Vestibular Physio in Vancouver, When Dizziness Hits Out of Nowhere, and What Dry Needling Can Actually Do
- scopophotography
- Jan 8
- 5 min read
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Meet Justin Shing
Justin is a Vancouver physiotherapist who works with dizziness and vestibular cases using a practical mix of assessment, vestibular exercises, hands-on manual therapy, and dry needling when appropriate. His dry needling training includes Evidence In Motion and Kinetacore Functional Dry Needling Level 2 completed in Vancouver, BC (2019).
Physio Focus : Vestibular rehab, BPPV support, post concussion dizziness, neck related dizziness, headaches, TMJ and jaw tension, dry needling
At a Glance
Best for: dizziness, vertigo, “room spinning,” balance issues, post-concussion symptoms, neck-related dizziness, motion sensitivity Common triggers: rolling in bed, bending down, looking up, picking up a child, quick head turns What we do: assessment, vestibular exercises, balance retraining, and when appropriate, BPPV repositioning maneuvers like Epley Where dry needling fits: helpful when neck or jaw tension, headaches, or muscle guarding is adding fuel to symptoms, not the primary treatment for BPPV Where to get help: Justin Shing offers vestibular therapy bookings in Yaletown, Burnaby and Kerrisdale
It hit me out of nowhere, picking up D. I still remember the moment because it felt so random. I was at home in Vancouver, in the regular morning rush, and D was asking to be picked up. I bent down, scooped him up, and suddenly the whole room shifted. Not a little lightheaded feeling. It was the kind of spin that makes you grip the counter and blink hard because your brain is trying to make sense of what your eyes are seeing.
The first thought was honestly, “I’m fine.” The second thought was, “I’m not fine.”
I put D down and tried to act normal. You know the move, keep your voice steady so your kid does not get worried. But inside, my body was going into alert mode. I started doing that quiet math people do when they get dizzy. What if this happens on the stairs? What if it happens while driving? What if I drop the kids?
Then it happened again, a couple days later, getting out of bed. I rolled over the “wrong” way and got that same spinning hit. That’s when it became real, because when dizziness repeats, your world gets smaller fast. You start moving carefully. You avoid quick turns. You stop looking up. You roll out of bed like you’re made of glass. And even when the spinning is not happening, you can feel slightly off. Not enough to call it vertigo, but enough that grocery store aisles feel weird, scrolling feels gross, and you get that floating sensation like your body is half a step behind your brain.
This is where a lot of people get stuck. They go online late at night, read endless threads, and bounce between “it’s crystals,” “it’s stress,” “it’s my neck,” and “it’s something scary.”
A lot of these cases sound different, but the emotions are the same: confusion, fear, and that frustrating feeling of not trusting your own body. As a physio, I also know something else: dizziness has patterns. And when you find the pattern, you can treat the right thing. A very common pattern is dizziness triggered by position changes like rolling in bed, bending down, or looking up, which can point toward BPPV in the right context.
That is why vestibular physiotherapy matters. It turns “random dizziness” into something we can assess, name, and fix.
Why did I get dizzy when I rolled out of bed or picked up my kid?
This is the question almost everyone asks first, and honestly, it is a fair one.
One common cause is BPPV, benign paroxysmal positional vertigo. It is a type of vertigo that is often triggered by position changes like rolling in bed, bending, or looking up.
Other common signs a vestibular physio will screen for include:
Vestibular neuritis or labyrinthitis style symptoms, often following a viral illness, where early vestibular rehab can help recovery
Concussion related dizziness and balance issues
Neck related dizziness, sometimes called cervicogenic dizziness, where neck irritation and altered sensor input can contribute to symptoms
Vestibular migraine patterns, where dizziness and sensory sensitivity come in waves
A proper assessment matters, because the right treatment depends on the cause.
What is vestibular physiotherapy?
Vestibular physio is physiotherapy for dizziness, vertigo, and balance problems that come from how your inner ear, eyes, brain, and body coordinate movement.
A good vestibular plan usually includes:
A thorough assessment of symptoms and triggers
Eye and head movement testing
Balance testing
A targeted home program to retrain the system
When appropriate, specific treatments for BPPV, like canalith repositioning maneuvers, such as the Epley maneuver.
Vestibular rehab is also supported in Canadian and provincial clinical pathways as an evidence-based approach, and early exercise-based rehab is emphasized for recovery in certain vestibular conditions.
When should dizziness be treated as urgent?
A vestibular physio is a great first step for many cases, but there are red flags where you should seek urgent medical care first.
Get urgent medical help if dizziness comes with:
new weakness, facial droop, severe trouble speaking, severe coordination changes
sudden severe headache that feels unusual
chest pain, fainting, or severe shortness of breath
sudden hearing loss or neurological symptoms
If it is “just dizziness” but it is persistent, worsening, or scary, that still counts as worth checking.
What does a vestibular physio assessment look like?
People are often surprised that vestibular physio is not just balance exercises.
A thorough assessment may include:
A detailed symptom history, triggers, timing, and pattern
Positional testing for BPPV and related causes
Eye movement tests and gaze stability
Balance and gait testing
Neck mobility and headache screening when relevant
The goal is not to guess. It is to identify which system is driving the symptoms, then build a plan that makes sense.
What you should expect from care
A clear assessment
A plan built around your specific triggers (bed, bending, screens, busy environments)
Progressions that rebuild confidence, balance, and normal movement
Honest boundaries on when you need medical follow up, especially with red flags
What are signs and symptoms to look out for?
Often people who experience dizziness or nausea have one or more of these going on at the same time:
Neck stiffness, headaches, screen posture overload
Jaw tension, clenching, TMJ symptoms, facial tightness
High stress and sleep debt, which can amplify symptoms
Guarding patterns that keep the nervous system on high alert
In those cases, manual therapy and targeted needling can help calm pain, reduce muscle guarding, and make vestibular rehab exercises more tolerable.
A good physiotherapist will pair targeted needling with manual therapy as part of a bigger plan to help you with your vestibular symptoms.
What treatment can look like when dizziness is mixed with neck or jaw tension
This is the zone where Justin’s style of care can be especially useful. He uses dry needling selectively inside a bigger plan, paired with manual therapy and realistic habit change, especially when jaw pain rides along with laptop days, neck tension, or clenching under stress.
That overlap matters because:
jaw clenching can feed neck tension
neck tension can feed headaches
headaches and neck irritation can amplify dizziness sensations
So a combined plan might include:
manual therapy for neck and upper back mobility
dry needling for specific overactive muscles when appropriate
breathing and down-regulation strategies when symptoms are jumpy
vestibular exercises when the vestibular system is involved
a progression plan so you stop avoiding movement
How long does vestibular physio take to work
This depends on the cause, but here is a grounded expectation.
BPPV often improves quickly with the correct maneuver, sometimes within a session or a small number of visits, though it can recur.
Other vestibular disorders may take weeks of consistent exercises and graded exposure, and early vestibular rehab is commonly recommended in care pathways.
If you have layered issues, like dizziness plus chronic neck tension plus stress, it can take longer, but it is still very treatable with a clear plan
The biggest predictor is consistency. The exercises look simple, but they work because they are repeated.
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