Dizziness and vertigo after a crash — why it happens and how it's treated.

Dizziness is a symptom, not a diagnosis, so the first job is to work out where it is coming from. After a crash, three causes show up most often. They feel different, and they are treated differently, which is why an assessment matters.

The first is the inner ear. A common form is BPPV, which stands for benign paroxysmal positional vertigo. In plain terms, tiny calcium crystals that normally sit in one part of the inner ear get knocked loose and drift into a part that senses movement. A jolt in a crash can dislodge them. The result is brief, intense spinning triggered by changing head position, such as rolling over in bed or looking up. The spinning usually lasts seconds rather than minutes.

The second is the neck, called cervicogenic dizziness. When the neck is strained and stiff after a whiplash injury, the signals it sends to the brain about head position can get out of step with what the eyes and inner ear report. That mismatch can feel like unsteadiness or light-headedness, and it often tracks with neck pain, stiffness, and certain neck movements.

The third is concussion. A crash can shake the brain even without a direct blow to the head, and the balance system can be affected. Dizziness, a foggy feeling, sensitivity to busy visual scenes, and trouble with quick head turns can all be part of a concussion. These causes can occur together, which is one reason self-diagnosis is hard.

Most post-crash dizziness is not an emergency. Some signs are. Call 911 or go to the emergency department if dizziness comes on suddenly and severely, or comes with any neurological warning signs: a sudden severe headache, slurred speech, weakness or numbness in the face, arm, or leg, double vision or loss of vision, trouble walking, fainting, a stiff neck with fever, or confusion.

The closest emergency department to the clinic is Lions Gate Hospital in North Vancouver. If you are unsure how serious a symptom is, the safest step is to get it checked rather than wait. For general guidance on when dizziness needs medical attention, BC residents can also use HealthLinkBC or call 8-1-1 to speak with a nurse. This page is educational and is not a diagnosis.

The main treatment for most crash-related dizziness is vestibular rehabilitation, a type of physiotherapy that targets the balance system. It starts with an assessment that looks at your eyes, your head movements, your balance, and your neck, so the cause can be sorted out before any exercises begin.

From there, treatment is matched to the cause. For BPPV, a clinician may use gentle, guided head-position changes that aim to move the loose inner-ear crystals back to where they belong. For inner-ear or concussion-related dizziness, the work centres on gaze and balance retraining: specific eye and head exercises that help the brain adapt, plus graded balance practice. When the neck is involved, treating the neck itself, through hands-on therapy and exercise, is part of the plan.

The exercises are dosed to your response. A small, short-lived increase in symptoms during retraining can be expected and is used to guide the next step rather than to stop. Your physiotherapist sets the pace based on how your symptoms behave, not a fixed timeline.

Under Enhanced Care, ICBC pre-approves physiotherapy in the first 12 weeks after a reported crash, and vestibular rehabilitation for crash-related dizziness falls within that physiotherapy care. You do not need a referral to start. A claim number and your Personal Health Number are enough. ICBC publishes the current details on its treatment-access page.

We confirm your coverage with ICBC before the first session and bill ICBC directly, so there is nothing to pay upfront for covered visits.