Understanding Vestibular Physiotherapy

Feeling dizzy, unsteady, or “off balance” can be unsettling and in many cases, completely disruptive to daily life. What many people don’t realize is just how common dizziness and balance disorders are. They account for 5–10% of all physician visits and affect around 50% of adults at some point in their lives.

The good news? Physiotherapy can help. At Plaza Physiotherapy, our team includes physiotherapists with specialized training in Vestibular Physiotherapy, a focused approach designed to assess and treat dizziness, vertigo, and balance issues that stem from the inner ear and related systems.

What Causes Dizziness and Balance Issues?

Dizziness isn’t caused by just one thing, however, it can originate from several systems in the body, including:

– Cardiovascular system
– Central nervous system
– Visual system
– Orthopedic system (bones, muscles, joints)
– Vestibular system (inner ear and balance organs)

Orthopedic Disorders

Vestibular-trained physiotherapists can help diagnose and treat balance problems related to:

Issues in the muscles, joints, and skeletal system that affect stability.

Peripheral vestibular disorders:

– Benign Paroxysmal Positional Vertigo (BPPV)
– Uncompensated Unilateral Vestibular Lesion (UVL)
– Bilateral Vestibular Lesions (BVL) (with some limitations in recovery)

Common Vestibular Conditions We Treat

1. Benign Paroxysmal positional vertigo (BPPV)

BPPV is the most common cause of vertigo and can affect people of all ages, though it becomes more common as we get older. It happens when tiny calcium crystals in the inner ear become dislodged and settle where they shouldn’t, sending incorrect signals to the brain.

People with BPPV often experience vertigo when:

– Rolling over in bed
– Looking up
– Bending forward
– Lying down

Symptoms are usually brief (less than 60 seconds) but can be intense, recurring, or long-lasting.

How physiotherapy helps:
Treatment involves a series of gentle, specific positional maneuvers that guide the crystals back to the correct location. Many people experience dramatic relief after just one or two sessions.

2. Unilateral Vestibular Lesion (UVL)

Your vestibular system contains a balance organ on each side of your head. A UVL occurs when one side becomes damaged or stops functioning properly.

Common symptoms include:

– Sudden onset of vertigo or severe dizziness
– Nausea (sometimes)
– Ongoing imbalance or unsteadiness even after the initial episode

Although the damage is often permanent, the brain can learn to compensate using the healthy side.

How physiotherapy helps:
Treatment focuses on exercises that gently challenge the vestibular system, helping the body adapt and rebuild stability. With consistency, most people notice improvements within 3–6 weeks.

3. Bilateral Vestibular Lesions (BVL)

When both sides of the vestibular system are affected, recovery is more challenging, but improvement is still possible.

How physiotherapy helps:
Treatment is similar to UVL therapy but may progress more gradually due to the extent of the damage.

What to Expect During Your Assessment

Your initial vestibular assessment is thorough and specialized. To help us understand your dizziness: 

– Please arrive 10 minutes early to complete forms and symptom questionnaires.
– The assessment may require us to reproduce some of your symptoms, which is necessary for accurate diagnosis.
– You may feel tired or dizzy afterward. We encourage arranging alternative transportation instead of driving yourself home.

This detailed evaluation helps us tailor your treatment plan with precision and care.

Your Treatment Plan

Treatment for BPPV

– Gentle positional techniques to move calcium crystals back into place
– Guidance on movement and sleeping positions for the following week
– Follow-up appointment typically scheduled one week later
– High success rate and fast symptom relief

Treatment for UVL and BVL

– Customized balance drills
– Exercises that may temporarily provoke dizziness (this is expected and part of the process)
– Ongoing progression as symptoms improve

Noticeable progress typically begins within 3–6 weeks when exercises are done consistently

We’re Here to Help You Get Back to Steady, Confident Movement

Dizziness and balance issues can feel overwhelming, but you don’t have to navigate them alone. With specialized Vestibular Rehabilitation Physiotherapy, many patients experience significant improvement, renewed confidence, and a return to the activities they love.

If you’re struggling with dizziness, vertigo, or unexplained imbalance, our team at Plaza Physiotherapy is here to support you with expert assessment and effective, evidence-based treatment.

To book an appointment or learn more, contact us at 604-438-9111 or visit www.plazaphysio.com.