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Dizziness is something that many adults suffer from, yet few know what to do when presented with the symptom.  Luckily, we can treat that too!

My patients who suffer from vestibular symptoms such as dizziness, vertigo, and disequilibrium are often surprised to be prescribed physical therapy by their medical doctor and are uncertain of my ability to help them.  However, vestibular rehabilitation is actually a large subset of physical therapy and can be very beneficial for those who suffer from vestibular disorders.



If you suffer from the following symptoms, you may be a candidate for vestibular rehab:

  • Dizziness
  • Lightheadedness
  • Spinning
  • Disequilibrium
  • Unsteadiness
  • Feeling of falling
  • Spatial disorientation
  • Difficulty focusing on objects in view
  • Sensitivity to lights or busy patterns

These symptoms may occur with various movements such as looking up, bending over, turning over in bed, or walking.



The vestibular system is comprised of the inner ear and part of the brain that work together to orient our body in space, control our eye movements, and maintain our balance along with our vision and proprioception (sense of position).  Problems with the vestibular system will result in the symptoms above and can be attributed to one of two disorders:

  1. Peripheral vestibular disorder, which is a problem with the organs of the inner ear.
  2. Central vestibular disorder, which is a problem with a part of the central nervous system (in the brain).



Peripheral vestibular disorders are treated with repositioning maneuvers, which are a series of specific head and body positions performed with the assistance of your physical therapist.  The most common peripheral vestibular disorder is Benign Paroxysmal Positional Vertigo (BPPV).  It occurs as a result of a small calcium carbonate crystal becoming displaced within the semicircular canals of the inner ear.  When the head is moved in a certain plane, the crystal will shift, stimulate nerve hairs in the canal, and send false signals to the brain, which in turn causes a spinning sensation.  BPPV is typically treated successfully with the canalith repositioning maneuver that moves the crystal out of the canal.  Once this happens, spinning should resolve though some patients may require a different maneuver to be performed or may continue to have non-specific dizziness or imbalance that can be treated with the exercises described below.

Central vestibular disorders are treated with a cluster of highly customizable exercises intent on compensating for vestibular damage by learning to use other senses as a substitute.   Three common methods are:

  1. Habituation, which is repeated exposure to symptom-provoking movements or stimuli that will eventually be ignored by the brain with time and practice.
  2. Gaze Stabilization, which is designed to improve control of eye movements to promote better focus of objects during movement.
  3. Balance Training, which is aimed at challenging a person’s balance in order to improve steadiness during more simple activities.


If you or someone you know is currently suffering from a form of dizziness, see your medical doctor to rule out cardiovascular problems then ask for a referral for physical therapy.


Jennifer Canales, PT, DPT, FAAOMPT
Greater Therapy Centers in Lewisville - Vista Ridge/Hebron




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