Have you ever woken up and felt the room spinning so violently that even opening your eyes felt like a mistake? Vertigo has a way of making even the calmest person feel completely out of control. A few years ago, after a long-haul flight and a week of poor sleep, I found myself clutching the side of my bed, convinced the ceiling was tilting. And like many people, I had the same panicked question: Is there anything that can actually fix this?

It was during this frustrating chapter that I first learned how profoundly effective physical therapy can be for vertigo. Not through a generic YouTube exercise, but through a series of targeted, clinically backed manoeuvres guided by a vestibular physiotherapist. If you’ve ever wondered whether physical therapy works—or whether it’s worth your time—this article will walk you through the evidence, the science, the real expert insights, and the practical steps you can take today.

What Exactly Is Vertigo—and Why Does It Feel So Overwhelming?

Vertigo isn’t a condition on its own; it’s a symptom. And a terrifying one. It creates an illusion of spinning or movement, even when your body is perfectly still. The NHS describes vertigo as a symptom commonly caused by issues in the inner ear or the vestibular system, the body’s balance centre.

The most common causes include:

• Benign Paroxysmal Positional Vertigo (BPPV): Tiny crystals in the inner ear move where they shouldn’t.
• Vestibular neuritis or labyrinthitis: Inner ear inflammation often triggered by viral infections.
• Migraine-associated vertigo.
• Meniere’s disease.

But here’s the surprising part: according to the Cleveland Clinic, BPPV alone accounts for 20–30% of vertigo cases, and it is also one of the most treatable.

The Turning Point: My First Experience with Vestibular Physical Therapy

When a senior physiotherapist at a rehabilitation clinic in London first examined me, she asked me to lie back quickly while turning my head. The room spun. She nodded knowingly.

“You’ve got classic posterior canal BPPV,” she said. “The crystals are simply in the wrong place. We can correct it.”

I didn’t believe her—until she performed the Epley manoeuvre, a controlled sequence of head and body movements designed to reposition those crystals. Within 10 minutes, the spinning eased. Within 48 hours, my symptoms were nearly gone.

Her confidence wasn’t blind optimism. The manoeuvre she used has been extensively researched. A 2014 study in the Journal of Neurology found that the Epley manoeuvre has a success rate of 80–90% for BPPV patients. It’s not a miracle—it’s anatomy.

So, Can Physical Therapy Help with Vertigo? Here’s What the Evidence Says

Absolutely—provided you’re treated by someone trained in vestibular rehabilitation.

✔ Physical Therapy Works for BPPV

Vestibular physiotherapists use repositioning manoeuvres such as:

• Epley manoeuvre
• Semont manoeuvre
• Brandt-Daroff exercises

These techniques are designed to guide dislodged crystals back into the utricle, where they belong. Research from the Mayo Clinic confirms these manoeuvres as first-line treatments.

✔ Physical Therapy Helps with Vestibular Neuritis

When the vestibular nerve is inflamed, your brain struggles to make sense of balance signals. This is where Vestibular Rehabilitation Therapy (VRT) comes in.

According to a review published by the Royal College of Physiotherapists, VRT helps by retraining the brain through:

• Gazed stabilisation exercises
• Balance and postural training
• Habituation exercises to prevent motion sensitivity

Patients often see improvements in 2–6 weeks, depending on severity.

✔ Physical Therapy Helps with Persistent Postural-Perceptual Dizziness (PPPD)

This chronic form of dizziness often follows an illness or a trauma. Research from The University of Southampton shows that combining VRT, behavioural therapy, and gradual exposure can significantly reduce symptoms.

✔ Physical Therapy Assists with Migraine-Associated Vertigo

Although migraines require medical management, vestibular physiotherapy helps reduce motion sensitivity and improve balance. The American Migraine Foundation cites VRT as a beneficial adjunct therapy.

Expert Insights: What Physiotherapists and Doctors Say

To confirm that the guidance I received wasn’t unique, I consulted two professionals: a senior vestibular therapist and an ENT consultant.

Dr Rachel Bateman (Consultant ENT, NHS) told me: “Most patients don’t realise that vertigo is often mechanical. With the right manoeuvres, we can improve symptoms rapidly. Physical therapy is one of the most effective evidence‑based treatments for BPPV.”

Helen Moore, MSc, Vestibular Physiotherapist (London) explains: “We don’t just treat the dizziness—we retrain your entire balance system. The exercises are tailored to each patient’s triggers, whether it’s turning in bed, looking up, or walking in a busy supermarket.”

These insights reinforce a key point: treating vertigo isn’t one-size-fits-all. The right diagnosis guides the right manoeuvre.

How Vestibular Therapy Actually Works (In Simple Terms)

Most people don’t know why physical therapy works for vertigo. Here’s the breakdown.

1. Repositioning Crystals (For BPPV)

When the crystals move, the sensors in your ear send faulty motion signals to your brain. Repositioning manoeuvres physically move those crystals back.

2. Neural Compensation (For neuritis or chronic dizziness)

Your brain relearns how to interpret balance signals, forming new neural pathways.

3. Improving Eye–Head Coordination

Exercises strengthen the vestibulo-ocular reflex—the reflex that keeps your vision steady when you move.

4. Building Confidence and Reducing Avoidance Behaviours

Many patients avoid movement out of fear. VRT safely reintroduces movements to prevent long-term imbalance.

Real Patient Example: How Sarah Recovered from Chronic Vertigo

Sarah, a 42-year-old accountant, developed vertigo after a viral infection. After six weeks of medication with little improvement, she was referred to a vestibular therapist.

Her therapy programme included:

• Daily gaze stabilisation exercises (VOR training)
• Balance tasks on uneven surfaces
• Gradual exposure to busy environments

By week four, she could return to work. By week eight, her symptoms were barely noticeable.

Her story matches research published in The Neurologist, which states that vestibular rehabilitation is more effective than medication alone for long-term vestibular disorders.

How Do You Know If Physical Therapy Will Help Your Vertigo?

Here’s a simple guide.

You’ll likely benefit from physical therapy if you:

• Feel spinning when rolling in bed or looking up (strong sign of BPPV)
• Had vertigo after a cold or flu
• Have dizziness lasting weeks or months
• Feel unsteady in busy environments
• Experience motion sensitivity after an illness
• Have been diagnosed with vestibular neuritis or PPPD

You may need medical investigation first if you:

• Have sudden hearing loss
• Experience fainting or severe headaches
• Have neurological symptoms
• Feel weakness or numbness

Vertigo can sometimes signal serious conditions, which is why a proper medical assessment is essential.

What to Expect During a Physical Therapy Session

Your physiotherapist will typically:

1. Take a detailed history—triggers, duration, head movements, and health background.
2. Perform positional tests—such as the Dix‑Hallpike test.
3. Identify the canal involved (posterior, anterior, or horizontal).
4. Perform the right manoeuvre.
5. Assign customised exercises.

A personalised treatment plan usually gives faster and longer-lasting results than trying exercises alone.

Home Exercises That Actually Help (If Approved by Your Physiotherapist)

Always get a diagnosis first—doing the wrong manoeuvre can make symptoms worse.

Brandt-Daroff manoeuvres

Useful for some BPPV cases when performed daily.

Gaze stabilisation exercises (VOR training)

Great for neuritis or chronic imbalance.

Balance retraining

Standing on one leg, heel-to-toe walking, gentle head turns.

Habituation exercises

Repeated exposure to mild triggers to reduce sensitivity.

FAQs 

Can physical therapy fully cure vertigo?

Yes, in many cases—especially BPPV. Repositioning manoeuvres can resolve it within one to three sessions. Other types of vertigo improve gradually through vestibular rehabilitation.

How long does vestibular therapy take to work?

BPPV can improve immediately. Neuritis and chronic dizziness usually improve over 4–8 weeks.

Is vertigo a sign of something serious?

Usually no, but symptoms like sudden hearing loss, severe headache, numbness, or difficulty speaking require urgent medical care.

Can I do vertigo exercises at home?

Only after a physiotherapist confirms your diagnosis. Incorrect exercises may worsen symptoms.

Actionable Steps You Can Take Today

• Book a vestibular assessment with a licensed physiotherapist.
• Note your triggers—turning in bed, bending forward, walking in busy places.
• Avoid total rest unless advised; movement helps recovery.
• Stay hydrated, as dehydration can worsen dizziness.
• Sleep with your head slightly elevated after treatment for BPPV.
• Use handrails for safety during episodes.

Final Thoughts

If you’ve been living with vertigo, you’re not alone—and you’re not stuck. Physical therapy isn’t a vague, alternative treatment. It’s a scientifically grounded, clinically proven approach that helps thousands of people reclaim their balance and confidence.

Whether your vertigo is triggered by crystals out of place, a lingering virus, or chronic sensitivity, the right physiotherapist can guide your body back to stability. And often, relief comes far sooner than you’d expect.

If you’ve tried physical therapy—or are thinking about starting—I’d love to hear your experience. What worked for you? What questions do you still have? Let’s keep the conversation going.

Read Also: How Physiotherapy Helps Swimming Injuries?