Vertigo, Dizziness & Loss of Balance

Physiotherapy Services and Treatments

Vertigo (spinning), dizziness and loss of balance are common symptoms of vestibular dysfunction. The vestibular system includes parts of the inner ear and brain that control balance and eye movements. Damage to this system from disease or injury results in vestibular dysfunction.


One of the most common causes of vertigo is BPPV. BPPV is characterized by vertigo that arises only with certain head movements, and typically lasts a few seconds or minutes. The spinning sensation, or vertigo, is caused by small crystals floating free in one of the semicircular canals of the inner ear, sending false signals of movement to the brain. Vertigo caused by BPPV is common in seniors and following head trauma (such as auto accidents).

Treatment for BPPV is usually quick and effective in one or two treatment sessions, using specific head movements such as the Epley manoeuvre.


Chronic vertigo, dizziness, loss of balance and fatigue are common symptoms of vestibular disorders such as Menière’s Disease, Labyrinthitis, and Vestibular Neuritis. These conditions can cause abnormal inner ear function in one or both ears. When this happens, you may feel dizziness, vertigo, nausea or loss of balance because the brain can no longer rely on the inner ear for accurate information about position and motion.

Fortunately, in most cases, the brain is able to adapt to abnormal vestibular signals after a few weeks, through a process called compensation. However, if the vestibular compensation process is not completely successful, the body tries to compensate using the eyes (vision), muscles and joints (proprioception). This overworks these areas and results in fatigue, headaches and muscle tension.

Vestibular Rehabilitation Therapy (VRT) is a special form of therapeutic exercise that is especially helpful in these cases. VRT helps to retrain the brain to recognize and process signals from the vestibular system in coordination with vision and proprioception. This process can take several months, and involves exercise that patients can do at home.

Vertigo can be caused by a variety of medical conditions besides the vestibular dysfunctions mentioned here. Some of these can be serious, even life-threatening. For this reason, we strongly urge our patients to see their doctor for medical clearance before starting physiotherapy treatment for vertigo.