Have you ever turned over in bed or looked up suddenly—only for the entire room to start spinning, as if you’ve stepped onto a runaway merry-go-round? If so, you already know how unsettling vertigo can be. For many patients I have worked with, vertigo is not just dizziness; it is fear, loss of confidence, and the constant worry of when the next episode will strike.
Vertigo is one of the most common yet misunderstood balance disorders. While medication can suppress symptoms temporarily, it rarely addresses the root cause. This is where physiotherapy plays a decisive and evidence-backed role. As a clinician who has observed vertigo patients regain their balance, independence, and quality of life through targeted physiotherapy, I can say with confidence: movement, when prescribed correctly, is often the cure—not the enemy.
This article explains how physiotherapy helps in treating vertigo, grounded in clinical evidence, expert insights, and real-world practice—so you can make informed, confident decisions about your care.
Understanding Vertigo: More Than Just Dizziness
Vertigo is a specific sensation of movement—usually spinning—either of yourself or your surroundings. Unlike general light-headedness, vertigo almost always points to a problem in the vestibular system, which includes:
- The inner ear (semicircular canals and otolith organs)
- The vestibular nerve
- Balance-processing centres in the brain
Common Types of Vertigo Seen in Physiotherapy Practice
Benign Paroxysmal Positional Vertigo (BPPV)
The most frequent diagnosis in clinics. Caused by displaced calcium crystals (otoconia) in the inner ear.
Vestibular Neuritis / Labyrinthitis
Inflammation of the vestibular nerve or inner ear, often viral, leading to sudden severe vertigo.
Cervicogenic Vertigo
Vertigo originating from neck dysfunction—commonly seen in desk workers, postural strain, or whiplash injuries.
Central Vertigo
Linked to neurological causes such as stroke or multiple sclerosis (requires medical co-management).
According to the National Institute for Health and Care Excellence (NICE), BPPV alone accounts for up to 42% of vertigo cases seen in primary care.
Why Medication Alone Often Falls Short
Many patients arrive at physiotherapy after weeks or months of relying on medicines like betahistine or vestibular suppressants. While these can reduce nausea, they do not retrain the brain.
Professor Adolfo Bronstein, neuro-otologist at Imperial College London, explains:
“The vestibular system recovers through exposure and adaptation. Prolonged avoidance or over-reliance on medication can actually delay recovery.”
Physiotherapy works with the nervous system’s natural ability to adapt—a process known as neuroplasticity.
How Physiotherapy Treats Vertigo: The Core Mechanisms
Physiotherapy for vertigo is not generic exercise. It is precise, diagnosis-driven, and progressive.
1. Canalith Repositioning Manoeuvres (For BPPV)
For BPPV, physiotherapy is often curative within 1–3 sessions.
The most widely used manoeuvres include:
- Epley manoeuvre
- Semont manoeuvre
- Barbecue roll (for horizontal canal BPPV)
A landmark review in the Cochrane Database of Systematic Reviews found that canalith repositioning is effective in over 80% of BPPV cases, far outperforming medication.
Clinical insight: In practice, I have seen patients walk in needing wall support and walk out symptom-free after a correctly applied manoeuvre—provided the diagnosis is accurate.
2. Vestibular Rehabilitation Therapy (VRT)
Vestibular Rehabilitation Therapy is the backbone of physiotherapy for non-BPPV vertigo.
It includes:
- Gaze stabilisation exercises (e.g. VOR x1, VOR x2)
- Habituation exercises for motion sensitivity
- Balance and postural retraining
Professor Susan Herdman, one of the world’s leading authorities on vestibular rehabilitation, notes:
“Vestibular rehabilitation is an exercise-based programme designed to promote vestibular adaptation and substitution.”
A 2015 systematic review in The Journal of Neurologic Physical Therapy confirmed that VRT significantly improves balance, reduces dizziness, and lowers fall risk in adults with chronic vertigo.
3. Cervical Spine Physiotherapy for Neck-Related Vertigo
Not all vertigo starts in the ear.
Patients with prolonged screen use, forward head posture, or past neck trauma often present with dizziness linked to faulty cervical proprioception.
Physiotherapy interventions include:
- Manual therapy for cervical joints
- Deep neck flexor activation
- Postural correction strategies
A study published in Manual Therapy demonstrated that combined neck mobilisation and exercise significantly reduced dizziness intensity in cervicogenic vertigo patients.
4. Balance Re-education and Fall Prevention
Vertigo increases fall risk—particularly in older adults.
Physiotherapy restores:
- Sensory integration (visual, vestibular, proprioceptive)
- Confidence in movement
- Safe walking and turning strategies
This is especially critical because fear of movement often worsens symptoms through avoidance.
A Real-World Patient Story
One of my patients, a 42-year-old schoolteacher, developed vertigo after a viral illness. She avoided stairs, stopped driving, and limited her work hours.
Through a six-week vestibular rehabilitation programme—starting gently and progressing methodically—she returned to full function.
Her words at discharge were telling:
“The exercises didn’t just stop the spinning. They gave me my life back.”
How Long Does Physiotherapy Take to Work?
This depends on the diagnosis:
- BPPV: Often immediate or within days
- Vestibular neuritis: 4–8 weeks
- Chronic or central causes: Longer-term, but with meaningful improvement
Consistency matters more than intensity.
When Should You See a Physiotherapist for Vertigo?
You should seek physiotherapy if:
- Vertigo is triggered by head movement
- You feel unsteady despite normal scans
- Medication is not resolving symptoms
- You have neck pain with dizziness
Red flags (such as sudden weakness, speech difficulty, or double vision) require urgent medical review.
How We Provide Vertigo Physiotherapy at Cure On Call
At Cure On Call, we deliver specialised physiotherapy for vertigo through clinic-based and home-visit services, ensuring patients receive expert care without unnecessary travel stress. Our physiotherapists conduct thorough vestibular and cervical assessments, apply evidence-based manoeuvres, and design personalised rehabilitation plans. By combining clinical precision with compassionate care, Cure On Call focuses not just on symptom relief—but on restoring confidence, independence, and long-term balance.
Practical Steps You Can Take Today
- Avoid complete bed rest unless advised
- Seek a physiotherapist trained in vestibular rehabilitation
- Perform prescribed exercises daily
- Maintain good posture, especially during screen use
- Do not self-diagnose BPPV manoeuvres without guidance
Frequently Asked Questions (FAQs)
Can physiotherapy permanently cure vertigo?
In many cases—especially BPPV—yes. For other types, physiotherapy significantly reduces symptoms and recurrence.
Is vestibular physiotherapy safe?
When performed by a trained professional, it is safe and evidence-based.
Can elderly patients benefit from physiotherapy for vertigo?
Absolutely. In fact, fall prevention benefits are particularly valuable in older adults.
Do exercises make vertigo worse initially?
Mild temporary symptom provocation is normal and part of adaptation—but it should be monitored.
Final Thoughts
Vertigo is frightening—but it is also treatable. Physiotherapy does not mask symptoms; it retrains the systems responsible for balance and orientation. With the right diagnosis, expert guidance, and patient commitment, recovery is not only possible—it is expected.
If you or someone you care for has experienced vertigo, I encourage you to explore physiotherapy as a first-line, not last-resort, solution.
Have you tried physiotherapy for vertigo? Share your experience or questions—we learn better together.
Read Also: How Physiotherapy Helps Swimming Injuries?
