Vertigo.
The room spins, you don't. Cause matters: BPPV, cervicogenic, or true vestibular pathology — different treatments, different urgencies.
A symptom with multiple sources.
Vertigo is a sensation of spinning or movement when nothing is actually moving. Your brain depends on three streams of information to know where you are in space: signals from your inner ear, your eyes, and your cervical spine. When any one of those streams is disrupted, the result is that off-balance, tilting, spinning feeling that makes you grab the nearest wall.
Most cases fall into one of three buckets. BPPV is loose calcium crystals in the inner ear that send the wrong signals when you move your head. Cervicogenic vertigo is a sensory mismatch driven by misaligned vertebrae in the upper neck. And true vestibular disease, like vestibular neuritis or labyrinthitis, usually follows a viral infection.
Here is what most people never hear: the upper neck is one of the most common — and most overlooked — sources of dizziness. Your ENT checked your ears. Your primary doctor ran bloodwork. But nobody looked at your cervical spine, where the joints feed constant position data to the balance centers of the brain.
We see this pattern in our Jacksonville and Orange Park offices constantly. Both BPPV and cervicogenic vertigo respond well to conservative care, and many patients feel a meaningful improvement within the first few visits once the actual driver is identified.
Does this sound familiar?
The right tool for the right cause.
Everyone assumes it is an ear problem. Often it is a neck problem.
Your brain constantly fuses three inputs — inner ear, vision, and the position sensors in your cervical spine — to build a stable picture of where your body is in space. When the upper neck joints are restricted or misaligned, they send distorted signals, and the mismatch registers as dizziness even when your ears are perfectly healthy.
This is why so many people cycle through an ENT, a round of bloodwork, and sometimes an MRI without ever getting an answer. The ears looked fine because the ears were never the problem. A cervical assessment is the missing step, and it is a quick one.
The three buckets — and why the distinction matters
BPPV is the most common type. Tiny calcium crystals in the inner ear get knocked loose and drift into a canal where they do not belong; when you move your head, they send a false sense of spinning. It responds to repositioning maneuvers, not medication.
Cervicogenic vertigo comes from the neck. Inner-ear inflammation — vestibular neuritis or labyrinthitis — usually follows a viral infection and is intense but self-limiting. Chronic vestibular disorders come and go unpredictably. Each of these needs a different plan, which is why guessing wastes months.
What to expect at your evaluation
We start by sorting which type of vertigo you have. Positional testing reproduces BPPV in a controlled way, cervical assessment checks the upper neck, and a careful symptom history flags anything that belongs to an ENT or neurologist instead. That sorting step is the whole game — the right maneuver for the wrong type will not help.
From there the plan is straightforward: repositioning for crystals, upper cervical work for a neck-driven pattern, soft-tissue release for muscle contribution, and a short course of balance retraining to lock in the result.
How long recovery takes
BPPV often resolves in one to three repositioning sessions. Cervicogenic vertigo usually eases over a few weeks of consistent care as neck motion normalizes. Residual unsteadiness responds to a short block of vestibular rehab.
We track your response at each visit and adjust the plan rather than repeating something that is not working. If the picture does not fit a mechanical cause, we refer you to the right specialist quickly instead of spinning through more appointments.
Questions, answered.
Stop bracing for the spin.
Thirty-minute evaluation to identify which type of vertigo you have and the protocol that resolves it.
Book a vertigo consult