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Vertigo and Dizziness Treatment in Needham, MA

Dizziness that hasn't settled is rarely one problem. We test the inner ear, eyes, neck, balance and blood flow together, find what is driving your symptoms, and build your rehab from the results.

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No referral needed · Progress measured by retesting

Videonystagmography: a person wears infrared goggles while eye movements are recorded

What kind of dizziness is it?

People describe dizziness many ways: the room spinning, you spinning, rocking, swaying side to side, or just feeling off. Words often seem to downplay it. Where it comes from matters more than the word, because each source calls for different care.

Where it starts	What it often feels like	Examples
Inner ear (peripheral)	Spinning that comes in episodes, often with head or position changes	BPPV, vestibular neuritis, Meniere's
How the brain processes balance (central)	Constant unsteadiness or rocking, worse in busy places	PPPD, after a concussion, vestibular migraine
Eyes working with the inner ear	Screens, scrolling, store aisles and moving crowds set it off; eyes tire quickly	After a concussion, after an inner-ear injury
Neck	Dizziness with neck movement, neck tension or guarding	Whiplash, concussion
Blood flow on standing	Lightheaded upright, close to fainting, better lying down	POTS, orthostatic intolerance

Most lingering dizziness is a mix of these. That is why we test them together instead of one at a time.

Conditions we see

Most patients come to us after an ENT, neurologist or primary care workup, often unsure which diagnosis fits.

Dizziness after a concussion

Inner ear, eyes, neck and blood flow tested together, weeks or months after the injury.

Vertigo, BPPV, vestibular neuritis, PPPD

Testing that tells inner-ear problems from brain-processing ones, in every plane of movement.

Dizziness on standing, POTS

Brain blood flow and CO2 measured on a tilt table.

Concussion with ongoing symptoms

Dizziness treated as part of the whole recovery plan.

Meniere's, acoustic neuroma

Rehab alongside your ENT's care, to improve daily function. Co-managed with ENT.

Less common neurological causes

A broad neurological workup when the usual answers don't fit.

How we find the cause

The right test comes before the right treatment. On your first visit, one doctor reads all of these together:

Video eye recordings (VNG): eye drifts at rest, optokinetic responses to full-field visual motion, saccades, and the vestibulo-ocular reflex (VOR) and its suppression during head movement.
Every plane of movement: your inner ear senses rotation (pitch, yaw and roll, through the semicircular canals) and straight-line movement (bob, heave and sway). We can test rotation in a rotary chair, up-and-down movement on a hydraulic table, and side-to-side movement. Which planes we test depends on your other results and the symptoms you describe. Many patients have never had these planes tested at all.
Computerized balance testing on firm and unstable surfaces, eyes open and closed, in different head positions.
Your neck: a hands-on exam of tension, guarding and how it affects your eyes and balance.
Blood flow to the brain and CO2, when standing up makes things worse.

These tests are rarely found together outside a hospital. Even in hospitals, they're split across departments that seldom coordinate one rehab plan, and rehab often happens somewhere else. Here, the same team runs your tests, builds your rehab from them, and keeps using the same equipment throughout your care to measure your progress. You see your own recordings and we explain them. Read the full testing detail.

Clinician turning a patient's head during computerized balance testing on the CAPS force plate

Patient standing on foam pads during balance training at Pro Performance Care

How care works

There is no standard dizziness plan. Your sessions are built from your own test results, and several therapies run at once (therapy stacking), so each visit works on the specific points your testing found.

Some patients need their head kept still while we train precise eye movements and optokinetic integration.
Others do best with neck work combined with head-position feedback, balance and eye drills.
Repositioning maneuvers like the Epley, rotary chair turns, and walking drills (including walking backwards) are used when they fit.

Care is frequent up front, then tapers to check-ins with a home plan built from your results. Patients who travel often start with an intensive of daily sessions. Progress is measured by repeating your first-day tests.

Two recent patients

A gymnast who couldn't drive, shop or look at a screen after hitting her head. Her eyes drifted at rest; after care, the drift and the light sensitivity were gone and she's back to reading and working.

Her story

A woman with two weeks of sudden, unexplained vertigo that didn't fit BPPV. Within three days her eye recordings were trending back toward normal.

Her story

Questions people ask

Is vertigo always loose crystals in the ear?

No. Loose crystals (BPPV) are one cause, and less common after a head injury than people think. The inner ear, its nerve, how the brain processes balance, the neck and blood flow can all be involved.

Is my dizziness just anxiety?

Being dizzy is anxiety-provoking. That doesn't mean anxiety is causing it. Our testing looks for the physical drivers, and we're used to patients who feel both.

Will it fade on its own?

Sometimes. When it has lingered for weeks or months, specific testing shows what is still holding it up.

Do I need a referral?

No. You can call us directly, and one of our doctors offers a free phone consult first.

Will testing make my dizziness worse?

It can be tiring, but it usually doesn't cause a flare. When it does, the flare is mild and comes the same day. We adjust tests to how you're doing, and we've never seen lasting worsening from test day.

How long does care take?

It depends on your findings. Acute problems like BPPV often need a short course; long-standing patterns like PPPD may take longer, or respond quickly to an intensive.

When to get urgent care

Go to the emergency room for dizziness with any stroke signs: sudden facial weakness, sudden arm weakness or numbness, slurred speech, sudden confusion or a sudden severe headache. Sudden, unexplained dizziness deserves extra caution. After a significant head injury, initial imaging can be warranted to rule out bleeding before rehab begins.

Get started

Pro Performance Care, 464 Hillside Ave, Suite 211, Needham, MA. Patients come from Needham, Wellesley, Newton, Dedham, across Greater Boston and farther.

Local patients