Patient Education

Feeling Dizzy? Physical Therapy May Be Able to Help

focus on woman's feet balancing on therapy ball

– Shivani Patel, PT

We may all experience dizziness from time to time — perhaps while riding the Tilt-a-Whirl at the fair, or after showing our toddler how to do a somersault. But for people with chronic vertigo and other vestibular issues, symptoms like dizziness can be debilitating. But physical therapy may be able to help.

More than 1 in 3 adults aged 40 and over in the United States have experienced vestibular dysfunction, or a disturbance in the body’s system of balance. And because vestibular problems are hard to diagnose, patients typically need to see more than one doctor before getting an accurate diagnosis.

Fortunately, many people with vestibular problems are finding relief in an unexpected place —physical therapy. Understanding how physical therapy helps with vestibular issues may help you decide if this kind of treatment is right for you.

Signs and Symptoms of Vestibular Disorders  

Your sense of balance is controlled by three things: the inner ear (vestibular system), the eyes (vision) and the sense of touch (proprioception). When something happens to disturb your vestibular system, you may experience symptoms that affect your balance, such as vertigo (sensation of movement or spinning), dizziness and imbalance.

Vestibular disorders can also cause changes to your hearing and vision, as well as cognitive challenges such as trouble concentrating. These disorders may be short-term (acute) or long-lasting (chronic).

How Can Physical Therapy Help?

People with vestibular disorders may benefit from vestibular rehabilitation therapy, which is specialized to treat the symptoms of these disorders. After performing a thorough evaluation that includes balance testing, gait assessment and other diagnostics, your physical therapist will design a treatment plan designed to address your unique needs.

Vestibular rehabilitation exercises are designed to promote central brain compensation, which realigns the vestibular system to help it function normally. Central brain compensation can be divided into three categories:

  • Adaptation, a process where nerve impulses in the brain gradually shift or “adapt” to incorrect signals from the damaged vestibular system, allowing the brain to recalibrate itself.
  • Habituation, a process that allows you to gradually desensitize yourself to vestibular movement and stimulation through repeated exposure to it.
  • Substitution, a recovery principle that uses other body functions or strategies to replace missing vestibular function.

Treatments for Peripheral Vestibular Disorders with Physical Therapy

  • Canalith Repositioning Procedure( For BPPV): Specialized maneuvers performed to treat benign paroxysmal positional vertigo (BPPV). One type of CRM is called the “Epley maneuver.” It involves a series of specifically patterned head and trunk movements to move tiny displaced otoliths (often referred to as “crystals”) to a place in the inner ear where they can’t cause symptoms.

Depending on your diagnosis and symptoms, your physical therapist will create a program of vestibular rehabilitation exercises based on these three categories of central brain compensation, helping to correct dysfunction and restore your vestibular system to proper functioning.

Recovery From Vestibular Disorders with Physical Therapy

Physical therapy for vestibular disorders can provide a wide variety of recovery outcomes, including:

  • Decreased dizziness
  • Decreased nausea or vomiting
  • Improved focus, concentration and memory
  • Improved balance while standing or sitting
  • Decreased risk of falling
  • Improved ability to stabilize gaze or vision and track or focus on objects near and far
  • Improved neck mobility with less stiffness and pain
  • Less fatigue and improved sleep
  • Decreased anxiety and depression and better ability to cope with stress

If you are struggling with vestibular issues and aren’t sure where to turn — or if you feel you’ve tried everything and nothing helps — consider talking to a physical therapist who specializes in vestibular rehabilitation. With the right treatment, you may finally find the relief you’ve been seeking.


If you or a loved one is seeking physical therapy, or to schedule an appointment with any of our Pure Healthy Back experts, visit our appointment requests page, or call 888-396-2642.


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