between blood flow and inner ear health. The vestibular system relies on a very small artery for its blood supply. Unlike many other parts of the body, this artery has limited backup circulation. Reduced blood flow may contribute to: Degeneration of balance structures Increased vulnerability of inner ear tissues Greater risk of otoconia becoming dislodged Recurrent vertigo episodes While more research is needed, these findings suggest that vascular health may play a greater role in dizziness and vertigo than previously understood. The Role of Vestibular Compensation Another important finding relates to something called vestibular compensation. When the balance system is disrupted, the brain works to adapt and recalibrate through a process known as neuroplasticity. Effective vestibular compensation helps individuals: Recover balance more quickly Reduce dizziness Improve confidence with movement Return to normal activities sooner The study suggests that some treatments may help support this adaptation process, potentially explaining why certain patients recover more quickly and experience fewer recurrences. What Does This Mean for People Experiencing Vertigo? The research reinforces several important points: Early Assessment Matters The sooner the cause of dizziness is identified, the sooner appropriate treatment can begin. Accurate Diagnosis Is Essential Not all dizziness is caused by BPPV. Symptoms may also arise from: Vestibular disorders Neck dysfunction Concussion Migraines Cardiovascular conditions Neurological disorders A thorough assessment is critical. Long-Term Management Is Important While repositioning manoeuvres remain highly effective, addressing underlying contributors such as balance deficits, mobility restrictions, physical deconditioning, and general health factors may help improve long-term outcomes. How Chiropractic Care May Help At Health Wise Chiropractic, we regularly assess patients experiencing dizziness, headaches, neck pain, postural dysfunction and balance concerns. Many people with dizziness also experience: Neck stiffness Reduced cervical mobility Headaches Muscle tension Postural strain A comprehensive assessment can help identify contributing musculoskeletal factors while ensuring patients receive appropriate referral for vestibular or medical evaluation when required. Looking for Help with Dizziness or Vertigo in Sunbury? If you're experiencing recurring vertigo, dizziness when rolling over in bed, balance issues, or neck-related symptoms, it's important to have the cause properly assessed. At Health Wise Chiropractic in Sunbury, we provide evidence-informed assessments and care for patients experiencing dizziness, headaches, neck pain and mobility concerns. Our goal is to help identify contributing factors, improve function, and guide you towards the most appropriate management pathway. References Based on research published in 2026 investigating the effects of combining flunarizine with the Epley manoeuvre for Benign Paroxysmal Positional Vertigo (BPPV), including outcomes related to symptom improvement, balance, recurrence rates and vestibular function. How Chiropractic Care May Help At Health Wise Chiropractic, we take a comprehensive approach to posture-related care. Treatment may include: Chiropractic adjustments Postural assessment Soft tissue therapy Corrective exercises Ergonomic advice Laser therapy Shockwave therapy Spinal decompression therapy We focus on addressing both the symptoms and the underlying biomechanical stress contributing to neck dysfunction. About the Author Dr Julian Simpson is an Australian chiropractor with over 15 years of experience in musculoskeletal healthcare and rehabilitation. He is a Board Member of the Chiropractic Australia Research Foundation and has reviewed and written more than 800 evidence-based health articles focused on spinal health, rehabilitation, sports injuries and conservative care approaches. His treatment focus includes: Chiropractic adjustments Sports chiropractic Massage therapy Shockwave therapy Laser therapy Non-surgical spinal decompression Dr Simpson provides patient care through Healthwise Chiropractic, serving communities including Sunbury, Melton, Diggers Rest and surrounding regions. Reference Zhu Y, Zhou H, Fan D, Li X, Yang J. Observation of the therapeutic effect of flunarizine capsules combined with the Epley manoeuvre in the treatment of benign paroxysmal positional vertigo. Ann Hum Biol. 2026 Dec;53(1):2669064. doi: 10.1080/03014460.2026.2669064. Epub 2026 May 28. PMID: 42209266.

Written by Dr Julian Simpson — Chiropractor with 15+ years of experience, Board Member of the Chiropractic Australia Research Foundation, and author/reviewer of 800+ health articles. New Research Explores the Link Between Jaw Function, Balance and Vertigo Recovery Could Jaw and Neck Function Influence Recovery From Vertigo? Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of dizziness and vertigo, affecting thousands of Australians each year. While repositioning manoeuvres such as the Epley manoeuvre are highly effective for treating the underlying vestibular problem, many patients continue to experience lingering symptoms including balance problems, unsteadiness, neck tension and dizziness even after successful treatment. A recent randomised controlled trial has explored whether adding temporomandibular joint (TMJ) treatment and soft tissue therapy to standard BPPV care could improve recovery outcomes. The findings provide some interesting insights into the relationship between the jaw, neck, balance system and dizziness. What is BPPV? BPPV occurs when tiny calcium crystals (otoconia) become displaced within the inner ear's balance system. These crystals interfere with normal vestibular function and can cause: Sudden spinning sensations (vertigo) Dizziness when rolling over in bed Loss of balance Nausea Motion sensitivity Difficulty walking confidently BPPV is considered the most common peripheral vestibular disorder and is typically treated using repositioning manoeuvres designed to guide the crystals back into their correct location. Why Do Some People Still Feel Dizzy After Treatment? Although repositioning manoeuvres are highly successful, research suggests that approximately 20–30% of people continue to experience residual dizziness, imbalance or postural instability even after the vertigo itself has resolved. Researchers believe this may be due to a combination of factors including: Incomplete vestibular compensation Sensorimotor integration issues Anxiety associated with dizziness Musculoskeletal dysfunction Altered proprioception from the neck and jaw This has led researchers to investigate whether treating musculoskeletal structures may assist some patients during recovery. What Did the Study Investigate? Researchers recruited 41 adults diagnosed with posterior canal BPPV. All participants received: Standard medical assessment Epley repositioning manoeuvres A home vestibular rehabilitation program performed twice daily for four weeks One group also received: TMJ mobilisation Soft tissue therapy targeting the jaw muscles Weekly treatment sessions over four weeks The goal was to determine whether addressing jaw function could improve dizziness, balance and recovery outcomes. What Were the Results? Both Groups Improved Significantly The good news is that both groups experienced substantial improvements in: Vertigo symptoms Dizziness severity Disability related to dizziness Anxiety levels Quality of life This reinforces the effectiveness of standard BPPV management, including repositioning manoeuvres and vestibular rehabilitation. Jaw Function Improved More in the Treatment Group Participants who received TMJ mobilisation experienced significantly greater improvements in: Jaw function Mouth opening Jaw mobility Temporomandibular disorder symptoms These improvements were substantially greater than those seen in the control group. Some Balance Measures Improved The treatment group also demonstrated greater improvement in selected balance tests, particularly tandem standing balance with eyes open. Researchers suggested this may indicate improvements in certain aspects of sensorimotor control and proprioceptive integration. However, the improvements were not consistent across all balance measures, meaning further research is still needed. What Does the Jaw Have to Do With Balance? This is where the study becomes particularly interesting. The jaw, neck and vestibular system share neurological connections through the nervous system. Researchers suggest that dysfunction within the temporomandibular joint or surrounding muscles may influence: Proprioception (the body's position sense) Postural control Sensorimotor integration Balance mechanisms The study authors proposed that manual therapy targeting the jaw and cranio-cervical region may influence these pathways and potentially assist recovery in some patients. What About Neck Function? Previous research has also shown links between cervical dysfunction and dizziness. The neck contains a high concentration of proprioceptive receptors that help the brain understand head position and movement. When neck joints and muscles are not functioning optimally, altered sensory information may contribute to: Dizziness Balance disturbances Unsteadiness Headaches Motion sensitivity This growing body of evidence supports the concept that dizziness is not always solely an inner ear problem. In some cases, musculoskeletal factors may also play a role. What Does This Mean for People Experiencing Dizziness? The most important takeaway from this research is that standard BPPV management remains the primary and most effective treatment for positional vertigo. However, for individuals who continue to experience: Residual dizziness Balance problems Jaw dysfunction Neck stiffness Headaches Ongoing postural instability a broader assessment of musculoskeletal factors may be beneficial. The researchers concluded that TMJ interventions may provide complementary benefits in selected cases, particularly for patients with ongoing balance challenges following conventional treatment. How Chiropractic Care May Help At Health Wise Chiropractic, we frequently assess patients presenting with: Dizziness Neck pain Headaches Jaw tension Postural dysfunction Balance concerns A comprehensive assessment can help identify whether musculoskeletal factors may be contributing to symptoms while ensuring appropriate referral for vestibular or medical assessment when required. Many patients experiencing dizziness also report: Reduced neck mobility Jaw tension or clicking Headaches Muscle tightness Postural strain Addressing these factors may help improve comfort, mobility and overall function as part of a broader management approach. Looking for Help With Dizziness, Vertigo or Jaw-Related Symptoms in Sunbury? If you're experiencing vertigo, balance problems, jaw discomfort, headaches or neck stiffness, it is important to have the underlying cause properly assessed. At Health Wise Chiropractic in Sunbury, we provide evidence-informed assessments for dizziness, headaches, neck pain and musculoskeletal dysfunction. Our goal is to identify contributing factors, improve function and help guide patients towards the most appropriate management pathway. How Chiropractic Care May Help At Health Wise Chiropractic, we take a comprehensive approach to posture-related care. Treatment may include: Chiropractic adjustments Postural assessment Soft tissue therapy Corrective exercises Ergonomic advice Laser therapy Shockwave therapy Spinal decompression therapy We focus on addressing both the symptoms and the underlying biomechanical stress contributing to neck dysfunction. About the Author Dr Julian Simpson is an Australian chiropractor with over 15 years of experience in musculoskeletal healthcare and rehabilitation. He is a Board Member of the Chiropractic Australia Research Foundation and has reviewed and written more than 800 evidence-based health articles focused on spinal health, rehabilitation, sports injuries and conservative care approaches. His treatment focus includes: Chiropractic adjustments Sports chiropractic Massage therapy Shockwave therapy Laser therapy Non-surgical spinal decompression Dr Simpson provides patient care through Healthwise Chiropractic, serving communities including Sunbury, Melton, Diggers Rest and surrounding regions. Reference Güler D, Araci A, Günizi H, Kar M. The role of temporomandibular joint mobilization in the management of benign paroxysmal positional vertigo: randomized controlled trial. Sci Rep. 2026 May 21. doi: 10.1038/s41598-026-52637-x. Epub ahead of print. PMID: 42168393.

Written by Dr Julian Simpson — Chiropractor with 15+ years of experience, Board Member of the Chiropractic Australia Research Foundation, and author/reviewer of 800+ health articles. New Research Reveals Why Some People Still Feel Dizzy After Vertigo Treatment Understanding the Brain's Role in Vertigo Recovery Most people think of Benign Paroxysmal Positional Vertigo (BPPV) as an inner ear problem. While that's true, new research suggests the story may be more complicated. A groundbreaking study has found that BPPV doesn't just affect the inner ear—it may also temporarily alter how different regions of the brain communicate with each other. These changes may help explain why many people continue to experience dizziness, imbalance, brain fog, or feelings of disorientation even after successful treatment. At Health Wise Chiropractic in Sunbury, we regularly see patients who have been told their vertigo has been "fixed" but still don't feel completely back to normal. This new research provides important insights into why that may occur. What is BPPV? Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo worldwide, accounting for approximately 20–30% of all vertigo cases. The condition occurs when tiny calcium carbonate crystals (otoconia) become displaced within the inner ear and move into one of the balance canals. When this happens, normal movement can trigger: Spinning sensations (vertigo) Dizziness Loss of balance Nausea Motion sensitivity Difficulty walking confidently BPPV most commonly affects middle-aged and older adults and can significantly impact quality of life, independence and confidence. The Good News: Treatment Works The primary treatment for BPPV is a repositioning manoeuvre, such as: Epley Manoeuvre Barbecue Roll Manoeuvre Yacovino Manoeuvre These techniques are designed to move displaced crystals back to their correct location within the inner ear. Research consistently shows that repositioning manoeuvres successfully eliminate abnormal eye movements and vertigo symptoms in approximately 80–90% of patients. However, there is an important catch. Why Do Many People Still Feel Dizzy? Despite successful treatment, studies show that approximately 31–61% of patients continue to experience residual dizziness for days, weeks or even months after their vertigo has resolved. Many people report: Feeling "off balance" Brain fog Motion sensitivity Spatial disorientation Reduced confidence when walking Anxiety about triggering symptoms again Researchers have long suspected that the brain may need time to adapt after the inner ear problem has been corrected. This new study provides some of the strongest evidence yet supporting that theory. What Did the Researchers Discover? Researchers compared 29 people diagnosed with BPPV to 29 healthy individuals. Using advanced functional near-infrared spectroscopy (fNIRS), they measured how different areas of the brain communicated with one another before and after repositioning treatment. The results were striking. Brain Connectivity Was Significantly Reduced Before treatment, people with BPPV showed significantly lower communication between key brain regions compared to healthy individuals. The most affected areas included: Visual processing centres Somatosensory (body awareness) regions Prefrontal cortex areas involved in attention and spatial awareness Researchers described this as a reduction in "functional connectivity" — essentially meaning that important brain networks were not working together as efficiently. The Brain Begins to Recover After Treatment Seven days after successful repositioning treatment, researchers observed improvements in several important brain regions. The biggest improvements occurred in: Visual Processing Centres The visual cortex demonstrated significant recovery after treatment. This is important because the brain relies heavily on visual information to maintain balance and orientation when vestibular function is disrupted. Somatosensory Regions Areas responsible for body awareness and proprioception also improved. These regions help us understand where our body is positioned in space and play a critical role in maintaining balance. But Recovery Was Not Complete Even after successful treatment, brain connectivity remained below normal levels. This suggests that recovery of the brain's balance networks may take considerably longer than recovery of the inner ear itself. Why Does This Matter? One of the most important findings was the strong relationship between brain connectivity and symptom severity. Researchers found that people with lower levels of brain network connectivity reported significantly worse dizziness and disability scores. In simple terms: The more disrupted the brain networks were, the worse people felt. This helps explain why some individuals continue experiencing symptoms despite successful treatment of the underlying vestibular problem. The Link Between Vision, Balance and Proprioception Balance depends on three major systems working together: The Vestibular System Your inner ear balance organs. The Visual System Information coming from your eyes. The Proprioceptive System Information from muscles, joints and ligaments that tells the brain where your body is in space. When vertigo develops, the brain must rapidly adapt to conflicting information coming from these systems. Researchers believe this adaptation process may temporarily alter communication between brain regions, leading to lingering symptoms even after the inner ear has recovered. Why Vestibular Rehabilitation May Help The study highlights the importance of ongoing rehabilitation after vertigo treatment. Research suggests vestibular rehabilitation exercises may help the brain: Improve sensory integration Restore balance control Reduce dizziness Improve confidence with movement Accelerate recovery of normal brain network function For some patients, vestibular rehabilitation may be just as important as the repositioning manoeuvre itself. What About the Neck? Previous research has demonstrated strong connections between the vestibular system, visual system and cervical spine. The neck contains thousands of proprioceptive receptors that help the brain understand: Head position Movement direction Balance Spatial orientation When neck joints or muscles become dysfunctional, altered sensory information may contribute to: Dizziness Balance disturbances Headaches Motion sensitivity Feelings of disorientation This may help explain why some people continue experiencing symptoms despite successful inner ear treatment. How Chiropractic Care May Help At Health Wise Chiropractic, we frequently assess patients experiencing: Vertigo Dizziness Neck pain Headaches Balance problems Postural dysfunction Many patients recovering from vertigo also present with: Neck stiffness Reduced cervical mobility Muscle tension Postural strain Ongoing balance concerns A comprehensive assessment can help identify musculoskeletal factors that may be contributing to symptoms while ensuring appropriate referral for vestibular or medical assessment where required. Practical Recommendations for People Recovering From Vertigo If you've recently experienced BPPV, research suggests several strategies may help support recovery: Continue Moving Avoiding movement can slow vestibular adaptation and recovery. Follow Professional Advice Complete any vestibular rehabilitation exercises prescribed by your healthcare provider. Address Neck Mobility Persistent neck stiffness may contribute to ongoing balance disturbances. Maintain Physical Activity Regular walking and gentle exercise can help promote vestibular compensation. Seek Assessment if Symptoms Persist Ongoing dizziness, headaches, balance problems or neck pain should be professionally evaluated. Looking for Help With Vertigo or Dizziness in Sunbury? If you're experiencing vertigo, lingering dizziness, balance problems, headaches or neck stiffness, it is important to understand that recovery may involve more than simply correcting the inner ear problem. At Health Wise Chiropractic in Sunbury, we provide evidence-informed assessments for dizziness, headaches, neck pain and balance-related concerns. Our goal is to identify contributing factors, improve function and help guide patients towards the most appropriate management pathway. How Chiropractic Care May Help At Health Wise Chiropractic, we take a comprehensive approach to posture-related care. Treatment may include: Chiropractic adjustments Postural assessment Soft tissue therapy Corrective exercises Ergonomic advice Laser therapy Shockwave therapy Spinal decompression therapy We focus on addressing both the symptoms and the underlying biomechanical stress contributing to neck dysfunction. About the Author Dr Julian Simpson is an Australian chiropractor with over 15 years of experience in musculoskeletal healthcare and rehabilitation. He is a Board Member of the Chiropractic Australia Research Foundation and has reviewed and written more than 800 evidence-based health articles focused on spinal health, rehabilitation, sports injuries and conservative care approaches. His treatment focus includes: Chiropractic adjustments Sports chiropractic Massage therapy Shockwave therapy Laser therapy Non-surgical spinal decompression Dr Simpson provides patient care through Healthwise Chiropractic, serving communities including Sunbury, Melton, Diggers Rest and surrounding regions. Reference Yang TH, Chung SD, Lin HC, Liu TC. Seasonal variation in climate, air pollution, and the incidence of benign paroxysmal positional vertigo. Sci Rep. 2026 May 21. doi: 10.1038/s41598-026-52205-3. Epub ahead of print. PMID: 42168266. Xiao J, Pan Q, Huang R, Jin S. Dynamic changes in brain network functional connectivity following repositioning treatment for benign paroxysmal positional vertigo: an fNIRS study. Front Neurol. 2026 Apr 13;17:1820148. doi: 10.3389/fneur.2026.1820148. PMID: 42051761; PMCID: PMC13111341.

Written by Dr Julian Simpson — Chiropractor with 15+ years of experience, Board Member of the Chiropractic Australia Research Foundation, and author/reviewer of 800+ health articles. Vertigo Is More Than Just Dizziness: New Research Reveals the Hidden Link Between Balance, Sleep and Mental Wellbeing Why Do Some People Struggle Long After Their Vertigo Settles? If you've ever experienced vertigo, you'll know it's far more than simply feeling a little dizzy. Many people across Sunbury, Melton and Melbourne's north-west describe feeling exhausted, anxious, foggy-headed and emotionally drained long after the spinning sensations have improved. Whether you're commuting down the Calder Freeway, working long shifts on your feet, caring for young children, or trying to stay active around local sporting clubs, ongoing dizziness can have a major impact on everyday life. New research is helping us understand why. A large 2025 study involving more than 600 participants found that Benign Paroxysmal Positional Vertigo (BPPV) may affect far more than the inner ear. Researchers discovered strong links between vertigo, anxiety, depression, sleep quality and changes in important brain neurotransmitters that help regulate mood, balance and recovery. The findings highlight why a comprehensive approach to vertigo management may be just as important as treating the inner ear itself. What Is BPPV? Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo worldwide. It occurs when tiny calcium crystals inside the inner ear become displaced and move into one of the balance canals. When this happens, normal head movements can trigger: Sudden spinning sensations Dizziness when rolling over in bed Balance problems Nausea Motion sensitivity Difficulty walking confidently Fear of movement Research estimates that approximately 2.4% of people will experience BPPV during their lifetime, with recurrence rates of 15–20% each year. Importantly, BPPV accounts for a significant proportion of all vestibular disorders seen in clinical practice. The Surprising Link Between Vertigo and Mental Health Most people assume vertigo is purely a physical condition. However, this new research found that people with BPPV experienced dramatically higher levels of anxiety and depression compared to healthy individuals. Researchers assessed 310 patients with BPPV and compared them with 300 healthy controls. The results were striking: Anxiety Scores Were Three Times Higher Patients with BPPV recorded average anxiety scores of: 15.09 compared to 5.00 in healthy controls This represents a substantial increase in anxiety symptoms. Depression Scores Were Nearly Three Times Higher Average depression scores were: 16.18 in the BPPV group 5.55 in healthy controls Researchers noted a strong relationship between dizziness severity and emotional wellbeing. Simply put: The worse the dizziness, the worse people tended to feel emotionally. Vertigo Can Seriously Impact Sleep One of the most overlooked aspects of vertigo is its effect on sleep quality. Many people with BPPV report: Difficulty getting comfortable in bed Fear of rolling onto the "wrong side" Frequent waking Poor quality sleep Daytime fatigue The study found BPPV sufferers had sleep quality scores almost four times worse than healthy participants. Average sleep scores were: 12.0 in BPPV patients 3.36 in healthy controls Researchers believe this creates a vicious cycle: Vertigo disrupts sleep, poor sleep affects recovery, and reduced recovery may increase dizziness and emotional distress. What Are Neurotransmitters and Why Do They Matter? One of the most fascinating aspects of the research involved measuring neurotransmitters. Neurotransmitters are chemical messengers that help your brain and nervous system communicate. They influence: Mood Balance Sleep Stress responses Movement control Learning and adaptation Researchers discovered that patients with BPPV had significantly lower levels of: Dopamine Often called the "motivation" neurotransmitter. Dopamine helps regulate: Movement Reward pathways Focus Learning Nervous system adaptation Norepinephrine Important for: Alertness Balance regulation Stress responses Vestibular compensation Epinephrine Plays a key role in: Physical resilience Nervous system regulation Adaptation to stress Patients with lower neurotransmitter levels generally reported: Greater dizziness More physical limitations Poorer emotional wellbeing Higher levels of depression Why Some People Continue Feeling "Off" After Treatment One of the most important findings is that successful treatment of the inner ear does not always mean immediate recovery. Many patients continue experiencing: Residual dizziness Motion sensitivity Anxiety Fatigue Poor sleep Reduced confidence Researchers believe this may occur because the brain needs time to recalibrate after vestibular dysfunction. The inner ear may recover quickly. The nervous system often takes longer. Why a Holistic Approach Works BestModern research increasingly shows that vertigo is rarely just an "ear problem."The most successful recovery plans often combine:Accurate diagnosisCanalith repositioning procedures when appropriateVestibular rehabilitation exercisesNeck and postural assessmentPhysical activity and movement strategiesSleep optimisationStress managementPatient educationAddressing all contributing factors often produces better long-term outcomes than focusing on a single aspect of care alone. Evidence-Based Recommendations for Managing Vertigo Current evidence suggests several strategies may help support recovery. 1. Obtain an Accurate Diagnosis BPPV should be properly assessed using recognised vestibular testing procedures such as: Dix-Hallpike testing Supine roll testing Vestibular assessment Not all dizziness is caused by BPPV. 2. Consider Repositioning Procedures When BPPV is confirmed, repositioning manoeuvres such as: Epley Manoeuvre Barbecue Roll Yacovino Manoeuvre remain the gold-standard treatment. Research shows these procedures successfully resolve symptoms in the majority of cases. 3. Address Neck Function Many people with dizziness also experience: Neck stiffness Reduced mobility Headaches Postural strain The neck provides important sensory information to the brain regarding balance and body position. 4. Prioritise Sleep The research demonstrated a strong relationship between vertigo severity and poor sleep quality. Practical sleep strategies include: Maintaining consistent bedtimes Reducing screen exposure before bed Limiting caffeine later in the day Creating a comfortable sleep environment 5. Keep Moving Gentle activity may help encourage vestibular adaptation. This might include: Walking Structured exercise Vestibular rehabilitation programmes Balance exercises Avoiding movement completely may delay recovery. 6. Manage Stress and Anxiety Because anxiety and vertigo influence one another, addressing emotional wellbeing may support overall recovery. Strategies may include: Mindfulness Relaxation techniques Counselling Exercise Professional support where appropriate Can Chiropractic Care Help? At Health Wise Chiropractic, we regularly assess patients experiencing: Dizziness Vertigo Neck pain Headaches Postural dysfunction Balance concerns Many patients presenting with vertigo also report: Neck stiffness Reduced cervical mobility Tension headaches Poor posture Ongoing feelings of instability A comprehensive assessment can help identify musculoskeletal factors that may be contributing to symptoms while ensuring appropriate referral for vestibular or medical assessment where required. Our approach focuses on helping patients improve function, mobility and confidence while supporting their broader recovery journey. Looking for Help With Vertigo in Sunbury or Melton? If you're experiencing vertigo, dizziness, balance problems, headaches or neck stiffness, you don't have to simply "put up with it." At Health Wise Chiropractic, our Sunbury and Melton teams provide evidence-informed assessments designed to identify potential contributing factors and help guide you towards the most appropriate management pathway. Whether your symptoms are new, recurring, or lingering after previous treatment, we're here to help you better understand what's happening and what steps may support your recovery. References Based on 2025 research investigating psychological health, sleep quality and neurotransmitter changes in 310 patients with Benign Paroxysmal Positional Vertigo (BPPV), alongside current evidence relating to vestibular rehabilitation, balance disorders and recovery from dizziness. How Chiropractic Care May Help At Health Wise Chiropractic, we take a comprehensive approach to posture-related care. Treatment may include: Chiropractic adjustments Postural assessment Soft tissue therapy Corrective exercises Ergonomic advice Laser therapy Shockwave therapy Spinal decompression therapy We focus on addressing both the symptoms and the underlying biomechanical stress contributing to neck dysfunction. About the Author Dr Julian Simpson is an Australian chiropractor with over 15 years of experience in musculoskeletal healthcare and rehabilitation. He is a Board Member of the Chiropractic Australia Research Foundation and has reviewed and written more than 800 evidence-based health articles focused on spinal health, rehabilitation, sports injuries and conservative care approaches. His treatment focus includes: Chiropractic adjustments Sports chiropractic Massage therapy Shockwave therapy Laser therapy Non-surgical spinal decompression Dr Simpson provides patient care through Healthwise Chiropractic, serving communities including Sunbury, Melton, Diggers Rest and surrounding regions. Reference Zhang Q, She R, Zhou H, Guo J, Hu Z. Serum neurotransmitter imbalances in benign paroxysmal positional vertigo: correlations with anxiety, depression, and sleep quality. Front Neurol. 2026 Apr 10;17:1798705. doi: 10.3389/fneur.2026.1798705. PMID: 42037689; PMCID: PMC13106000.

Written by Dr Julian Simpson — Chiropractor with 15+ years of experience, Board Member of the Chiropractic Australia Research Foundation, and author/reviewer of 800+ health articles. Could Low Vitamin D Be Making Your Vertigo Return? What New Research Reveals About BPPV and Dizziness Tired of Feeling Dizzy Every Time You Roll Over in Bed? If you've ever experienced a sudden spinning sensation when turning your head, getting out of bed, or looking up at a shelf, you're not alone. Many people across Sunbury, Melton and surrounding communities experience episodes of dizziness that seem to come out of nowhere. For busy parents juggling school drop-offs, tradies working long days, or commuters travelling the Calder Freeway and Western Highway, recurring dizziness can quickly disrupt daily life. One of the most common causes of these symptoms is a condition called Benign Paroxysmal Positional Vertigo (BPPV). While BPPV is usually very treatable, many sufferers find their symptoms return weeks or months later. Exciting new research is now shedding light on a surprisingly simple factor that may influence whether vertigo comes back: Vitamin D levels. What Exactly Is BPPV? BPPV is the most common cause of peripheral vertigo and affects approximately 1 in 10 people during their lifetime. The condition occurs when tiny calcium carbonate crystals inside the inner ear, known as otoconia, become dislodged and move into the balance canals of the ear. This can trigger symptoms including: Sudden spinning sensations Dizziness when changing head position Nausea Loss of balance Brief episodes of vertigo lasting less than a minute Unsteadiness when walking BPPV can affect people of all ages but is most commonly seen in middle-aged and older adults, particularly women. The Surprising Link Between Vitamin D and Vertigo Researchers have increasingly discovered that the same calcium-regulating processes responsible for healthy bones may also be important for healthy balance organs inside the ear. The tiny otoconia crystals responsible for detecting movement are largely made from calcium carbonate. When calcium metabolism becomes disrupted, these crystals may become more fragile, unstable, or prone to dislodgement. This is where Vitamin D becomes important. Vitamin D helps regulate: Calcium absorption Bone metabolism Otoconia structure and maintenance Inner ear function Several studies have now found that people with recurrent BPPV are significantly more likely to have low Vitamin D levels. What Did The New Research Find? A recent prospective study followed 60 patients diagnosed with BPPV over a six-month period. Researchers measured Vitamin D levels and tracked whether vertigo symptoms returned after successful treatment using the Epley manoeuvre. The findings were striking. 75% of Patients Were Vitamin D Deficient Three out of every four participants had Vitamin D levels below the recommended range. Vertigo Returned More Often in People With Low Vitamin D Among participants with Vitamin D levels below 20 ng/ml: 28.9% experienced a recurrence of BPPV Among those with normal Vitamin D levels: Only 6.7% experienced recurrence This represented a statistically significant difference. Severe Deficiency Was Associated With The Highest Risk Researchers found the greatest relapse rates in people with the lowest Vitamin D levels. Patients with Vitamin D levels below 10 ng/ml experienced recurrence rates of approximately: 64.3% This suggests that the lower the Vitamin D level, the greater the likelihood of BPPV returning. Most Recurrences Happened Early Interestingly: 11 of the 13 relapses occurred within the first two months All relapses occurred within the first three months No further recurrences were observed after Vitamin D levels normalised Why Might Vitamin D Matter So Much? Scientists believe Vitamin D plays a crucial role in maintaining the integrity of the inner ear's balance structures. When Vitamin D levels fall: Calcium regulation becomes impaired Otoconia crystals may deteriorate Crystal fragments may break away more easily The risk of triggering BPPV episodes may increase This theory is supported by laboratory studies showing structural changes in balance organs when Vitamin D deficiency is present. How Is BPPV Usually Treated? The good news is that BPPV often responds extremely well to specific repositioning procedures. The most common is the Epley manoeuvre, which is designed to guide displaced crystals back into their proper position within the inner ear. Many patients experience substantial relief after just one or two treatments. At Health Wise Chiropractic, we work closely with patients experiencing dizziness and balance disorders by providing comprehensive assessments and, where appropriate, evidence-based management strategies alongside communication with GPs and other healthcare providers. Why A Holistic Approach Often Works Best Modern healthcare increasingly recognises that long-term outcomes improve when treatment addresses both symptoms and underlying contributing factors. Why Looking Beyond Symptoms MattersSimply repositioning the crystals may resolve an episode of vertigo, but identifying factors that contribute to recurrence can help reduce the likelihood of future episodes.A comprehensive approach may include:Vestibular assessmentCanalith repositioning proceduresPostural evaluationBalance retraining exercisesLifestyle recommendationsNutritional considerationsVitamin D testing when clinically appropriateCollaboration with GPs and other healthcare professionals Could You Be At Higher Risk? You may wish to discuss Vitamin D testing with your healthcare provider if you: Have experienced repeated episodes of BPPV Spend most of your day indoors Have osteoporosis or osteopenia Are over 40 years of age Have previously been diagnosed with Vitamin D deficiency Experience recurring dizziness despite successful treatment Many Australians are unknowingly deficient in Vitamin D, particularly during winter months when sun exposure decreases. Practical Steps To Support Your Recovery If you're experiencing dizziness or recurrent vertigo: 1. Seek An Accurate Diagnosis Not all dizziness is BPPV. A thorough assessment is important to identify the true cause. 2. Have Appropriate Positional Testing Performed Tests such as the Dix-Hallpike manoeuvre help determine whether BPPV is present. 3. Follow Recommended Repositioning Procedures Evidence-based manoeuvres such as the Epley manoeuvre can be highly effective when correctly applied. 4. Consider Underlying Risk Factors Discuss factors such as: Vitamin D status Bone health Physical activity levels Balance function General health conditions 5. Stay Active Appropriate movement and vestibular rehabilitation exercises may help improve confidence and balance during recovery. Supporting Sunbury and Melton Families With Evidence-Based Care Recurring dizziness can affect every aspect of daily life—from work productivity and exercise participation to confidence when driving or caring for family members. At Health Wise Chiropractic, our experienced team takes the time to understand the bigger picture behind your symptoms. We focus on thorough assessment, personalised care, patient education, and evidence-informed recommendations to help you move, feel, and function at your best. Whether you're in Sunbury, Melton, Diggers Rest, Bacchus Marsh, Caroline Springs or surrounding areas, we're here to help you better understand your symptoms and explore the most appropriate pathways towards recovery. Book an Assessment Today If recurring dizziness, vertigo, neck stiffness, headaches or balance concerns are affecting your quality of life, our Health Wise Chiropractic team in Sunbury and Melton would be delighted to help. A personalised assessment could be the first step towards understanding what's contributing to your symptoms—and getting you back to enjoying life with confidence. How Chiropractic Care May Help At Health Wise Chiropractic, we take a comprehensive approach to posture-related care. Treatment may include: Chiropractic adjustments Postural assessment Soft tissue therapy Corrective exercises Ergonomic advice Laser therapy Shockwave therapy Spinal decompression therapy We focus on addressing both the symptoms and the underlying biomechanical stress contributing to neck dysfunction. About the Author Dr Julian Simpson is an Australian chiropractor with over 15 years of experience in musculoskeletal healthcare and rehabilitation. He is a Board Member of the Chiropractic Australia Research Foundation and has reviewed and written more than 800 evidence-based health articles focused on spinal health, rehabilitation, sports injuries and conservative care approaches. His treatment focus includes: Chiropractic adjustments Sports chiropractic Massage therapy Shockwave therapy Laser therapy Non-surgical spinal decompression Dr Simpson provides patient care through Healthwise Chiropractic, serving communities including Sunbury, Melton, Diggers Rest and surrounding regions. Walia MS, Tuli N, Hussain A, Bansal S, Bhagat R. Effect of Vitamin D Deficiency on Incidence and Relapse of Benign Paroxysmal Positional Vertigo. Iran J Otorhinolaryngol. 2026;38(2):99-108. doi: 10.22038/ijorl.2026.90851.4032. PMID: 42006900; PMCID: PMC13090813.

Written by Dr Julian Simpson — Chiropractor with 15+ years of experience, Board Member of the Chiropractic Australia Research Foundation, and author/reviewer of 800+ health articles. Why Does Vertigo Keep Coming Back? New Research Reveals the Hidden Link Between Inflammation and Recurring Dizziness Struggling With Recurring Vertigo in Sunbury or Melton? Few health problems are as frustrating as vertigo. One moment you're getting ready for work, helping the kids get organised, or preparing for another commute down the Calder Freeway or Western Highway. The next, the room suddenly feels like it's spinning. For many people across Sunbury, Melton and surrounding communities, Benign Paroxysmal Positional Vertigo (BPPV) can seem to disappear after treatment, only to unexpectedly return weeks or months later. While BPPV has traditionally been viewed as a simple mechanical problem of the inner ear, exciting new research suggests there may be much more to the story. Scientists are now discovering that inflammation throughout the body may influence whether vertigo becomes a recurring problem. What Is BPPV? BPPV is one of the most common causes of dizziness and vertigo. The condition occurs when tiny calcium crystals, known as otoconia, become displaced within the inner ear's balance system. These crystals move into areas where they shouldn't be, sending incorrect signals to the brain about movement and position. Common symptoms include: Sudden spinning sensations Dizziness when rolling over in bed Vertigo when looking up or bending down Nausea Balance difficulties Brief episodes lasting seconds to minutes Although BPPV is highly treatable, recurrence remains common and can significantly affect quality of life. Why Recurring Vertigo Matters Research shows that BPPV doesn't simply affect balance. Repeated episodes can lead to: Reduced confidence when walking Increased fall risk Avoidance of physical activity Difficulty driving or travelling Lost productivity at work Increased healthcare visits For active families throughout Sunbury and Melton, recurring vertigo can interfere with everything from weekend sport to everyday household activities. What Did The New Research Discover? Researchers followed 300 patients diagnosed with BPPV and monitored them for six months after treatment. The findings revealed that approximately: 26% of patients experienced a recurrence of vertigo within six months The researchers investigated whether common markers of inflammation found in routine blood tests could help predict who was more likely to experience a relapse. Key Finding #1: Higher Inflammation Was Linked to Higher Recurrence Risk Patients whose vertigo returned had significantly higher levels of inflammatory markers, including: Neutrophil-to-Lymphocyte Ratio (NLR) C-Reactive Protein (CRP) Systemic Immune-Inflammation Index (SII) Compared with patients who remained symptom-free, those experiencing recurrence consistently showed evidence of greater systemic inflammation. Key Finding #2: NLR Was The Strongest Predictor The most significant finding involved the Neutrophil-to-Lymphocyte Ratio (NLR). Researchers found that for every increase in NLR, the likelihood of BPPV recurrence increased significantly. NLR demonstrated the strongest predictive ability among all inflammatory markers studied. Key Finding #3: Inflammation May Affect The Inner Ear Scientists believe inflammation may influence: Inner ear blood flow Vestibular nerve function Otoconia stability The health of the delicate structures responsible for balance Rather than being solely a mechanical issue, BPPV may also be influenced by broader whole-body health factors. Why This Matters For Your Overall Health This research highlights something healthcare providers have increasingly recognised over recent years: Your body doesn't work in isolated systems. Inflammation associated with: Poor sleep Chronic stress Metabolic conditions Physical inactivity Obesity Cardiovascular disease may influence many aspects of health, including balance and vestibular function. This reinforces the importance of taking a holistic approach to health rather than focusing solely on symptom relief. What Does Evidence-Based Care Look Like? Whether you're dealing with vertigo, neck pain, headaches or lower back pain, modern healthcare research consistently supports a comprehensive, multimodal approach. For example, lower back pain remains one of the world's leading causes of disability, accounting for approximately 24% of all global disability-adjusted life years linked to workplace ergonomic factors. Clinical Practice Guidelines worldwide show remarkable agreement regarding conservative spinal care: 90% of guidelines recommend Spinal Manipulative Therapy (SMT) for lower back pain 100% recommend SMT as part of care for neck pain Importantly, research consistently shows the best outcomes occur when manual therapy is combined with other evidence-based strategies rather than used in isolation. What A Multimodal Care Plan May Include A personalised management programme may involve: 1. Comprehensive Assessment Understanding contributing factors such as: Posture Movement patterns Vestibular function Occupational demands Exercise habits General health status 2. Hands-On Care Depending on individual findings, treatment may include: Spinal Manipulative Therapy (SMT) Joint mobilisation Soft tissue techniques Vestibular rehabilitation approaches 3. Tailored Exercise Programmes Exercise may help: Improve balance Enhance mobility Strengthen supporting muscles Optimise recovery 4. Patient Education Understanding your condition often improves outcomes by helping you: Recognise triggers Manage flare-ups Maintain long-term improvements 5. Active Self-Management Developing sustainable habits that support long-term health and resilience. Why A Holistic Approach Works BestResearch consistently demonstrates that the best outcomes occur when healthcare combines multiple evidence-based strategies rather than relying on a single modality.A multidisciplinary approach addresses:Physical functionMovement qualityExercise capacityLifestyle factorsStress managementPatient educationLong-term preventionThis whole-person approach helps optimise recovery while empowering patients to actively participate in their own health journey. Is Chiropractic Care Safe? Safety is understandably one of the most common questions patients ask. The good news is that extensive clinical reviews have demonstrated that serious complications associated with conservative manual therapy are exceptionally rare. In fact, conservative care is widely considered a safe frontline treatment option for many musculoskeletal conditions, particularly when compared with the well-documented risks associated with prolonged prescription medication use. As with any healthcare intervention, a thorough assessment and appropriate clinical decision-making remain essential. Supporting Sunbury and Melton Families With Evidence-Based Care At Health Wise Chiropractic, we understand that recurring dizziness, neck stiffness, headaches and back pain can make everyday life more difficult. Our approach focuses on identifying the factors contributing to your symptoms, providing personalised care, and helping you build long-term strategies that support better movement, function and wellbeing. Whether you're managing long hours at a desk, spending time travelling between Melbourne and the western suburbs, or simply wanting to stay active with your family, our experienced team is here to help. Take The Next Step Towards Better Balance And Better Health If recurring vertigo, dizziness, neck pain or back pain is affecting your quality of life, the team at Health Wise Chiropractic in Sunbury and Melton is here to support you. Through thorough assessment, evidence-informed care, tailored exercise programmes and practical education, we'll help you understand what's driving your symptoms and create a personalised plan designed to optimise your health for the long term. How Chiropractic Care May Help At Health Wise Chiropractic, we take a comprehensive approach to posture-related care. Treatment may include: Chiropractic adjustments Postural assessment Soft tissue therapy Corrective exercises Ergonomic advice Laser therapy Shockwave therapy Spinal decompression therapy We focus on addressing both the symptoms and the underlying biomechanical stress contributing to neck dysfunction. About the Author Dr Julian Simpson is an Australian chiropractor with over 15 years of experience in musculoskeletal healthcare and rehabilitation. He is a Board Member of the Chiropractic Australia Research Foundation and has reviewed and written more than 800 evidence-based health articles focused on spinal health, rehabilitation, sports injuries and conservative care approaches. His treatment focus includes: Chiropractic adjustments Sports chiropractic Massage therapy Shockwave therapy Laser therapy Non-surgical spinal decompression Dr Simpson provides patient care through Healthwise Chiropractic, serving communities including Sunbury, Melton, Diggers Rest and surrounding regions. Reference Doğan B, Baklacı D. Association between systemic inflammatory markers and recurrence risk in benign paroxysmal positional vertigo: a retrospective cohort study. Acta Biochim Pol. 2026 Mar 23;73:16188. doi: 10.3389/abp.2026.16188. PMID: 41948030; PMCID: PMC13050786.

Written by Dr Julian Simpson — Chiropractor with 15+ years of experience, Board Member of the Chiropractic Australia Research Foundation, and author/reviewer of 800+ health articles. New Research Highlights a Simpler Way to Diagnose a Common Cause of Vertigo Understanding BPPV, Dizziness and Why Accurate Diagnosis Matters Feeling dizzy when you roll over in bed, look up, or change position can be frightening. For many Australians, these symptoms are caused by a condition known as Benign Paroxysmal Positional Vertigo (BPPV), one of the most common causes of vertigo and balance disturbances. Recent research has identified a simpler and more comfortable way to help diagnose certain forms of BPPV, potentially improving patient experience and allowing faster treatment. At Health Wise Chiropractic in Sunbury, we regularly help patients understand the causes of dizziness and determine when referral for vestibular assessment may be appropriate. What is BPPV? BPPV occurs when tiny calcium carbonate crystals, known as otoconia, become dislodged from their normal location within the inner ear. When these crystals move into one of the balance canals of the inner ear, they can interfere with normal balance signals being sent to the brain. This can trigger episodes of: Vertigo (a spinning sensation) Dizziness when changing position Loss of balance Nausea Motion sensitivity Difficulty walking or turning BPPV is estimated to account for up to 20% of all dizziness presentations and is one of the most common vestibular disorders seen in clinical practice. A Commonly Missed Form of Vertigo While many healthcare professionals are familiar with posterior canal BPPV, the second most common form affects the horizontal semicircular canal. Research suggests horizontal canal BPPV accounts for approximately 16–31% of all BPPV cases. This form can be more challenging to diagnose because symptoms and eye movement patterns (nystagmus) are often more complex. As a result, some patients experience prolonged symptoms before receiving the correct diagnosis and treatment. What Did the New Study Find? Researchers analysed 209 patients diagnosed with horizontal canal BPPV and investigated the effectiveness of a simple assessment known as the Lying-Down Test (LDT). The LDT involves moving from a seated position to lying flat, making it significantly more comfortable than some traditional diagnostic procedures. The findings were impressive: The test correctly identified the affected side in approximately 97% of cases. The test produced positive findings in over 60% of patients. Patients with positive results often required fewer diagnostic manoeuvres. Older adults aged over 60 were more likely to demonstrate positive findings. The test was well tolerated and easier for many patients to complete. The researchers concluded that the Lying-Down Test is a reliable and valuable addition to the assessment process for horizontal canal BPPV. Why Faster Diagnosis Matters Anyone who has experienced vertigo knows how disruptive it can be. Symptoms can interfere with: Driving Work performance Exercise Sleep quality Daily activities Confidence when moving around Research has consistently shown that appropriate diagnosis and treatment can dramatically improve symptoms, often within a short period. The sooner the correct diagnosis is made, the sooner effective treatment can begin. The Importance of Comprehensive Assessment Not all dizziness is caused by BPPV. Dizziness and balance problems may also be associated with: Vestibular disorders Inner ear infections Migraines Neck-related dysfunction Concussion Neurological conditions Medication side effects Cardiovascular issues This is why a thorough history and examination are essential before any treatment recommendations are made. How Chiropractic Care May Help While chiropractors do not treat the inner ear itself, a comprehensive chiropractic assessment may help identify musculoskeletal factors that can contribute to symptoms such as dizziness, balance disturbances, neck stiffness and headaches. Many patients experiencing dizziness also report: Neck pain Reduced neck mobility Muscle tension Postural strain Headaches Addressing these factors may help improve overall function and comfort while ensuring patients receive appropriate referrals when vestibular assessment or medical investigation is required. When Should You Seek Help? If you experience: Sudden episodes of spinning sensations Dizziness when rolling over in bed Symptoms triggered by looking up or bending down Balance problems Recurrent vertigo it is important to seek professional assessment. Early diagnosis can help identify whether symptoms are related to BPPV, vestibular dysfunction, neck-related causes or other health conditions requiring further investigation. Looking for Help with Dizziness in Sunbury? At Health Wise Chiropractic, we provide comprehensive assessments for patients experiencing dizziness, neck pain, headaches and balance-related concerns. Our goal is to identify contributing factors, provide evidence-informed care where appropriate, and help guide patients towards the most suitable management pathway. If you're experiencing dizziness, vertigo or recurring neck-related symptoms, contact Health Wise Chiropractic in Sunbury to arrange an assessment and discuss your options. How Chiropractic Care May Help At Health Wise Chiropractic, we take a comprehensive approach to posture-related care. Treatment may include: Chiropractic adjustments Postural assessment Soft tissue therapy Corrective exercises Ergonomic advice Laser therapy Shockwave therapy Spinal decompression therapy We focus on addressing both the symptoms and the underlying biomechanical stress contributing to neck dysfunction. About the Author Dr Julian Simpson is an Australian chiropractor with over 15 years of experience in musculoskeletal healthcare and rehabilitation. He is a Board Member of the Chiropractic Australia Research Foundation and has reviewed and written more than 800 evidence-based health articles focused on spinal health, rehabilitation, sports injuries and conservative care approaches. His treatment focus includes: Chiropractic adjustments Sports chiropractic Massage therapy Shockwave therapy Laser therapy Non-surgical spinal decompression Dr Simpson provides patient care through Healthwise Chiropractic, serving communities including Sunbury, Melton, Diggers Rest and surrounding regions. Reference Xia K, Gao R, Zhang X, Yan X, He D. Re-evaluating the lying-down test: a step-saving and well-tolerated diagnostic adjunct for horizontal canal benign paroxysmal positional vertigo. Front Neurol. 2026 May 25;17:1830444. doi: 10.3389/fneur.2026.1830444. PMID: 42266592; PMCID: PMC13243013.

Written by Dr Julian Simpson — Chiropractor with 15+ years of experience, Board Member of the Chiropractic Australia Research Foundation, and author/reviewer of 800+ health articles. Dizziness When You Roll Over in Bed? It Might Not Be "Just Vertigo" Understanding Atypical Vertigo: When Common Inner Ear Problems Aren't So Straightforward Ever Feel Dizzy Turning Over in Bed or Looking Up? If you've ever rolled over in bed, looked up to grab something from a shelf, or tilted your head back while gardening and suddenly felt the room spin, you're not alone. For many people across Sunbury and Melton, dizziness and vertigo can be incredibly unsettling. Whether you're commuting along the Calder Freeway, travelling the Western Highway for work, or simply trying to keep up with active family life, unexpected bouts of dizziness can quickly affect confidence, mobility, and quality of life. Most people have heard of Benign Paroxysmal Positional Vertigo (BPPV) — one of the most common causes of vertigo. However, emerging research shows that not every case follows the textbook pattern. In fact, some studies suggest that up to 40% of positional vertigo presentations in specialist clinics may involve atypical features, making diagnosis more challenging than many people realise. Understanding these less common presentations can help people receive the right care sooner and avoid unnecessary worry. What Exactly Is BPPV? BPPV occurs when tiny calcium carbonate crystals, called otoconia, become displaced within the inner ear. Normally these crystals help your body detect movement and balance. When they move into one of the inner ear's balance canals, they can trigger false signals to the brain whenever the head changes position. This commonly causes: Sudden spinning sensations Brief episodes of vertigo Nausea Loss of balance Unsteadiness when changing positions Symptoms when rolling in bed, bending over, or looking up The good news is that typical BPPV often responds extremely well to specific repositioning manoeuvres designed to guide these crystals back where they belong. When Vertigo Doesn't Follow the Rules While classic BPPV has well-recognised patterns, researchers are increasingly identifying a variety of atypical BPPV presentations. These cases can be confusing because symptoms may not match what clinicians normally expect. Examples include: Vertigo Without Visible Eye Movements Normally, BPPV produces a characteristic eye movement called nystagmus during testing. However, some people experience: Vertigo Nausea Balance disturbances without obvious nystagmus being observed. This is sometimes referred to as subjective BPPV. Multiple Canal Involvement Instead of affecting a single balance canal, some patients experience involvement of: Two canals Multiple canals on the same side Both ears simultaneously This often occurs following: Falls Sporting injuries Motor vehicle accidents Head trauma Persistent Symptoms Most BPPV episodes are brief. Atypical variants may involve: Longer-lasting dizziness Symptoms that don't respond immediately to treatment Recurrent episodes More complex eye movement patterns Why Accurate Diagnosis Matters One of the most important findings from recent neuro-otology research is that not all positional dizziness originates from the inner ear. Some forms of positional vertigo can arise from the: Brainstem Cerebellum Central nervous system This is known as Central Positional Vertigo or Central Positional Nystagmus (CPN). While relatively uncommon, central causes require a very different management approach. Potential underlying causes may include: Vestibular migraine Multiple sclerosis Stroke affecting balance centres Tumours affecting vestibular pathways Other neurological disorders This is why thorough assessment is so important whenever symptoms don't fit the expected pattern. Warning Signs That Need Further Investigation Research highlights several features that may suggest a central rather than peripheral cause. These include: Persistent dizziness that does not improve Symptoms that worsen despite appropriate treatment Double vision Facial weakness Limb numbness Difficulty speaking Severe headaches Unusual eye movement patterns Symptoms lasting several minutes rather than seconds These signs don't automatically indicate a serious problem, but they do warrant further investigation and potentially referral for additional testing. The Importance of Comprehensive Assessment At Health Wise Chiropractic, we understand that dizziness can have many different causes. That's why a thorough assessment often includes: Detailed History Understanding: When symptoms started What movements trigger symptoms Previous injuries Migraine history Medication use Previous episodes of vertigo Positional Testing Specific tests help evaluate how the balance system responds to movement. These may include: Dix-Hallpike testing Roll testing Head positioning assessments Balance evaluation Neurological Screening Where appropriate, clinicians may assess: Eye movements Coordination Balance control Reflexes Other neurological indicators This helps ensure patients receive the most appropriate pathway of care. What Does Research Say About Conservative Care? When dizziness is related to typical BPPV, evidence strongly supports the use of repositioning manoeuvres to restore normal vestibular function. For musculoskeletal conditions that often accompany dizziness—such as neck stiffness, headaches, postural strain, and balance dysfunction—research continues to support conservative, evidence-based care. Importantly: Lower back pain alone accounts for approximately 24% of all global disability-adjusted life years related to workplace ergonomic factors (Ead et al., 2024). Modern Clinical Practice Guidelines show overwhelming support for Spinal Manipulative Therapy (SMT), with 90% recommending it for lower back pain and 100% recommending it for neck pain (Trager et al., 2024). Evidence consistently supports combining manual therapy with exercise and education rather than relying on a single treatment modality. Why a Multimodal Approach Matters Research shows people generally achieve the best outcomes when care includes multiple strategies working together. The most effective healthcare programmes rarely rely on a single treatment. Research consistently shows that combining hands-on care, targeted exercise, education, lifestyle modifications, and active self-management produces better long-term outcomes than passive treatment alone. This approach helps: Improve movement confidence Restore the balance function Optimise posture Reduce neck tension Support vestibular rehabilitation Improve long-term resilience What an Evidence-Based Recovery Plan May Look Like Every patient is different, but a comprehensive approach may include: Step 1: Accurate Assessment Identify whether symptoms are consistent with: Typical BPPV Atypical BPPV Vestibular dysfunction Neck-related dizziness A condition requiring medical referral Step 2: Appropriate Repositioning Manoeuvres Where indicated, specific manoeuvres may help reposition displaced otoconia. Step 3: Vestibular Rehabilitation Tailored exercises designed to: Improve balance Reduce motion sensitivity Restore confidence with movement Step 4: Neck and Postural Care Addressing: Cervical stiffness Joint restriction Muscle tension Postural stress from desk work and commuting Step 5: Education and Self-Management Helping patients understand: Triggers Recovery expectations Home exercises Strategies to reduce recurrence Is Manual Therapy Safe? Safety is understandably one of the most common questions patients ask. Large clinical reviews have shown that serious complications associated with conservative manual therapy are extremely rare. Research suggests that appropriately delivered manual therapy has a strong safety profile and compares favourably with the known risks associated with prolonged prescription medication use (Breen et al., 1999). As with any healthcare intervention, assessment and individualisation remain essential. When Should You Seek Help? If you're experiencing: Recurrent vertigo Balance problems Neck-related dizziness Unsteadiness when walking Symptoms when rolling in bed Ongoing episodes that aren't improving a professional assessment can help identify the underlying cause and guide the most appropriate management strategy. Supporting Sunbury and Melton Families Through Better Balance and Mobility At Health Wise Chiropractic, our teams in Sunbury and Melton regularly help local residents navigate dizziness, balance concerns, neck tension, headaches, and musculoskeletal issues that can affect everyday life. Whether you're commuting daily, working long hours at a desk, keeping up with young children, or simply wanting greater confidence in your movement, our evidence-informed approach focuses on helping you understand what's driving your symptoms and creating a personalised plan to optimise your recovery. If dizziness, vertigo, or balance concerns are affecting your daily life, the Health Wise Chiropractic team in Sunbury and Melton is here to help you take the next step toward feeling steadier, stronger, and more confident. How Chiropractic Care May Help At Health Wise Chiropractic, we take a comprehensive approach to posture-related care. Treatment may include: Chiropractic adjustments Postural assessment Soft tissue therapy Corrective exercises Ergonomic advice Laser therapy Shockwave therapy Spinal decompression therapy We focus on addressing both the symptoms and the underlying biomechanical stress contributing to neck dysfunction. About the Author Dr Julian Simpson is an Australian chiropractor with over 15 years of experience in musculoskeletal healthcare and rehabilitation. He is a Board Member of the Chiropractic Australia Research Foundation and has reviewed and written more than 800 evidence-based health articles focused on spinal health, rehabilitation, sports injuries and conservative care approaches. His treatment focus includes: Chiropractic adjustments Sports chiropractic Massage therapy Shockwave therapy Laser therapy Non-surgical spinal decompression Dr Simpson provides patient care through Healthwise Chiropractic, serving communities including Sunbury, Melton, Diggers Rest and surrounding regions. reference Sideris G, Korres G, Lazarou I, Vasileiou E, Male A, Kaski D. Differentiating Atypical BPPV from Central Positional Vertigo: A Narrative Review. NeuroSci. 2026 Mar 3;7(2):32. doi: 10.3390/neurosci7020032. PMID: 41874035; PMCID: PMC13010662.

Written by Dr Julian Simpson — Chiropractor with 15+ years of experience, Board Member of the Chiropractic Australia Research Foundation, and author/reviewer of 800+ health articles. Why Your Vertigo Keeps Coming Back: The Hidden Link Between Inner Ear Balance, Health Conditions, and Everyday Function When “Just Vertigo” Starts Interrupting Real Life If you’ve ever been sitting up in bed in Sunbury or rolling over after a long day commuting home along the Calder Freeway and suddenly felt the room spin, you’ll know how disruptive vertigo can be. For many people across Sunbury and Melton, these episodes don’t just happen once. They come back—sometimes weeks or months later—leaving you cautious with movement, uneasy when driving, and unsure whether it’s something serious or “just one of those things.” What research is now showing is that benign positional vertigo (BPPV), while often mechanical in origin, is rarely influenced by the inner ear alone. Instead, it appears to be shaped by broader health factors that affect the body’s balance system over time. What the Research Says About BPPV and Recurrence BPPV is one of the most common causes of vertigo worldwide. It occurs when tiny calcium crystals in the inner ear shift into the wrong balance canal, sending false signals about movement. While treatment is usually quick and effective, recurrence is surprisingly common. Recent clinical research shows: BPPV recurrence rates sit around 20–30% within 6 months of treatment Large cohort data confirms a 24.7% recurrence rate in real-world clinical settings This means roughly 1 in 4 people experience it again within half a year But the more important question is why it comes back. The Evidence: It’s Not Just an Ear Problem A large retrospective clinical study involving 300 patients found that recurrence of BPPV is significantly associated with systemic health conditions—not just inner ear mechanics. Key findings from the research: People with recurrence were more likely to have: Diabetes mellitus (DM) → ~1.6x increased risk Hypertension (HT) → ~1.5x increased risk Migraine → ~1.75x increased risk These findings suggest that BPPV is influenced by whole-body systems that affect: Blood flow to the inner ear Metabolic health Neurological sensitivity Vestibular stability and recovery In other words, the inner ear doesn’t operate in isolation—it responds to the health of the entire body. Why This Matters for Everyday Australians For many people in Sunbury and Melton, these risk factors are already part of daily life: Long hours sitting at a desk job in Melbourne Travelling daily via the Western Highway or Calder Highway Managing stress, sleep disruption, and busy family schedules Living with conditions like blood pressure or blood sugar fluctuations These factors don’t “cause vertigo” on their own—but they can influence how stable the balance system remains over time. How Chiropractic Care Fits Into the Bigger Picture While BPPV itself is treated with specific vestibular repositioning techniques, research increasingly supports a broader, whole-body approach to reducing recurrence risk and improving functional stability. Lower back pain and musculoskeletal strain are also highly prevalent, with global data showing: Lower back pain accounts for approximately 24% of all global disability-adjusted life years linked to workplace ergonomic factors (Ead et al., 2024) This matters because spinal function, posture, and neck mechanics all directly influence balance input from the cervical spine. What Clinical Guidelines Say About Manual Therapy Modern international Clinical Practice Guidelines strongly support conservative spinal care: 90% of guidelines recommend spinal manipulative therapy (SMT) for lower back pain 100% of guidelines recommend SMT for neck pain (Trager et al., 2024) This level of consensus is significant. It reflects a strong evidence base supporting spinal care as a frontline healthcare modality when appropriately applied. Why a Multimodal Approach Works Best Research consistently shows that the best outcomes come from combining several approaches rather than relying on a single treatment alone. This is known as a multimodal care approach, which may include: Manual therapy or spinal adjustments Targeted exercise rehabilitation Postural correction strategies Vestibular or balance retraining (when relevant) Patient education and self-management programmes Studies support this integrated model as more effective than passive care alone (Gevers-Montoro et al., 2021; LeFebvre et al., 2012). What a Chiropractic Care Plan May Look Like At Health Wise Chiropractic, care is tailored to the individual, but a typical evidence-informed pathway may include: 1. Comprehensive Assessment Posture and spinal alignment analysis Neck and upper back mobility testing Neurological screening where appropriate Balance and dizziness history review (if relevant) 2. Identifying Contributing Factors Cervical joint restriction Muscle tension patterns Ergonomic strain from work or driving Lifestyle and recovery stressors 3. Manual Therapy and SMT (When Appropriate) Gentle spinal adjustments Joint mobilisation techniques Soft tissue therapy to reduce muscular tension 4. Active Rehabilitation Neck stability exercises Balance and proprioception retraining Postural correction drills Functional movement re-education 5. Education and Prevention Understanding triggers and recurrence patterns Workplace setup advice Home strategies to reduce strain during commuting or screen time Long-term self-management planning Why a Holistic Approach Matters When multiple systems contribute to dizziness, balance issues, or musculoskeletal strain, the most effective care programmes address the body as a connected system. Combining manual therapy, exercise, education, and lifestyle support helps optimise spinal function, reduce recurrence risk, and improve long-term stability—rather than focusing on symptoms in isolation. Is Chiropractic Care Safe? Safety is a valid and important concern. Clinical reviews indicate that: Serious complications from conservative manual therapy are extremely rare When delivered appropriately, manual therapy is considered a safe, frontline healthcare modality Risk profiles are favourable compared with long-term reliance on prescription pain medication (Breen et al., 1999) As with any healthcare approach, individual assessment is essential to ensure care is appropriate and safe. Supporting Sunbury and Melton Through Better Balance and Spinal Health Whether you’re: Driving long distances along busy commuter corridors Sitting at a desk all day Managing recurring neck stiffness or dizziness Or simply trying to stay active with family life your spine and nervous system play a central role in how your body adapts and maintains balance. At Health Wise Chiropractic in Sunbury and Melton, our focus is on helping you understand the why behind your symptoms, not just treating the surface presentation. Through evidence-based care programmes that combine assessment, manual therapy, rehabilitation, and education, we aim to help local residents move more freely, feel more stable, and return to everyday life with confidence. If recurrent dizziness, vertigo, or neck-related tension is affecting your routine, a tailored assessment may be the next step toward clarity and recovery. How Chiropractic Care May Help At Health Wise Chiropractic, we take a comprehensive approach to posture-related care. Treatment may include: Chiropractic adjustments Postural assessment Soft tissue therapy Corrective exercises Ergonomic advice Laser therapy Shockwave therapy Spinal decompression therapy We focus on addressing both the symptoms and the underlying biomechanical stress contributing to neck dysfunction. About the Author Dr Julian Simpson is an Australian chiropractor with over 15 years of experience in musculoskeletal healthcare and rehabilitation. He is a Board Member of the Chiropractic Australia Research Foundation and has reviewed and written more than 800 evidence-based health articles focused on spinal health, rehabilitation, sports injuries and conservative care approaches. His treatment focus includes: Chiropractic adjustments Sports chiropractic Massage therapy Shockwave therapy Laser therapy Non-surgical spinal decompression Dr Simpson provides patient care through Healthwise Chiropractic, serving communities including Sunbury, Melton, Diggers Rest and surrounding regions. reference Doğan B, Baklacı D. Association between diabetes mellitus, hypertension, migraine, and recurrence risk in benign paroxysmal positional vertigo: a retrospective cohort study. Front Neurol. 2026 Feb 24;17:1785013. doi: 10.3389/fneur.2026.1785013. PMID: 41815728; PMCID: PMC12971438.