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Vertigo and Physical Therapy – How Physiotherapy Can Help


Vertigo and Physical Therapy – How Physiotherapy Can Help

Vertigo is one of the most common diseases in the world population. It is a perception of motion disorder caused by a dysfunctional vestibular system. This is the system that is responsible for maintaining balance.

Dizziness caused by vertigo can make it difficult for patients to go about their day-to-day lives. Physical therapy and exercise therapy have proven to be effective against impairment caused by the loss of balance due to vertigo.

What is vertigo?

Vertigo is a sub-type of dizziness caused by dysfunction in the vestibular system. Often wrongly associated with a fear of heights, those who suffer from vertigo often feel dizzy even when standing on firm ground.

Vertigo can be divided into two categories: objective and subjective vertigo. Objective vertigo occurs when the patient feels that the objects and environment around them are moving. Subjective vertigo refers to the sensation that the patient is moving.

Benign paroxysmal Positional Vertigo

The most common form of vertigo is known as Benign Paroxysmal Positional Vertigo (BPPV), which is characterized by sudden and severe dizziness when you move your head around.

BPPV occurs when small, micro-sized calcium crystals called otoconia become dislodged from their normal location on the utricle (one of the inner ear sensory organs). These otoconia are usually embedded in a gelatin-like material on top of the utricle. If there are enough otoconia floating around, they can aggregate into a larger clump.

Because they are heavy, they migrate into the lowest part of the inner ear. Once in the semicircular canal, they may still move when the head changes position. It is the movement of these stones that cause an unwanted flow of fluid even when the head has stopped moving. This leads to a false sense that the head and body are spinning around or that the world is spinning around you.

Causes of vertigo

There are two main causes of vertigo distinguished by the dysfunctional organ involved:

Peripheral, Otologic or Vestibular Vertigo: The type of vertigo is caused by a dysfunctional vestibular system located in the inner ear. BPPV and Meniere’s diseases are peripheral vertigos.

Central Vertigo: This type of vertigo is caused by an injury to the Central Nervous System (CNS). The injury might be caused by a lesion in the brain stem that causes the illusion of movement, nausea, slurred speech, and double-vision.

Vertigo and physiotherapy

The best way to battle vertigo is by practicing physiotherapy known as vestibular rehabilitation. These exercises are initially practiced with a licensed physiotherapist but can eventually be practiced at home.

Typically, these exercises consist of movement that worsens the vertigo followed by difficult balance tasks. However, by doing these repetitively, the balance system in the brain learns to function better.

Physiotherapy treatment for vertigo patients will help to overcome the effects of vertigo with the following methods:

Repositioning fragments in the inner ear

Physiotherapy treatment for vertigo includes exercises that reposition the fragments inside the ear. They are specific techniques that your physiotherapist will guide you through to overcome the dizziness.

When you are recovering from vertigo, these techniques assist in relocating the ear rocks to an area in the inner that won’t stimulate dizziness or vertigo. Such physiotherapy exercises aim to gradually reduce the frequency and strength of the dizzy spells.

Improving balance

When you are recovering from vertigo, you will find it difficult to maintain your balance. This can be either while you are standing or walking or both. Sometimes walking through a crowd or being surrounded by people will lead to balance problems.

In such cases, a physiotherapy treatment for vertigo patients includes balance and motion exercises that depend on the extent of balance difficulty.


Patients suffering from vertigo may have difficulty in controlling eye movements. As a result, dizziness and headaches often occur, especially when the patient tries to move their head.

This denotes a lack of stability. A physiotherapist can conduct gaze stabilization exercises that involves methods such as having the patient gaze at one point while moving their head side to side or moving the eyes sideways without moving the head.

The best exercises for treating vertigo

When first assessed by a physiotherapist, they will put you through a series of tests such as rotation tests, head-thrust tests, caloric reflex tests, and eye-head coordination tests to measure posture, balance, and gait.

A rehabilitation plan is developed depending on the severity of the condition. From there, your physiotherapist will prescribe specific exercises that can be performed in therapy or at home to retrain the brain to recognize and process signals and coordinate with the vision system.

The following are common exercises used by physiotherapists to treat vertigo:

Brandt-Daroff exercise

The Brandt-Daroff exercise is one of the simplest, yet effective, ways of reducing vertigo-related issues.

The exercise can be performed unsupervised at home.

To perform the Brandt-Daroff exercise, being by finding a firm seating above ground level to lie on, such as the edge of your bed. Lift yourself into an upright seated position, relaxing your body. Slowly move into the lying position on one of your sides while your nose is still pointing at the ceiling.

You will experience your regular bout of dizziness. Wait until it subsides and then sit back up. If you experience dizziness while getting back up, waiting before repeating the exercise on the other side.

Perform this exercise in a set of 20 at least twice a day.

Balance exercises

Sports and walking can have a major impact on your motion perception. To improve your general balance, try to walk for at least 20 minutes a day for five days a week.

Sports-type activities such as playing catch can drastically improve vertigo related symptoms.

Head exercises

At home, you can try performing head exercises to reduce your vertigo symptoms. Start with rocking your head back and forth, imitating the movement that triggers dizziness. Gradually increase your speed.

You can also perform this exercise by moving your head side to side.

Once the dizziness begins to subside during these exercises, try repeating them with your eyes closed. You should try to perform this exercise daily for 3 weeks in order to observe any differences.

Eye exercises

Vertigo can cause blurred vision. Simple eye exercises can be performed to keep your sight stable.

Start with looking up slowly and then looking down slowly. As you get comfortable with the movement, gradually increase the pace. You can perform the same exercise by moving your eyes side to side.

Another exercise you can try is to make use of your hand as a focal point. Hold your arm out and let your eyes focus on one of your fingers. Then move your arm sideways while your eyes remain focused on your finger.

Don’t let vertigo affect your life

If you suffer from vertigo or are unsure how to perform at-home exercises, please contact our trained physiotherapists at InHome Physical Therapy and Massage. We are capable of providing in-home physiotherapy services in the Edmonton and Calgary areas.