Physio for dizziness and vertigo: vestibular treatment

Dizziness and vertigo

Dizziness is a broad word. Some people feel faint or lightheaded. Others have vertigo, a sense that they or the room is spinning. Others feel unsteady on their feet. The cause matters, so the first step is to have your symptoms checked by a doctor.

Many cases come from the vestibular system, the balance organs in the inner ear and the brain pathways that process them.

Common vestibular causes

• BPPV (benign paroxysmal positional vertigo): short spins triggered by head movements such as rolling over in bed or looking up. It is caused by tiny crystals moving in the inner ear
• Vestibular neuritis or labyrinthitis: sudden severe vertigo, often after a viral illness, followed by days or weeks of unsteadiness
• Vestibular migraine: dizziness linked with migraine
• Concussion or neck-related dizziness: symptoms after a head injury or neck problem
• Age-related balance changes

What a vestibular physio does

Some physios have extra training in vestibular and balance problems. They will ask about your symptoms and triggers, then test your eye movements, head movements, balance and walking. If BPPV is likely, they can perform positional tests.

• For BPPV, a physio can perform a repositioning manoeuvre, such as the Epley manoeuvre, which often relieves symptoms in one or a few visits
• For other causes, a vestibular rehabilitation program of eye, head and balance exercises helps the brain adapt
• Advice about activities, driving, work and staying active safely
• Referral back to your doctor or on to an ENT or neurologist if needed

Vestibular exercises can briefly make you feel worse while your brain adjusts. Your physio will guide how much to do.

When to get urgent help

Call 000 or go to an emergency department straight away if dizziness comes with any of the following, as they can be signs of stroke or another serious condition:

• Sudden severe headache
• Face drooping, arm or leg weakness, or numbness
• Slurred speech or trouble understanding speech
• Double vision or sudden loss of vision
• Difficulty walking or you cannot stand
• Chest pain, shortness of breath or fainting

See your doctor first

See your GP before booking physio for new or unexplained dizziness. They can check blood pressure, medications, hearing, heart and other causes. It is also a good idea if you have had a fall; our guide to falls prevention and balance physio explains how physio can help with balance.

Costs and funding

Vestibular physio fees vary by clinic, and private health extras may pay a rebate. See our cost guide.

Common questions

This guide is general information, not medical advice. Talk to your doctor or physio about your own situation.