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.com

www.Goodliferehab.com

Midwest Vestibular Rehab Symposium

Hosted by:

🎤 Dr. Abbie Ross, PT, NCS

🎤 Dr. Danielle Tolman, PT

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This 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 Timestamps

01:26 From neuro rehab to orthopedic & vestibular care
05:18 Why dizziness & pain are not owned by one specialty
06:18 Definition of cervicogenic dizziness (updated understanding)
06:48 Prevalence: How common is it really?
08:14 Cervical spine involvement in dizziness cases
10:12 Why movement loss matters more than pain
11:36 Real-world complexity: vestibular + cervical overlap
14:20 Neck’s role in balance reflexes
17:12 Why function matters more than symptoms
19:07 Testing beyond standard vestibular exams
21:04 Why symptoms alone can mislead treatment
22:02 Helping patients understand the neck-dizziness connection
24:02 Real-life clinical example explained
26:28 Pain science vs dizziness: overlapping principles
27:55 Drivers of symptoms: stress, lifestyle, comorbidities
29:17 Functional neurological disorders & validation
30:41 Nervous system regulation strategies
32:09 Practical tools: breathing, guided imagery, small wins
33:35 Therapist challenges with patient buy-in
35:00 Posture tips that actually work
36:54 Simple, effective home exercise strategies
38:17 Clinical pearls: what clinicians must remember
39:15 Words matter: how language affects recovery
40:13 Using reassurance to reduce fear
41:35 Why joy and meaningful activity matter in recovery
44:06 Empowerment: patients can change and improve