Have you ever stood up, turned your head, or rolled over in bed and suddenly felt dizzy or as though the room was spinning? Dizziness and balance problems can be unsettling, especially when they start interfering with your ability to drive, exercise, work, or enjoy everyday activities.
Although dizziness can have several causes, one possibility is a problem with your vestibular system, which helps your brain understand your body's position and maintain balance.
At VanCity Physio, we understand how frustrating it can be when dizziness affects your confidence and daily routine. Vestibular physiotherapy may help reduce symptoms, improve balance, and help you return to your normal activities, depending on the underlying cause.
In this guide, we explain common causes of dizziness, how vestibular physiotherapy works, and when it may be time to seek professional help.
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Dizziness is a broad term that can describe several different sensations, including feeling lightheaded, unsteady, disoriented, or as though the room is spinning.
Understanding the type of dizziness you experience can help determine what assessment and treatment may be appropriate.
Benign paroxysmal positional vertigo, commonly known as BPPV, is one of the most common causes of vertigo.
It occurs when tiny calcium crystals inside the inner ear move into the wrong position. This can cause brief episodes of spinning sensations, particularly when changing the position of your head.
Common triggers include:
A physiotherapist with appropriate vestibular training can assess for BPPV and, when indicated, use specific repositioning manoeuvres to help move the displaced crystals back into the correct position.
The vestibular system is located in your inner ear and plays an important role in maintaining balance and keeping your vision steady when your head moves.
When the vestibular system is not functioning properly, you may experience:
Vestibular rehabilitation exercises may help improve your ability to maintain balance, coordinate head and eye movements, and manage symptoms during everyday activities.
As we age, changes in vision, muscle strength, reaction time, sensation, and the vestibular system can affect balance. These changes may increase the risk of falls, particularly when walking on uneven ground, navigating stairs, or moving in low-light conditions.
Balance-focused physiotherapy, often through a structured active rehabilitation program, can help improve strength, coordination, stability, and confidence with movement.
Some people experience dizziness, motion sensitivity, headaches, or balance difficulties following a concussion. These symptoms can affect concentration, exercise tolerance, work, and everyday activities.
Depending on the findings of an assessment, concussion therapy may include balance training, gaze-stabilization exercises, or a gradual return to physical activity. Treatment should be tailored to the individual's symptoms and recovery needs.
Because dizziness after a concussion can have multiple causes, an appropriate medical assessment may also be necessary.
Vestibular physiotherapy is a specialized area of physiotherapy that focuses on dizziness, vertigo, balance difficulties, and problems with the body's ability to coordinate head and eye movements.
The goal is to identify contributing factors and develop an individualized treatment plan to help improve function and reduce the impact of symptoms. A thorough clinical physiotherapy assessment is the starting point.
Depending on your assessment findings, treatment may include:
Vestibular Assessment: Your physiotherapist evaluates your symptoms, balance, movement, and relevant eye and head responses to help identify possible vestibular problems.
Canalith Repositioning Manoeuvres: If you have BPPV, specific head and body movements may help reposition displaced inner-ear crystals.
Gaze-Stabilization Exercises: These exercises help train your eyes to maintain a clear image while your head moves.
Balance and Coordination Training: Targeted exercises can help improve stability when standing, walking, turning, and navigating different environments.
Habituation Exercises: For certain conditions, carefully selected movements can help reduce sensitivity to motions that trigger dizziness.
Not every person with dizziness needs the same treatment. A proper assessment is important because the most effective approach depends on the underlying cause.
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Yes, physiotherapy can help with certain causes of vertigo, particularly BPPV and some vestibular disorders.
For people with BPPV, an appropriate repositioning manoeuvre can often provide significant relief. For other vestibular conditions, a structured rehabilitation program may help improve balance, gaze stability, and tolerance for movement.
However, dizziness is not always caused by an inner-ear problem. Dehydration, medication effects, blood pressure changes, migraines, neurological conditions, and other medical issues can also cause dizziness. This is why it is important to determine the likely cause before beginning treatment.
If your symptoms are new, persistent, worsening, or unexplained, consult a healthcare professional to determine the appropriate next steps.
Consider an assessment if you experience:
A physiotherapist can assess whether your symptoms may respond to vestibular rehabilitation or whether further medical evaluation is needed.
Important: Seek emergency medical attention if dizziness begins suddenly with symptoms such as difficulty speaking, facial drooping, new weakness or numbness, double vision, inability to walk, or a sudden severe headache. Sudden dizziness accompanied by chest pain, fainting, or other serious symptoms also requires urgent assessment. Do not assume these symptoms are caused by an inner-ear problem.
Not all causes of dizziness or balance difficulties can be prevented. However, maintaining physical activity and addressing contributing factors can support balance and mobility.
Helpful strategies may include:
Maintain your strength: Exercises that improve leg and core strength can support stability during everyday activities.
Practise balance safely: Appropriate balance exercises can help improve coordination and confidence.
Stay physically active: Regular movement supports strength, mobility, and overall function.
Reduce fall hazards: Keep walkways clear and ensure your home has adequate lighting.
Address persistent symptoms early: Recurrent dizziness or unexplained balance problems should be assessed rather than ignored.
If you already experience dizziness, avoid starting challenging balance exercises without guidance, particularly if you are at risk of falling. A physiotherapist can recommend appropriate exercises based on your abilities and symptoms.
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Dizziness can affect much more than your sense of balance. It can make everyday movements uncomfortable, limit your independence, and leave you feeling uncertain about participating in activities you once enjoyed.
The good news is that many vestibular conditions can be managed with appropriate assessment and treatment. At VanCity Physio, our goal is to help patients understand their symptoms, improve their movement, and work toward returning to the activities that matter to them.
If you are experiencing vertigo, dizziness, or balance difficulties, book an assessment at our Downtown clinic or Fairview clinic, or call us at 604-398-5584 to learn whether vestibular physiotherapy is right for you.
What is vestibular physiotherapy and how does it help dizziness?
Vestibular physiotherapy is a specialized treatment for dizziness, vertigo, and balance problems linked to the inner ear and the systems that coordinate head and eye movement. It uses assessment, repositioning manoeuvres, gaze-stabilization, and balance training to reduce symptoms and improve stability.
How quickly does vestibular physiotherapy work?
It depends on the cause. BPPV often improves within one to three sessions after a repositioning manoeuvre, while vestibular hypofunction or concussion-related dizziness usually takes several weeks of consistent exercises.
Can physiotherapy cure vertigo?
For BPPV, repositioning manoeuvres often resolve symptoms completely. For other vestibular conditions, rehabilitation can significantly reduce dizziness and improve balance, though results vary depending on the underlying cause.
Is my dizziness always coming from my inner ear?
No. Dehydration, medication effects, blood pressure changes, migraines, and neurological conditions can also cause dizziness. That's why an assessment matters before starting treatment, and why new or unexplained symptoms should be checked by a healthcare professional.
When is dizziness a medical emergency?
Seek emergency care if dizziness starts suddenly with difficulty speaking, facial drooping, new weakness or numbness, double vision, inability to walk, a severe headache, chest pain, or fainting. These need urgent attention and should not be assumed to be an inner-ear issue.
Do I need a referral to see a physiotherapist in Vancouver?
No referral is required in British Columbia. VanCity Physio also offers direct billing to most extended health plans, including ICBC and WorkSafeBC.
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