Understanding Dizziness and Vertigo: How Physiotherapy May Help

Understanding Dizziness and Vertigo: How Physiotherapy May Help

By The InHome Physiotherapy Team

Feeling dizzy, lightheaded, unsteady, or as though the room is spinning can be unsettling and may interfere with daily activities, mobility, and confidence. While dizziness and vertigo are common symptoms, they are not conditions themselves. Rather, they can be signs of several underlying health concerns.

A thorough assessment is often the first step toward understanding the cause of dizziness and determining whether vestibular physiotherapy may be an appropriate treatment option.

Dizziness vs. Vertigo: What’s the Difference?

Although the terms are often used interchangeably, dizziness and vertigo are not exactly the same.

Dizziness is a broad term that can describe sensations such as:

• Lightheadedness
• Feeling faint
• Unsteadiness
• Loss of balance
• Feeling “off” or disoriented

Vertigo is a specific type of dizziness characterized by the sensation that you or your surroundings are moving or spinning when no actual movement is occurring.

Some people describe vertigo as:

• The room spinning around them
• Feeling as though they are moving while standing still
• A sensation of tipping, swaying, or rotating

Vertigo may also be accompanied by nausea, motion sensitivity, balance difficulties, or visual disturbances.

What Causes Dizziness and Vertigo?

Maintaining balance requires coordination between several body systems, including:

• The vestibular system (located in the inner ear)
• Vision
• Muscles and joints
• The brain and nervous system

When one or more of these systems is not functioning properly, dizziness or balance difficulties may occur.

Common causes include:

Inner Ear Conditions

Several vestibular disorders can affect balance and spatial awareness, including:

• Benign Paroxysmal Positional Vertigo (BPPV)
• Vestibular neuritis
• Labyrinthitis
• Ménière’s disease
• Vestibular hypofunction

Neck and Head Injuries

Conditions such as:

• Concussion
• Whiplash injuries
• Motor vehicle accident-related trauma

may affect the body’s ability to process movement and position information.

Neurological Conditions

Certain neurological disorders may contribute to dizziness or balance difficulties, including:

• Migraine disorders
• Stroke
• Multiple sclerosis
• Other neurological conditions

Medical and Lifestyle Factors

Dizziness can also be associated with:

• Blood pressure changes
• Dehydration
• Medication side effects
• Anxiety or panic disorders
• Other medical conditions

Because dizziness can result from many different causes, proper assessment is important before beginning treatment.

What Is BPPV?

One of the most common causes of vertigo is Benign Paroxysmal Positional Vertigo (BPPV).

BPPV occurs when tiny calcium carbonate crystals within the inner ear become displaced and move into areas where they do not belong. When the head changes position, these crystals can stimulate the balance organs incorrectly, causing brief episodes of vertigo.

People with BPPV often notice symptoms when:

• Rolling over in bed
• Looking up
• Bending forward
• Changing head position quickly

Fortunately, BPPV can often be effectively managed through specific repositioning techniques performed by appropriately trained healthcare professionals.

How Vestibular Physiotherapy May Help

Vestibular physiotherapy is an area of physiotherapy that focuses on reducing dizziness, improving balance, and helping individuals return to daily activities safely and confidently.

Following a comprehensive assessment, a physiotherapist may develop a personalized treatment plan based on the underlying cause of the symptoms.

Treatment may include:

Vestibular Rehabilitation Exercises

Vestibular rehabilitation uses targeted exercises designed to help the brain adapt to altered balance signals and improve the body’s ability to process movement information.

These exercises are individualized and may focus on:

• Balance
• Stability
• Movement tolerance
• Walking confidence
• Visual motion sensitivity

Canalith Repositioning Techniques

For individuals diagnosed with BPPV, physiotherapists trained in vestibular care may use repositioning maneuvers, such as the Epley maneuver, to help move displaced inner ear crystals back into their proper location.

Balance and Gait Training

Many people with dizziness develop fear of movement or concerns about falling.

Balance training may help improve:

• Standing stability
• Walking confidence
• Coordination
• Functional mobility
• Fall risk management

Gaze Stabilization Exercises

Some vestibular conditions make it difficult to keep vision clear during head movements.

Gaze stabilization exercises may help improve coordination between the eyes, inner ear, and brain, supporting clearer vision during movement.

Habituation Exercises

Certain movements or environments may trigger dizziness symptoms.

Habituation exercises involve gradual, controlled exposure to symptom-provoking movements under the guidance of a physiotherapist to help reduce sensitivity over time.

What Happens During a Vestibular Physiotherapy Assessment?

Assessment may include an evaluation of:

• Symptom history
• Balance
• Walking patterns
• Eye movements
• Head and neck movements
• Positional testing
• Functional mobility

The findings help determine whether symptoms may be related to the vestibular system, another musculoskeletal issue, or whether referral to another healthcare provider is appropriate.

When Should You Seek Medical Attention?

While many causes of dizziness are treatable, some symptoms require urgent medical evaluation.

Seek immediate medical attention if dizziness or vertigo occurs with:

• Sudden weakness
• Facial drooping
• Difficulty speaking
• Double vision
• Loss of consciousness
• Severe headache
• Chest pain
• Sudden loss of coordination

These symptoms may indicate a serious medical condition requiring emergency assessment.

Can Physiotherapy Help Everyone with Dizziness?

The effectiveness of physiotherapy depends on the underlying cause of symptoms.

Many individuals with vestibular disorders, balance impairments, or movement-related dizziness may benefit from vestibular rehabilitation. However, treatment recommendations should always be based on a comprehensive assessment and individualized clinical reasoning.

If physiotherapy is not the most appropriate intervention, a physiotherapist can often recommend further medical evaluation or referral to another healthcare professional.

Supporting Confidence and Function

Living with dizziness or vertigo can affect mobility, independence, work, recreation, and overall quality of life. Through individualized assessment and targeted treatment, vestibular physiotherapy may help improve balance, reduce symptoms, and increase confidence in daily activities.

At InHome Physical Therapy, our physiotherapists provide personalized assessments and treatment plans designed to address each individual’s unique needs and goals, whether treatment is provided in the clinic or in the comfort of home.