Dizziness and vertigo is one of those problems like fatigue that can make you cringe when it shows up in the office because there are so many possibilities as to what's causing it. Anything from cardiovascular to inner ear to medication to blood pressure to mild head injury etc. However when it comes to positional vertigo that is often triggered by change in position of the head and neck, the two main culprits are going to be the cervical spine in the inner ear and sometimes a combination of both. Most of the time the testing can be a little bit elusive because the testing itself will activate both the cervical spine and the inner ear at the same time. (For example Dixie Hall Pike test). The swivel test can be a useful add-on to other testing because it will hold the head stationary while deeply activating cervical rotation, thus eliminating stimulus to the inner year and vestibular system while deeply stimulating the cervical spine. All you need is a good old-fashioned swivel stool or chair and a good pair of steady hands to hold the head.