Understanding Vertigo

Feeling like the room is spinning, tilting, or moving when you’re standing still can be alarming. Vertigo is more than just dizziness, it’s a sensation of movement that often affects balance, confidence, and day-to-day activities. Fortunately, physiotherapy can play a major role in identifying the cause of vertigo and helping people recover safely and effectively.

What Is Vertigo?

Vertigo is usually caused by a problem within the vestibular system, which is the part of the inner ear and brain that are responsible for balance and spatial awareness. Symptoms can include:

• – Spinning sensations
• – Nausea or vomiting
• – Unsteadiness when walking
• – Difficulty focusing the eyes
• – Sensitivity to head movements
• – Feeling “off balance” or lightheaded

There are several different types of vertigo, and treatment depends on the underlying cause.

Benign Paroxysmal Positional Vertigo (BPPV)

BPPV is one of the most common causes of vertigo. It occurs when tiny calcium crystals inside the inner ear become displaced and move into the wrong canal. This causes short bursts of spinning sensations, usually triggered by rolling in bed, looking up, or bending down.

Physiotherapists trained in vestibular rehabilitation can assess which ear and canal are affected and perform specific repositioning manoeuvres, such as the Epley manoeuvre, to move the crystals back into the correct position. Many people experience significant improvement within one or two treatments.

Vestibular Neuritis and Labyrinthitis

Vestibular neuritis and labyrinthitis are conditions caused by inflammation of the inner ear or vestibular nerve, often following a viral infection. Symptoms may include severe vertigo, nausea, balance difficulties, and sometimes hearing loss.

Once the acute symptoms settle, physiotherapy focuses on vestibular rehabilitation exercises to help retrain the brain and improve balance. These exercises may include:

• – Eye and head coordination exercises
• – Balance retraining
• – Walking and movement exercises
• – Habituation exercises to reduce motion sensitivity

The goal is to help the nervous system adapt and restore normal movement confidence.

Persistent Postural-Perceptual Dizziness (PPPD)

PPPD is a chronic condition characterised by ongoing dizziness and unsteadiness, often worsened by busy environments, movement, or standing upright. It can sometimes develop after an episode of vertigo, illness, or high stress.

Physiotherapy treatment for PPPD involves gradual exposure to movement, balance training, and strategies to reduce sensitivity within the vestibular system. Education and reassurance are also important parts of recovery, helping people regain confidence in movement and daily activities.

Cervicogenic Dizziness

Not all dizziness comes from the inner ear. Cervicogenic dizziness is related to dysfunction in the neck, often following poor posture, muscle tension, or whiplash injuries. Symptoms can include dizziness, neck pain, stiffness, and headaches.

Physiotherapy treatment may include:

• – Manual therapy for the neck joints and muscles
• – Postural correction
• – Strengthening exercises
• – Mobility and movement retraining

Addressing the underlying neck dysfunction often helps reduce dizziness symptoms significantly.

How Physiotherapy Helps

A physiotherapist with vestibular training can perform a detailed assessment to determine the likely cause of vertigo and tailor treatment accordingly. Physiotherapy aims to:

• – Reduce dizziness symptoms
• – Improve balance and stability
• – Restore confidence in movement
• – Reduce falls risk
• – Support a safe return to normal activities

Early assessment and treatment can often speed up recovery and prevent symptoms from becoming persistent.

When to Seek Help

While vertigo is commonly related to the vestibular system, it is important to seek medical attention if symptoms are sudden, severe, or accompanied by weakness, double vision, difficulty speaking, chest pain, or numbness.

If dizziness or vertigo is interfering with your daily life, physiotherapy may help you regain balance, confidence, and control. A tailored vestibular rehabilitation program can make a significant difference in recovery and long-term symptom management.