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Take Charge of Your Dizziness: The Power of Self-Advocacy in Vestibular Care

By Dr. Rupali Vyas, Vestibular Specialist


Over the last 15 years as a Vestibular Specialist, as I see more complex case presentations with people suffering from dizziness & vertigo, I see a gap where patients are unable to advocate for themselves at the right time—leading to negative outcomes and chronic symptoms.


Common Key Problems Identified


  • Overdiagnosis of BPPV (Benign Paroxysmal Positional Vertigo) in general physical therapy settings

  • Inappropriate repeated Epley maneuvers without symptom resolution

  • Failure to refer to Vestibular Specialists when treatment isn't working

  • Lack of knowledge seen in non-Vestibular Therapists about other peripheral or central vestibular disorders besides BPPV that may require further investigation


Non-Vestibular Specialists Should Focus On:


  • Recognition of red flags when BPPV treatment isn't working

  • Understanding when specialist referral is appropriate

  • Encouraging self-advocacy strategies for patients


Important Timelines


  • BPPV should improve within 1–3 sessions if correctly diagnosed

  • After 2–3 unsuccessful treatments, specialist referral should be considered

  • Continued treatment beyond 4–6 sessions without improvement is inappropriate


Patients should not accept repeated unsuccessful treatments.This scenario unfortunately occurs too frequently in clinical practice and highlights the importance of proper vestibular training and timely specialist referral.


Why Self-Advocacy Matters


Too often, patients are told to “wait and see,” are misdiagnosed, or are made to feel like their concerns are not urgent enough.


Being your own advocate as a patient means reclaiming your role in the healing process. Your body’s wisdom is valid, and it deserves to be heard.


If something is not working, you do not need to suffer in silence or wait for things to improve. Speak up. Ask questions. Seek change. Pursue answers that lead to real progress.


Why Seeking Care from a Vestibular Specialist at the Right Time Matters


Refer to the image below to understand the processes that could precipitate chronic vestibular conditions like PPPD (Persistent Postural-Perceptual Dizziness) due to neural maladaptation.


Final Thoughts


I hope everyone understands that as a patient, it’s not just about improvement. It’s about reclaiming your power in the healing process and becoming an active voice in your own care.

As a patient if you are not fully aware of what’s going on ,ask questions. Express your concerns. And if progress isn’t happening, don’t hesitate to seek out a Vestibular Specialist directly.




Contact Us


If you're unsure whether your symptoms are being properly addressed, or if you’d like a second opinion from a Vestibular Specialist, we're here to help.


Reach out today to schedule a FREE consultation or ask any questions. We’re committed to helping you find clarity, support, and a path forward.


📞 Phone: 650-336-5394

🌐 Website: www.congruencept.com If you are outside California, a helpful place to start is the 

👉 Vestibular Disorders Association (VEDA) Clinician Directory —a reliable resource where you can find qualified vestibular providers near you.


 
 
 

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