Dizziness and Pain: The Intersection of the Vestibular and Musculoskeletal Systems

In this episode of Talk Dizzy To Me, Dr. Abbie Ross, PT, NCS and Dr. Danielle Tolman PT are joined by Dr. Mickey Shah, PT, D.Sc. NCS, OCS, FAAOMPT, Dip. MDT; Certified Vestibular Rehabilitation Specialist - Emory, AVPT (Pittsburgh) to unpack the connection between pain and dizziness.Together, they explore how the neck plays a critical role in balance, why dizziness isn’t always vestibular, and how clinicians can better assess and treat patients with overlapping symptoms.From real clinical insights to practical strategies, this episode bridges the gap between vestibular therapy, pain science, and musculoskeletal care—making it a must-watch for clinicians and patients alike.Episode Resources: www.EvidenceCEU.comwww.Goodliferehab.comMidwest Vestibular Rehab SymposiumHosted by:🎤 Dr. Abbie Ross, PT, NCS🎤 Dr. Danielle Tolman, PTFor episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠[email protected]⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Join our online program and community, The Dizzy Reset™. ⁠Use code TALKDIZZYTOME for 40% off your first month!⁠Connect with Us:→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Book a free call with us⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Get free resources straight to your inbox⁠⁠⁠⁠⁠⁠⁠⁠⁠→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠Join our online program and community, The Dizzy Reset™, for FREE⁠⁠⁠⁠⁠→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Watch podcast episodes (and more) on YouTube ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Follow us on Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Follow us on TikTok⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Follow us on Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Disclaimer⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Enjoying the podcast? Leave us a review!⁠→ ⁠Avulux glasses, use code DIZZYRESET for $25 off⁠This episode is for educational purposes only and is not a substitute for medical advice. Always consult a qualified healthcare provider for diagnosis and treatment. The views expressed by guests are their own and do not necessarily reflect those of the host(s).Episode Timestamps01:26 From neuro rehab to orthopedic & vestibular care05:18 Why dizziness & pain are not owned by one specialty06:18 Definition of cervicogenic dizziness (updated understanding)06:48 Prevalence: How common is it really?08:14 Cervical spine involvement in dizziness cases10:12 Why movement loss matters more than pain11:36 Real-world complexity: vestibular + cervical overlap14:20 Neck’s role in balance reflexes17:12 Why function matters more than symptoms19:07 Testing beyond standard vestibular exams21:04 Why symptoms alone can mislead treatment22:02 Helping patients understand the neck-dizziness connection24:02 Real-life clinical example explained26:28 Pain science vs dizziness: overlapping principles27:55 Drivers of symptoms: stress, lifestyle, comorbidities29:17 Functional neurological disorders & validation30:41 Nervous system regulation strategies32:09 Practical tools: breathing, guided imagery, small wins33:35 Therapist challenges with patient buy-in35:00 Posture tips that actually work36:54 Simple, effective home exercise strategies38:17 Clinical pearls: what clinicians must remember39:15 Words matter: how language affects recovery40:13 Using reassurance to reduce fear41:35 Why joy and meaningful activity matter in recovery44:06 Empowerment: patients can change and improve