When Should Dizziness Be Checked by a Doctor
Most dizziness isn't caused by anything dangerous, and common causes like benign paroxysmal positional vertigo (BPPV) often respond well to treatment. Occasionally, though, dizziness is a sign of something that needs urgent medical care.
This guide sets out the warning signs, when to see your GP, and when seeing a vestibular physiotherapist may be a sensible next step. It isn't a diagnostic tool. If you're unsure, get medical advice.
Call 000 if dizziness or vertigo comes with any of these
Seek emergency help immediately if your dizziness or vertigo comes with:
- sudden, severe headache, especially the worst you've ever had
- weakness, numbness or tingling in the face, arm or leg, particularly on one side
- facial drooping
- slurred speech or difficulty understanding speech
- double vision or sudden loss of vision
- difficulty walking, a sudden loss of coordination, or being unable to stand
- difficulty swallowing
- chest pain, palpitations or shortness of breath
- fainting or loss of consciousness
- dizziness after a significant head injury
These can be signs of stroke, heart problems or other serious conditions where fast treatment matters. Remember F.A.S.T.: Face drooping, Arm weakness, Speech difficulty, Time to call 000.
See your GP promptly if you have
- new dizziness that hasn't been assessed before
- sudden hearing loss, ringing in one ear, or a feeling of fullness in the ear (sudden hearing loss should be assessed urgently, ideally the same day)
- dizziness with fever, ear pain or discharge
- persistent vomiting or being unable to keep fluids down
- dizziness when standing up, especially if you have also felt faint, or have started or changed medications
- dizziness that is getting progressively worse
- repeated falls
- dizziness alongside other new or unexplained symptoms such as weight loss or ongoing fatigue
Your GP can check your blood pressure, heart, blood tests and medications, and refer you for specialist tests or to an ENT specialist or neurologist if needed.
If you're unsure how urgent your symptoms are, you can call healthdirect on 1800 022 222 for advice from a registered nurse, 24 hours a day.
When can a vestibular physiotherapist help?
Physiotherapists with training in vestibular rehabilitation assess and treat problems of the balance system. Seeing one may be appropriate when:
- your vertigo is triggered by head position, such as rolling in bed, lying down or looking up, which is typical of BPPV
- you are still dizzy or unsteady weeks after an episode of vestibular neuritis or labyrinthitis
- your doctor has ruled out serious causes and suggested vestibular rehabilitation
- you have ongoing dizziness made worse by head movement, busy environments or screens
- you feel off-balance or unsteady when walking, and medical causes have been considered
- you have been diagnosed with a condition such as vestibular migraine or PPPD and your doctor recommends physiotherapy as part of your management
In Australia you don't need a referral to see a physiotherapist privately. A good vestibular physiotherapist will also screen for warning signs and refer you back to your GP if your symptoms don't fit a vestibular pattern. Here's what to expect at a vestibular assessment.
Doctor or physio? A quick guide
| Situation | Best first step |
|---|---|
| Dizziness with any stroke or heart warning sign | Call 000 |
| Sudden hearing loss with or without vertigo | GP or emergency department, urgently |
| New dizziness, not yet assessed, no warning signs | GP, or a physio who will screen and refer if needed |
| Brief spinning when rolling in bed or looking up | Vestibular physiotherapist or GP |
| Ongoing unsteadiness after a diagnosed inner-ear illness | Vestibular physiotherapist |
| Diagnosed vestibular migraine, Ménière's disease or PPPD | Your doctor leads; physio may help as part of a team |
Working together
Dizziness often has more than one contributing factor, so many people are best served by their GP, a physiotherapist and sometimes a specialist working together. Telling each of them about your full history, and about any new symptoms, helps everyone give you safer, more effective care.
Key points
- Dizziness with stroke-like symptoms, chest pain, fainting or a severe headache is an emergency: call 000.
- New, worsening or unexplained dizziness, or sudden hearing changes, should be checked by a GP.
- A vestibular physiotherapist can assess and treat many balance-system problems, such as BPPV and ongoing dizziness after an inner-ear illness.
- Physiotherapy complements medical care. It doesn't replace it.
This article is general information only and is not a substitute for individual medical advice. In an emergency, call 000.
References
- healthdirect.gov.au/vertigo and /dizziness (red flags, 1800 022 222)
- Stroke Foundation F.A.S.T
- Tasmanian Health primary care dizziness guidelines (2024)