The goal of balance and vestibular therapy is to improve your ability to safely participate in daily activities.

Specialized balance physical therapy can be used to address vestibular and balance problems that are the result of a variety of diagnoses. Such therapy is recommended for treating the following symptoms:

• Dizziness or vertigo
• Motion sickness that occurs when walking in crowds or busy environments
• Spinning sensation when looking up, bending over or lying down in bed
• Unsteadiness or frequent falls
• Concussion

At your first appointment, your vestibular physical therapist will start with a thorough history of your symptoms then perform a noninvasive examination to assess your vestibular and balance systems. This exam will allow your provider to best understand your symptoms.

Following the assessment, your therapist will work with you to create a personalized care plan that may include hands-on treatments, exercises, or education involving lifestyle and activity modifications. Management of vestibular dysfunction or imbalance often requires a multidisciplinary approach. Collaboration with other health care providers may be recommended.

What is balance?

Balance is the ability to maintain an upright position at rest or during movement. There are three main systems that work to keep us balanced:

• Visual system (eyes)
• Vestibular system (inner ear)
• Somatosensory system (touch/sensation)

These three systems receive information about body position in relation to gravity and our surroundings, allowing us to react and move freely without falling. Illness, injury, medication interactions or aging can affect these systems and lead to decreased balance and a higher risk for falls. Generalized weakness, impaired coordination or orthopedic injuries are other factors that may increase your chance of falling.

Balance and vestibular therapy is a safe and effective treatment option to improve balance and decrease your fall risk.

What is the vestibular system?

The vestibular system consists of the inner ear and its connections to the brain. This system assists in keeping us balanced as well as coordinates head and eye movements. Vertigo and dizziness are common symptoms that occur when a person experiences vestibular dysfunction. Other symptoms include:

Vertigo versus dizziness – what are the differences?

Vertigo is an abnormal sensation of movement and feeling described as if you or your environment are spinning. In contrast, dizziness is a general term often used when feeling lightheaded, faint or unsteady. It is helpful to differentiate between the two when talking to your health care provider about your symptoms.

What is Benign Paroxysmal Positional Vertigo (BPPV)?

Benign: Not malignant or damaging
Paroxysmal: Sudden onset or episodic
Positional: Triggered by movement or changes in head position
Vertigo: True rotational dizziness described as if you and the room are spinning1

BPPV is episodic vertigo that typically lasts less than one minute. It occurs when provoked by certain head movements or position changes such as looking up, bending over, lying down or turning from side to side in bed. Some individuals may also experience nausea or unsteadiness between episodes.

BPPV is a common condition caused by a problem of the inner ear and affects approximately 2.4% of the population.2 More commonly seen in adults, it increases in frequency with age and affects women more often than men. Possible triggers include head injury, migraine, inner ear infection, osteoporosis or diabetes. BPPV will not cause hearing loss.

What causes the spinning?

Parts of the inner ear contain microscopic crystals called otoconia – often referred to as “ear crystals or rocks”. If these crystals become loose, they can end up in one of the semicircular canals. When the head is turned into certain positions, the subsequent movement of these crystals in the canal sends a false message to the brain indicating that the head is spinning, and thus creating a sensation of vertigo. This also results in an eye movement called nystagmus which may cause your surroundings to appear as if they are moving.

Can BPPV be treated with balance & vestibular therapy?

BPPV should be diagnosed and treated by a trained healthcare provider. Often, you may be referred to a physical therapist for balance and vestibular therapy. During the initial assessment, your provider will move your head through a series of testing positions to observe all eye movements and determine which positions provoke vertigo. The assessment may also involve the use of video goggles to record eye movements.

An effective and noninvasive treatment for BPPV is called a canalith repositioning maneuver. The treatment works by moving the ear crystals out of the semicircular canals and back to their normal position within the inner ear.

The likelihood of experiencing BPPV again is high with an approximate 1% per month recurrence rate. If your symptoms return, contact your physical therapist to schedule an appointment. Medications will not cure BPPV.

Be proactive

By making it a priority to discuss your balance and vertigo symptoms with your doctor, you can rule out a medication interaction or more serious condition, such as heart attack or stroke. If your doctor believes that you are at risk for falls or that your symptoms are related to your vestibular system, a referral for imbalance physical therapy may help you improve. 

Do I need a prescription?

Medicare, Medicaid, as well as some insurance plans require a prescription to begin therapy. If you have questions, kindly contact us. We're happy to help you obtain a prescription, as needed.

Contact us

Contact us if you experience vertigo or dizziness. Balance and vestibular therapy is a proven treatment option for addressing symptoms.