What I might suggest looking at is if your vertigo could be caused by a misalignment of your upper cervical vertebrae with your neck and jaw. If you are having muscle spasms moving the vertebrae around, you can have vertigo, and severe headaches up the back and sides of your head. Some of those conditions might also compromise blood flow which then could cause dizziness. If you haven't considered this before, I would recommend possibly seeing a spine specialist and getting imaging to diagnose any alignment or instability spine problems. A physical therapist should not treat your neck without imaging and a doctor's approval because instability in the upper C spine can be serious. I have experienced sudden vertigo and at the time, I didn't know my upper cervical vertebrae were out of alignment. All I had to do was look upward, and I lost my balance immediately. At the time, I did have a cervical spine problem and had not had surgery, and it was generating lots of muscle spasms that did change the normal alignment and curve of my C spine and everything was tighter on one side causing vertebrae to twist or tilt. My physical therapist very gently realigned my spine and released the muscle spasms which corrected the vertigo. The other symptoms you mention with severe headaches, arm weakness, fatigue and tingling can also be spine related. I certainly would recommend seeing a Mayo specialist. I am a Mayo spine surgery patient and at my first visit, I was evaluated by a neurologist first (with other tests and evaluations recommended by him), and then I saw the neurosurgeon. The neurologist can evaluate where nerves are being affected that bring on your symptoms, and that helps a spine surgeon understand more about the case (if it is a spine issue). They need to identify the source of the problem before treating it. Since my spine surgery, I have had a great recovery and I do not have vertigo or balance problems. I don't have spine related pain. I do also have thoracic outlet syndrome (TOS) which causes a compression of nerves and vessels to the arms which could be something else to look at for yourself. Mayo can evaluate that too. TOS is often misunderstood and there are not many places a patient can go to get help for TOS and my treatment for that is physical therapy. Let me know if I can answer anything else about my experience at Mayo.

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