When ordinary movement feels unsettling
Turning your head, getting out of bed or walking through a busy space can become difficult when dizziness or imbalance is part of daily life. Vestibular physiotherapy begins by understanding the pattern of symptoms and whether rehabilitation is appropriate.
The vestibular system in the inner ear helps with balance and keeping vision steady as you move. Dizziness can also have other causes, so choosing the right assessment is important.
BPPV: when a change in position brings on spinning
Benign paroxysmal positional vertigo, or BPPV, is a common inner-ear cause of brief spinning sensations. It occurs when tiny calcium crystals become displaced into a semicircular canal, where they interfere with the signals your brain receives about head movement. Rolling over in bed, lying back or looking up can trigger an episode.
Your physiotherapist uses positional testing and observes your eye movements to identify whether BPPV is present and which ear and canal are involved. This helps us choose a targeted treatment rather than a general exercise routine.
Targeted treatment for BPPV
Canalith repositioning manoeuvres use a sequence of head and body positions to move the displaced crystals out of the affected canal. The Epley manoeuvre is one option for posterior-canal BPPV; other findings call for different manoeuvres. We adapt positioning to your physical needs and explain what to expect.
At Progress Physiotherapy, our commitment to evidence-informed practice includes using clinical guidelines to guide BPPV assessment and appropriate repositioning treatment. We reassess your response and address any remaining balance or movement concerns as part of your recovery plan.
Vestibular rehabilitation beyond BPPV
Not all dizziness is BPPV. We also assess unilateral vestibular loss (UVL) and vestibular hypofunction when appropriate. For reduced inner-ear balance function, rehabilitation can include exercises to improve visual steadiness during head movement, balance practice and gradual movement progression. Your goals might be walking confidently outdoors, navigating busy shops or turning your head comfortably during everyday activity.
What does the assessment involve?
We ask about the timing, triggers and duration of symptoms, changes in hearing or vision, falls, health history and medication. Appropriate tests may look at eye and head movement, positional symptoms, standing balance and walking.
Some presentations need medical investigation or a different provider. We explain the findings and discuss whether our clinic is the right setting for your care.
Different findings need different treatment
- Position-related vertigo. If findings are consistent with benign paroxysmal positional vertigo (BPPV), a trained clinician may use a repositioning manoeuvre. This is different from a general balance program.
- Reduced vestibular function. Appropriate gaze-stability and movement exercises may help you adapt to an inner-ear balance deficit.
- Balance and walking limitations. A plan may include supported balance practice, strength and gradual exposure to everyday movement demands.
Progress Physiotherapy’s commitment to evidence-informed care includes drawing on clinical guidelines that support vestibular rehabilitation for peripheral vestibular hypofunction. Your assessment identifies the type of dizziness or balance concern and guides the exercises and treatment selected for you.
A program matched to your tolerance
Some exercises deliberately bring on mild symptoms as part of a controlled progression. The amount and duration need to be appropriate for your condition. Your physiotherapist explains the intended response, how to practise safely and when to stop or seek advice.
We review changes in daily tasks—such as turning while walking, moving around home or feeling more secure in shops—as well as relevant assessment findings.
Before you book
Call reception for a vestibular appointment. We will help arrange the appropriate clinician and confirm appointment details. Tell us if you use a walking aid or need assistance attending.
Bring relevant medical reports, your medication list and your usual glasses and mobility aids. If you expect to feel unsteady, consider arranging someone to accompany you.
Sudden dizziness with new weakness, difficulty speaking, severe headache or an inability to walk needs urgent medical assessment. Call 911.
Your questions, answered
Is vestibular physiotherapy just the Epley manoeuvre?
No. Repositioning manoeuvres are used for specific positional vertigo findings. Other vestibular problems may need gaze-stability, balance or movement exercises and a different assessment.
Can treatment begin at my assessment?
Yes. When the assessment identifies BPPV and repositioning is appropriate, treatment can begin at that visit. We explain the findings and the next steps before proceeding.
Can BPPV come back?
BPPV can recur. If spinning returns, contact us for reassessment so we can check the cause and choose the appropriate treatment.
Should I try an online manoeuvre first?
An assessment helps identify the affected ear and canal and whether a manoeuvre is suitable for you. Your physiotherapist can teach a home manoeuvre when appropriate, with instructions tailored to your findings.
How soon should I improve?
This depends on the cause, duration of symptoms and other health factors. We discuss realistic expectations once we have assessed you and review your response.
Research & further reading
Clinical guideline informing our BPPV care: assessment and repositioning treatment
