Condition
Vertigo & Dizziness
Positional vertigo (BPPV) assessed and treated with repositioning manoeuvres, plus balance retraining for persistent dizziness and unsteadiness.
Treated under Neuro & Stroke Rehab
Vertigo — the sensation that you or the room is spinning — is not the same as light-headedness, and the distinction genuinely matters, because the causes and treatments differ. True spinning vertigo frequently originates in the inner ear balance organ, and several inner-ear causes respond very well to specific physiotherapy treatment.
The most common cause is benign paroxysmal positional vertigo (BPPV), in which small calcium crystals become displaced into one of the semicircular canals of the inner ear. Head movement then moves the fluid abnormally and the brain receives a signal of intense rotation. It is unpleasant but mechanical — and often correctable in a small number of treatments.
Recognising BPPV
Where the pattern fits, assessment uses specific positional tests that reproduce the vertigo and allow the physiotherapist to identify which ear and which canal is involved by observing the characteristic eye movements.
- Brief, intense spinning triggered by a change in head position — rolling over in bed, lying down, sitting up, or looking up.
- Episodes typically lasting seconds to a minute rather than continuously.
- Symptoms consistently provoked by the same movements.
- Nausea accompanying the episodes, sometimes with lingering unsteadiness between them.
- No hearing loss, ear discharge or ringing associated with the attacks.
Treatment for BPPV
BPPV is treated with repositioning manoeuvres — a precise sequence of head and body positions that guides the displaced crystals out of the affected canal and back where they belong. The Epley manoeuvre is the best known, and the technique chosen depends on which canal is involved.
These manoeuvres are effective in a high proportion of cases, often within one to three treatments. It is normal to feel unsteady or slightly nauseated for a day or two afterwards, and you will be given clear instructions about positioning immediately following treatment. Where symptoms recur, repeat treatment is usually effective again.
Dizziness that is not BPPV
Not all dizziness is positional. Vestibular neuritis and labyrinthitis produce sustained vertigo over days, often after a viral illness, and are treated with vestibular rehabilitation — graded exercises that retrain the brain to compensate for a reduced signal from one ear.
Persistent unsteadiness after a vestibular episode, dizziness related to neck problems, and balance difficulty in older adults or after a stroke all respond to structured balance retraining. Assessment identifies which of these applies, and the exercise programme is matched to it.
When dizziness needs medical assessment first
Some causes of dizziness are not vestibular and require medical review rather than physiotherapy. Seek medical attention promptly if dizziness is accompanied by:
- Sudden severe headache, double vision, slurred speech, facial droop or limb weakness.
- New hearing loss, ear discharge or significant ringing in the ear.
- Fainting, chest pain or palpitations.
- Dizziness following a head injury.
- Difficulty walking that is out of proportion to the dizziness itself.
Frequently asked questions
How quickly can BPPV be treated?
Many cases resolve within one to three sessions of repositioning treatment once the affected canal is correctly identified. Some people need a few more, and recurrence can be re-treated effectively.
Is the treatment itself unpleasant?
The manoeuvre usually provokes the vertigo briefly, which is expected and confirms the diagnosis. It typically lasts under a minute per position, and mild unsteadiness or nausea for a day or two afterwards is normal.
What is the difference between vertigo and dizziness?
Vertigo is a specific spinning sensation, often from the inner ear. General dizziness or light-headedness has a wider range of causes, including blood pressure and medication. The distinction guides both assessment and treatment.
Will medication cure BPPV?
Medication may reduce nausea but does not reposition the displaced crystals, so it does not resolve the underlying cause. Repositioning manoeuvres address the mechanical problem directly.
Can vertigo come back after successful treatment?
Yes, recurrence is possible, particularly in the first year. It responds to repeat treatment, and you can be taught what to do if symptoms return.
Next steps
Ready to start treatment?
Message us on WhatsApp with what is bothering you and when you are free. Tell us if you would prefer a male or female physiotherapist and we will schedule accordingly.
Saturday–Thursday, 9:00 AM – 9:00 PM · Friday — closed