What's in Your Head: Tools for Pain and Dizziness

Episode 23: Vestibular Migraine—Practical Strategies for Treatment

Dizziness in the grocery store? Discomfort scrolling on your phone? Feeling off balance when turning your head? Vestibular migraine can cause dizziness, motion sensitivity, and vertigo—even without a headache.

In this episode of What’s in Your Head: Tools for Pain & Dizziness, physical therapist Dr. Pete Schultz explores vestibular migraine and how an individualized treatment plan can help you build confidence in everyday activities.

Topics include:

• Common symptoms and what to expect during a medical evaluation.
• Vestibular rehabilitation for balance, head movement, and visual motion sensitivity.
• Breathing exercises and biofeedback to support self-regulation.
• Mindfulness, somatic tracking, and pain reprocessing concepts for responding to symptoms with less fear.
• Gradually returning to cardiovascular exercise.
• Addressing coexisting neck pain, stiffness, and movement limitations.
• Coordinating medical care, rehabilitation, and self-management.

Progress isn’t always a straight line. It can mean tolerating a grocery store more comfortably, recovering more quickly after a flare, or feeling more confident moving your body. Start with a clear diagnosis, a manageable plan, and the right support.

Learn more:

Podcast and resources: painanddizzy.com

Physical therapy in NYC: dynamicsportspt.com

Disclaimer: This podcast is for educational purposes only and does not replace individualized medical advice, diagnosis, or treatment. Consult a qualified healthcare professional about your symptoms and before starting a new treatment or exercise program. Sudden dizziness accompanied by weakness, trouble speaking, double vision, inability to walk, or a sudden severe headache requires emergency evaluation. Sudden new hearing loss also requires urgent medical attention.

Can physical therapy and Pain Reprocessing Therapy work together for headache relief? In this episode of What’s in Your Head? Tools for Pain & Dizziness, Pete Schultz, PT, DPT, OCS, explores how neck function, neurological factors, and pain processing can overlap—and why treatment should evolve as your symptoms and needs change.

Pete discusses migraine, tension-type headaches, cervicogenic headaches, and other head pain patterns, explaining why identifying the headache type is an essential starting point for individualized care.

Topics include:

• How neck pain can contribute to headaches—and why neck pain doesn’t always mean the headache starts in the neck.
• The role of manual therapy, mobility, strengthening, and workstation adjustments.
• When headache-specific medical care and vestibular rehabilitation may be appropriate.
• How biofeedback, paced breathing, and relaxation fit into treatment.
• Using Pain Reprocessing Therapy, somatic tracking, and gradual exposure to address fear and avoidance.
• Measuring progress through greater confidence, activity, and participation—not just pain intensity.

Your pain is real. Understanding the nervous system’s role can open additional treatment possibilities. The goal is a coordinated approach that helps you move better, feel safer, and return to the activities you enjoy.

Learn more:
Podcast: painandizzy.com
Physical therapy and headache evaluations in NYC: Dynamic Sports Physical Therapy

Disclaimer: This podcast is for educational purposes only and does not provide individualized medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional about your symptoms and before changing your treatment. Pain Reprocessing Therapy and the other approaches discussed are not substitutes for appropriate medical evaluation. New, worsening, or substantially changing headaches warrant medical assessment. Seek emergency care for a sudden, severe headache or a headache accompanied by new neurological symptoms.

In this episode of What’s In Your Head: Tools for Pain & Dizziness, Dr. Pete Schultz explores tinnitus, hyperacusis, phonophobia, and misophonia—and why these symptoms can become especially challenging after concussion or migraine.

We discuss the difference between these conditions, how the brain filters and interprets sound, and how attention, fear, hypervigilance, stress, and nervous system sensitization can amplify persistent symptoms.

You’ll also learn when hearing protection is truly necessary, including practical examples involving concerts, power tools, firearms, industrial noise, airplane cabins, and jet engines. We break down decibel levels, the 3-decibel “half-time” rule, and why excessive earplug use in otherwise safe environments may sometimes reinforce sound sensitivity and fear.

The episode also covers concussion-related tinnitus and sound sensitivity, the role of the cervical spine, vestibular system, migraine, and TMJ, and how a multidisciplinary treatment approach may help.

Treatment strategies discussed include:

• Medical and audiological evaluation
• Neck physical therapy
• Vestibular rehabilitation
• Somatic tracking and Pain Reprocessing Therapy
• Nervous system regulation
• Biofeedback
• Mindfulness
• Graded exposure to sound
• Gradual return to meaningful activities

The goal is not to ignore symptoms or push through dangerous noise. It is to protect your hearing when sound is truly hazardous while helping the nervous system relearn that normal everyday sound can be safe.

Disclaimer: This podcast is for educational and informational purposes only and is not intended to provide individualized medical advice, diagnosis, or treatment. Tinnitus and sound sensitivity can have many potential causes and should be evaluated by an appropriate healthcare professional. New or sudden tinnitus, sudden or one-sided hearing loss, pulsatile tinnitus, severe vertigo, significant ear pain, or new neurological symptoms warrant prompt medical evaluation. Always consult a qualified healthcare provider regarding your individual symptoms and treatment.

Learn more at PainAndDizzy.com and DynamicSportsPT.com.

What if being too flexible is actually contributing to your pain?

In this episode of What's in Your Head: Tools for Pain & Dizziness, Dr. Pete Schultz explores Ehlers-Danlos syndrome (EDS) and Hypermobility Spectrum Disorder (HSD)—two conditions that affect connective tissue and can lead to chronic pain, recurrent injuries, headaches, dizziness, fatigue, and joint instability.

You'll learn:

• What Ehlers-Danlos syndrome is and the different subtypes
• The difference between hypermobile EDS and Hypermobility Spectrum Disorder
• How EDS is diagnosed using the Beighton Score and current diagnostic criteria
• Why some people with hypermobility have no pain while others develop persistent symptoms
• The role of connective tissue, fascia, muscles, and the nervous system in chronic pain
• Why strengthening—not stretching—is often the key to feeling better
• Evidence-based physical therapy strategies including progressive strength training, balance and proprioception exercises, endurance training, pacing, and flare-up management
• How stress, sleep, fear, and nervous system sensitization can amplify symptoms—and practical strategies to help regulate the nervous system

Whether you've recently been diagnosed, suspect you're hypermobile, or you're a healthcare professional looking to better understand these conditions, this episode provides practical, evidence-based information to help you stay active, build resilience, and improve function.

Learn more:
🌐 https://www.painanddizzy.com
🌐 https://www.dynamicsportspt.com

Disclaimer:
This podcast is for educational purposes only and is not intended to provide medical advice, diagnosis, or treatment. The information discussed should not replace an evaluation by your physician, physical therapist, or other qualified healthcare professional. Always consult your healthcare provider regarding any medical condition or before beginning a new treatment or exercise program. Individual treatment should always be based on your specific medical history and clinical presentation.

Episode 19: Understanding Hip Pain – Why It Hurts and What Helps

Hip pain isn't just one condition—it can come from the hip joint, muscles, tendons, bursae, lower back, pelvis, or even the nervous system when pain becomes persistent.

In this episode, Dr. Pete Schultz breaks down the most common causes of hip pain, including labral tears, femoroacetabular impingement (FAI), hip arthritis, hip flexor and gluteal tendinopathy, bursitis, hip dysplasia, SCFE, and athletic pubalgia (sports hernia). You'll learn how these conditions differ, who typically develops them, and the most effective rehabilitation strategies for each.

Pete also explains why aggressive stretching isn't always the answer, why balancing mobility and stability is essential, the importance of thoracic spine mobility, and how to safely build strength without irritating your hip.

Finally, he discusses persistent hip pain and the role of the nervous system, including how stress, fear, sleep, and pain beliefs can influence recovery, along with practical tools such as breathing exercises, HRV biofeedback, mindfulness, pain neuroscience education, and pain reprocessing therapy.

Whether you're an athlete, weekend warrior, or simply dealing with nagging hip pain, this episode will help you better understand your symptoms and guide you toward smarter, evidence-based treatment.

Learn more:
🌐 https://www.DynamicSportsPT.com
🌐 https://www.PainandDizzy.com

Disclaimer: This podcast is for educational purposes only and is not intended to provide medical advice, diagnosis, or treatment. Always consult your physician or another qualified healthcare professional regarding any medical condition or before starting a new treatment or exercise program.

Midlife, Menopause & Pain: Why Everything Suddenly Hurts (and What You Can Do About It)

Why do so many women notice new aches, headaches, joint stiffness, and persistent pain during midlife? Is it "just getting older," or is something else happening?

In this episode of What's in Your Head: Tools for Pain and Dizziness, Dr. Pete Schultz, Doctor of Physical Therapy, expands on his recent discussion with physicians from Hospital for Special Surgery to explore why pain often changes during perimenopause and menopause.

You'll learn how hormonal changes, sleep disruption, stress, decreased physical activity, and increased nervous system sensitivity all work together to influence pain—and why pain doesn't always mean tissue damage.

Pete discusses:

• Why pain during midlife is multifactorial
• How estrogen influences inflammation and pain sensitivity
• The role of the nervous system in persistent pain
• Why movement is one of the best medicines for pain
• Physical therapy strategies for migraine, frozen shoulder, neck pain, low back pain, and persistent pain
• The six pillars of Lifestyle Medicine and how they support recovery
• Practical tools including exercise, pain education, breathing, mindfulness, biofeedback, and graded exposure to help people return to the activities they love

Whether you're experiencing new pain yourself or you're a healthcare professional looking to better understand the unique challenges of midlife, this episode offers practical, evidence-informed strategies to help you move with greater confidence.

Learn more about Dynamic Sports Physical Therapy:
https://www.dynamicsportspt.com

Explore more podcast episodes, articles, and educational resources:
https://www.painanddizzy.com

Ménière's disease is a complex inner ear disorder that can cause episodes of vertigo, hearing loss, tinnitus, and a feeling of fullness in the ear. While these symptoms can be frightening and unpredictable, there are many strategies that can help people better manage the condition and improve their quality of life.

In this episode of What's in Your Head: Tools for Pain & Dizziness, Dr. Pete Schultz discusses what Ménière's disease is, how it is diagnosed, and why symptoms can vary so much from person to person. You'll learn about hearing tests, vestibular testing, medical management, and the important role of vestibular rehabilitation in helping patients regain confidence and improve balance.

The episode also explores practical, evidence-informed treatment approaches including:

• Vestibular rehabilitation therapy
• Balance and habituation exercises
• Education and pacing strategies
• Cardiovascular exercise
• Neck physical therapy and posture training
• Stress management and nervous system regulation
• Biofeedback
• Mindfulness
• Pain reprocessing techniques and somatic tracking for persistent symptoms

Whether you've recently been diagnosed, have been living with Ménière's disease for years, or are a healthcare professional looking to better understand current treatment options, this episode provides practical tools to help you navigate the condition.

Disclaimer: This podcast is intended for educational purposes only and should not replace medical advice, diagnosis, or treatment from your healthcare provider.

To learn more about dizziness, vertigo, headaches, concussion, and persistent pain, visit PainandDizzy.com.

If you're looking for one-on-one physical therapy for dizziness, vestibular disorders, concussion, headaches, orthopedic injuries, or chronic pain, visit DynamicSportsPT.com to learn more or schedule an appointment.

Somatic Tracking: A 5-Minute Guided Exercise to Calm Pain, Dizziness, and Other Symptoms

In this special guided episode of What's in Your Head: Tools for Pain and Dizziness, Dr. Pete Schultz leads you through a simple five-minute somatic tracking exercise designed to help calm an overprotective nervous system.

Somatic tracking is a core technique used in Pain Reprocessing Therapy (PRT) and other mind-body approaches for persistent pain and symptoms. Rather than trying to ignore or fight uncomfortable sensations, you'll learn how to observe them with curiosity, reduce fear, and reinforce a sense of safety.

During this guided practice, you'll:

•  Learn the purpose of somatic tracking 
•  Practice slow, calming breathing 
•  Use visualization to gently focus on uncomfortable sensations 
•  Shift your nervous system from danger and fear toward safety and calm 
•  Build a skill you can use anytime you experience pain, dizziness, headaches, or other persistent symptoms 

This exercise can be practiced sitting, standing, or lying down and can be repeated whenever you need a few minutes to reconnect with your body in a safe and compassionate way.

Remember, the goal isn't to eliminate symptoms immediately—it's to teach your brain that your body is safe, helping reduce unnecessary danger signals over time.

If you find this exercise helpful, consider saving this episode so you can return to it whenever you need a moment to reset your nervous system.

For more information about pain, dizziness, concussion, headaches, and physical therapy, visit PainAndDizzy.com or DynamicSportsPT.com.

If you enjoyed this episode, please subscribe, leave a review, and share it with someone who may benefit from learning these powerful self-regulation techniques.

In this episode of What’s in Your Head: Tools for Pain & Dizziness, Pete Schultz, DPT, OCS, takes a deep dive into fibromyalgia — a chronic widespread pain condition that is often misunderstood, misdiagnosed, and frustrating for patients trying to find answers.

Pete discusses how fibromyalgia is considered a clinical diagnosis, what symptoms are commonly associated with it, and why modern pain science now views fibromyalgia as involving a sensitized nervous system and altered pain processing rather than simply a muscle or joint problem alone.

Topics covered in this episode include:

• What fibromyalgia is and how it is diagnosed
 • Common symptoms including widespread pain, fatigue, sleep problems, headaches, dizziness, and “brain fog”
 • Central sensitization and how the nervous system can become overly protective
 • The difference between tissue damage and pain sensitivity
 • Why imaging and lab tests are often normal
 • The biopsychosocial model of chronic pain
 • Pain neuroscience education and understanding pain as protection
 • Physical therapy approaches for movement, strength, mobility, and graded exercise
 • The role of sleep, stress, autonomic nervous system regulation, and pacing
 • Biofeedback and self-regulation tools to calm the nervous system
 • Mindfulness, somatic tracking, and Pain Reprocessing Therapy concepts
 • Graded exposure and returning to feared or avoided activities safely
 • Why recovery is usually multifactorial rather than one single treatment

This episode emphasizes that fibromyalgia symptoms are real, that patients are not “making it up,” and that many people improve through a comprehensive approach that combines education, movement, nervous system regulation, and individualized care.

Whether you are someone living with fibromyalgia, a healthcare provider, or a family member trying to better understand chronic pain, this episode provides practical tools and an evidence-informed framework for understanding and treating persistent symptoms.

For physical therapy evaluations, vestibular therapy, concussion management, headache treatment, and persistent pain rehabilitation visit:

www.DynamicSportsPT.com

For more resources, podcast episodes, and education on pain, dizziness, headaches, concussion, and nervous system regulation visit:

www.painanddizzy.com

Disclaimer:
 This podcast is for educational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult your physician or qualified healthcare provider regarding any medical condition or treatment decisions.

In this episode of What’s in Your Head, Dr. Pete Schultz breaks down the different types of low back pain commonly seen in physical therapy — and why low back pain is often much more complex than people think.

Pete discusses:

• Lumbar disc herniations
• Sciatica and lumbar radiculopathy
• Spinal stenosis
• Lumbar strains and sprains
• Segmental stiffness and hypomobility
• SI joint and lumbar instability
• Pars fractures in adolescent athletes
• Chronic and neuroplastic low back pain

The episode also explores why imaging findings do not always match symptoms, why two people with the same MRI can have completely different experiences, and how physical therapists evaluate the multiple systems that can contribute to pain.

If you are looking for a physical therapy evaluation for pain, dizziness, headaches, concussion, or vestibular issues, visit Dynamic Sports Physical Therapy:
https://www.dynamicsportspt.com

For more education and tools related to pain and dizziness:
https://www.painanddizzy.com

Disclaimer:
This podcast is for educational purposes only and should not be considered individualized medical advice. Always consult your physician or qualified healthcare provider regarding medical concerns or symptoms.