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Vestibular Physiotherapy: An Overview of Techniques and Approaches

Vestibular Physiotherapy is a type of physical therapy that focuses on treating balance and dizziness disorders. It is used to assist patients who experience vertigo and other vestibular disorders. Treatment is tailored to each individual and can include exercises to improve balance, coordination, and strength, as well as manual therapy and postural re-education. It can help reduce the symptoms of vestibular disorders, improve quality of life, and reduce the risk of falls.

Overview of Vestibular Physiotherapy

Vestibular physiotherapy is a type of physical therapy that is used to treat vestibular disorders, which are disorders of the inner ear that can cause balance problems, vertigo, and dizziness. It focuses on treating the symptoms of vestibular disorders, such as vertigo and dizziness, as well as improving balance and coordination. The goals of vestibular physiotherapy are to reduce dizziness and improve balance, coordination, and safety. Treatment typically includes balance and coordination exercises, vestibular rehabilitation exercises, manual therapy, and lifestyle modifications.

Types of Vestibular Conditions Treated

  1. Benign Paroxysmal Positional Vertigo (BPPV): BPPV is a type of vertigo that occurs when small crystals of calcium carbonate (otoconia) in the inner ear become dislodged and cause the vestibular system to become unbalanced. The resulting dizziness can be severe, causing nausea, vomiting, and balance difficulties. BPPV can be treated with a series of maneuvers known as the Epley maneuver.
  2. Vestibular Neuritis/Labyrinthitis: Vestibular neuritis is an inflammation of the vestibular nerve, which carries messages from the inner ear to the brain that help maintain balance and coordination. The result is severe vertigo, nausea, and imbalance. Vestibular neuritis can be treated with medications and physical therapy.
  3. Ménière’s Disease: Ménière’s disease is an inner ear disorder that causes vertigo, ringing in the ear (tinnitus), hearing loss, and a feeling of fullness in the ear. It is typically treated with diuretics, anti-nausea medications, and corticosteroids.
  4. Perilymph Fistula: Perilymph fistula is a disorder of the inner ear caused by a tear in the thin membrane between the inner and middle ear. It can cause vertigo, hearing loss, ringing in the ear (tinnitus), and balance problems. Treatment typically involves surgery to repair the tear.
  5. Vestibular Migraine: Vestibular migraine is a type of migraine headache that causes vertigo and other symptoms, such as nausea and imbalance. Treatment typically involves medications to reduce the severity of the symptoms.

Benefits of Vestibular Physiotherapy

  1. Improves balance and coordination: Vestibular physiotherapy can help improve balance and coordination in people who have vestibular disorders. This can improve your ability to perform daily activities and reduce the risk of falls.
  2. Relieves dizziness: It can help reduce the symptoms of dizziness, such as vertigo, lightheadedness, and nausea.
  3. Strengthens neck muscles: It can help strengthen the muscles in your neck, which can help reduce the symptoms of dizziness.
  4. Improves vision: It can help improve your vision by exercising your eyes in a specific way. This can help reduce the symptoms of dizziness and make it easier to focus on objects.
  5. Improves body awareness: It can help improve your body awareness, which can help reduce the risk of falls. It can also help you become aware of any changes in your body position.
  6. Improves quality of life: It can help improve your quality of life by improving your balance and coordination, reducing dizziness, and improving your vision. This can make it easier for you to perform daily activities and enjoy life.

Other Therapies Used in Vestibular Physiotherapy

  1. Balance/Gait Training: Balance and gait training exercises are used to help improve coordination and strength, as well as improve a person’s ability to perform activities of daily living.
  2. Manual Therapy: Manual therapy can help decrease pain and improve joint mobility, allowing for improved movement and balance.
  3. Postural Re-Education: Postural re-education can help improve posture and body awareness, which can lead to improved balance and coordination.
  4. Vestibular Rehabilitation Exercises: Vestibular rehabilitation exercises can be used to retrain the vestibular system, leading to improved balance and coordination.
  5. Proprioceptive Exercises: Proprioceptive exercises can help improve the body’s ability to sense and respond to the environment, leading to improved balance and coordination.
  6. Gaze Stabilization Exercises: Gaze stabilization exercises can help reduce dizziness and improve balance by training the eyes and head to move in a coordinated manner.
  7. Cognitive Behavioral Therapy: Cognitive behavioral therapy can help improve psychological well-being, which can improve a person’s overall response to vestibular dysfunction.


Vestibular Physiotherapy is a safe and effective option for treating vestibular disorders. It can help to reduce symptoms, improve balance, and improve the overall quality of life. It is important to work with a qualified physiotherapist to ensure that the treatment is tailored to the individual’s needs and that progress is monitored.