Stop the World from Spinning: Vestibular Rehab and Vertigo

Danh NgoVestibular HealthLeave a Comment

Have you ever felt like the room was spinning? And we’re not talking about the one time at the Jimmy Buffet concert. Today, we’re going to discuss vertigo, the unsettling sensation that the objects in your field of vision are moving.

Vertigo and associated conditions affect millions of Americans every year. People experience in different ways and the causes of vertigo are diverse and sometimes physicians are unable to pinpoint an exact cause.

If you have experienced this, vestibular rehab can be helpful. Read ahead to learn more about this condition and how it’s treated.

The Physiology of Balance and Coordination

Some bodily functions are seemingly automatic. We don’t really have to think about keeping our balance until we are losing it.

You have structures within your inner ear that can detect head movements and changes in position. The semicircular canals are tiny tubes that contain hairlike structures suspended in a liquid.

The liquid moves around in the canals when you move and this causes the hairs to move. An extremely specialized nerve ending detects these movements and sends a message to your brain. This message lets feel your body’s position in relation to the ground.

Vertigo and Vertigo-Associated Conditions

Here are some of the most common causes of vertigo but numerous medical conditions and medications can lead to vertigo.

Benign Paroxysmal Positional Vertigo

What do you say we just stick to BPPV for short? Jokes aside, if we break down the name we get a pretty good idea of what it is.

It is a condition characterized by vertigo and uncontrollable eye movements (nystagmus) that occurs following sudden movements of the head and neck (i.e. changes in position). It’s benign because it tends to get better with time.

It is caused by the accumulation of calcium-rich debris within the semicircular canals of the inner ear. This debris results in erratic nerve signaling that causes vertigo.

Diagnosing BPPV

A paroxysm is a sudden ‘attack’ or episode of something. The symptoms of BPPV tend to come and go, lasting as little as twenty seconds. However, these episodes can be quite severe in some people.

A medical professional can use special maneuvers to aid in the diagnosis of BPPV

A classic example is a Dix-Hallpike maneuver. The examiner carefully but quickly manipulates the patient’s head and neck position. A person with BPPV will immediately experience an episode of vertigo.

Treating BPPV

Fortunately, the treatment of BPPV is simple and highly effective. There are several options for people living with BPPV.

There are several medications you can take, including nausea pills, but they do not treat the cause and have side effects. Surgical options include neurectomy and posterior canal occlusion.

Before you go under the knife, your health care provider will likely perform one of several therapeutic maneuvers. They clear the buildup that causes the symptoms.


Sometimes referred to as vestibular neuronitis, labyrinthitis is a common cause of vertigo. It is often accompanied by nausea, tinnitus (ringing in the ears), and nystagmus.

It tends to be related to infection. Patients often have a recent history of an upper respiratory tract infection

Ménière’s Disease

Ménière’s Disease (MD) is a disorder that leads to vertigo, ringing in the ear, and progressive hearing loss. Typically, the symptoms are present only on one side but it may become bilateral overtime.

We aren’t sure of the exact cause but fluid build-up inside the ear canal results in the onset of symptoms. Occasionally, MD can run in the family.

Vestibular Rehabilitation Therapy

There are many different pharmaceutical treatments but they have side effects and they often fail to provide lasting relief.

Vestibular rehabilitation (VR) is a form of specialized physical therapy. It is an effective alternative to medication for many people with vertigo.

How Does VR Work?

The goal of VR is to reduce both the cause and effect of vertigo and other conditions that affect balance and gaze instability.

A physical therapist specializing in VR will tailor an exercise program depending on your knees.

Exercises for Vertigo

You don’t necessarily need to buy new sneakers and a gym membership for VR therapy. Balance therapy and eye exercises can be performed by just about everyone anywhere.

For the most part, they consist of balance, habituation, and gaze stabilization exercises. Over time, people with severe vertigo can train their brains to compensate for the changes occurring in their vestibular system.

How Effective is VR?

It can take time and this can be frustrating. However, VR therapy gives consistent results for many people dealing with vertigo. 

Sometimes, VR works best in conjunction with surgical and pharmaceutical treatments. It can be part of the post-surgical rehab program.

Benefits of Vestibular Rehab

Some conditions benefit more from VR than others.

These include BPPV, Ménèiere’s disease, dizziness, headaches, motion sickness, and neck stiffness, loss of balance. Also, certain patients who have had strokes or other kinds of brain injury.

Elderly people at risk of a fall can learn how to improve their balance. You can be perfectly ‘healthy’ and still benefit. Even strapping athletes can improve their balance and coordination through vestibular rehabilitation.

Is VR T Right for Me?

It’s important that you seek professional medical advice if you think you may be experiencing vertigo, dizziness, loss of balance or other symptoms we’ve mentioned.

Generally speaking, VR therapy is effective at treating vertigo caused by movement. If you remember from before, BPPV is a common cause of vertigo. This therapy is often useful in these cases.

That being said, there are certain causes of vertigo with particular treatments and won’t respond to VR. A physician might decide your vertigo is best treated otherwise.

Keeping Steady

The sensation of vertigo and losing your balance is horribly unsettling, to say the least. Unfortunately, this can lead to a significant loss of quality of life as it becomes difficult to enjoy your favorite activities.

Balance problems are potentially dangerous because they increase the risk of a fall. However, there are proven treatment options and the vast majority of people with vertigo see improvement over time, especially with some vestibular rehab.

Take care of your health and live life to the fullest. 

If you need a second opinion on your dizziness or prefer fixing it without medication by a Vestibular Expert, click on the button below for you free chat with Dr Ngo. We have 15 years of experiences helping people like you get back to the activities you love.


Danh Ngo PT, DPT, OCS, SCS

Doctor of Physical Therapy

Board Certified Specialist in Orthopedic and Sports Medicine

Mind Body Health Results Coach

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