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What is vestibular rehabilitation?

Vestibular rehabilitation is concerned with the treatment or a range of conditions that affect the inner ear and your sense of balance, dizziness and nausea. A simple assessment could determine if physiotherapy is suitable in treating your type of vestibular issue. For the majority of cases one or two sessions can significantly reduce symptoms or eliminate them altogether.

What causes vestibular problems?

Your vestibular system is responsible for coordinating your balance and involves signals passed from the inner ear to the brain. When there is a problem confused signals are sent to the brain giving the false sensation of movement and imbalance. This conflicting information produces symptoms of dizziness, nausea and headaches. Over long periods it can leave you feeling exhausted and dramatically limit many aspects of everyday life.

Vestibular rehabilitation exercies carried out by a specilaist therapistAbove: Vestibular rehabilitation exercies carried out by a specilaist therapist

Some vestibular conditions that are routinely treated using physiotherapy include;

  • Vestibular Neuronitis
  • Labyrinthitis
  • Migraine Associated Dizziness
  • Meniere's
  • Acoustic Neuroma
  • Benign Paroxysmal Positional Vertigo (BPPV)
  • Dizziness in the elderly

What would a vestibular physiotherapy assessment involve?

Vestibular problems can have a range of different causes, some of which respond extremely well to physiotherapy intervention. An initial assessment, using non-invasive tests, would be required to identify the likely cause of the vestibular problem. These test would include;

  • Eye tests
  • Balance tests
  • Positional tests
  • Gait analysis

If the results are inconclusive or the symptoms are more complex you may be referred for further medical tests to confirm the cause of your vestibular issues. Your local GP surgery or hospital may carry out some of the following tests under the guidance of a neurologist or other specialist.

  • MRI scan
  • Hearing tests
  • Caloric tests
  • Vestibular function tests-including rotating chair test and videonystagmography

What would vestibular physiotherapy treatment involve?

After comprehensive testing to establish the cause of your vestibular problems your physiotherapist has a range of treatment options to target your specific condition. Typically treatment would involve a combination of advice on activity modification and manual treatments to help reset and retrain your vestibular system. The treatments can be carried out at your home for convenience and to limit symptom agitation and often include an extensive home exercise plan to follow between therapy sessions. Treatment options include;

Epley Manoeuvre -

This treatment would be chosen if BPPV was diagnosed. It involves various head and body movements to resolve the dizzy symptoms. It is a very effective treatment that usually works within one session.

Gaze Stability Retraining -

Gaze stability retraining involves exercises which work the eyes to improve focus while moving the head. It strengthens the vestibular system making it work harder to not allow the brain to become confused and cause dizziness.


Balance Retraining Exercises -

Balance exercises can take on many forms. Balance training involves exercises that challenge your balance whether this is standing on one leg, closing your eyes or using uneven surfaces. The more you practice balance the better it becomes making you more stable. This can strengthen the input from the balance sensors in feeding correct information into the vestibular system to override incorrect messages.

Strengthening Exercises -

Strengthening exercises involve movements with or without resistance which aim to build up strength in the body. Having muscles that are stronger will mean the body is more capable of responding to imbalance.


Gait Drills -

Gait drills involve various walking based exercises. This may include walking over obstacles, walking and turning your head or walking and counting backwards. Practicing these gait drills will challenge the whole of the vestibular symptom meaning is can cope better when put under pressure without causing symptoms.


Functional task practice-

Practicing task desensitises the vestibular system meaning you can do activities without getting symptoms.

Symptom management strategies-


Having the mechanisms to cope with symptoms means the condition can be kept under control.


Relaxation advice-

Having the ability to relax fully helps the body to recover from vestibular symptoms. This may involve relaxation scripts or just general advice on sleep.


Pacing of activity-


Fatigue plays a big part in Labyrinthitis therefore leaning to pace activities is vital to control symptoms and make a stage recovery. Doing too much too soon overloads the vestibular system.


Graded exposure program to difficult situations-

Hiding away might seem like a good idea as you do not become dizzy but you need to gradually expose the body to situations which are more challenging. You will be given set tasks to do each day to achieve this.

Benefits of vestibular rehabilitation?

The benefits of physiotherapy treatment to someone with a vestibular condition can be life changing. Not only will they gain a greater understanding of their condition and develop coping strategies, some people will experience an immediate and lasting relief from their symptoms. Allowing them to resume normal activities free of limitation. Some of the benefits experienced by clients undergoing vestibular rehabilitation include;

  • Reduced dizziness and risk of falls.
  • Improved Visual focus.
  • Improved balance.
  • Regain energy levels, improved exercise tolerance.
  • Return to normal activities of daily living.
  • Increased confidence, particularly in physical ability.

How can I arrange a vestibular physiotherapy assessment?

If you have been diagnosed by your doctor as having a vestibular condition and are beginning to show symptoms, you would benefit from an assessment with one of our experienced physiotherapists.

You can contact us directly to arrange an assessment and we can advise you if further treatment is recommended, and give you advice on self-management. To arrange an appointment please email or call 0330 088 7800.

Why choose for your vestibular rehabilitation?

At we can apply a range of therapy techniques and advice to manage your symptoms and maintain the best possible level of physical ability and independence. We can also advise you on activity and home adaptations to make daily living easier. Along with advice for you and your family on appropriate self-management techniques to maximise your functional ability between therapy sessions. As a vestibular rehabilitation specialist we offer;

  • Specialist trained physiotherapists
  • Good links with consultants
  • Convenient appointment times
  • A number of convenient clinic locations
  • Excellent clinical facilities
  • No waiting lists

For more information on how Physiotherapy can help treat vestibular conditions, or to book yourself an appointment, please contact us via email us at or call us on 0330 088 7800.

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