Vertigo
Regain your balance and confidence with personalised vestibular physiotherapy designed to reduce dizziness and improve everyday movement.
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What is Vertigo?
Vertigo is a sensation that you or your surroundings are spinning or moving when there is no actual movement. It is a symptom rather than a disease and can have several causes, including problems affecting the inner ear or the brain and nervous system. Vertigo may occur with nausea, vomiting, imbalance, difficulty walking, or sensitivity to head movements. At Pure Physio, after appropriate assessment and diagnosis, vestibular physiotherapy can help certain types of vertigo by improving balance, supporting the brain’s adaptation to vestibular problems, and using specific repositioning manoeuvres when clinically appropriate.
Vertigo is a specific type of dizziness.
It creates a false sensation of movement.
A person may feel:
The Room Is Spinning
Their Body Is Spinning
The Environment Is Moving
They Are Swaying or Tilting
Vertigo can occur suddenly or develop gradually depending on its cause.
It is commonly divided into:
Peripheral Vertigo
This usually results from problems affecting the:
Inner Ear
or
Vestibular Nerve
The vestibular system helps the brain understand:
Head Position
Movement
Balance
Common causes include:
Benign Paroxysmal Positional Vertigo (BPPV)
Vestibular Neuritis
Labyrinthitis
Ménière’s Disease
Central Vertigo
This results from problems affecting the:
Brain
or
Central Nervous System
Potential causes can include certain neurological conditions and, less commonly, stroke.
Because the cause of vertigo can vary, proper assessment is important before beginning treatment.
What Are The Symptoms Of Vertigo?
Spinning Sensation: Feeling as though you or the surroundings are spinning.
Swaying or Tilting Sensation: A feeling of moving, rocking, or leaning.
Loss of Balance: Difficulty maintaining stability while standing or walking.
Unsteadiness: Feeling unstable or as though you may fall.
Nausea: Feeling sick to the stomach.
Vomiting: Severe vertigo can cause vomiting.
Dizziness with Head Movement: Turning the head or changing position may trigger symptoms.
Symptoms When Getting Out of Bed: Positional changes can trigger vertigo in conditions such as BPPV.
Difficulty Walking: Severe dizziness may make walking difficult.
Motion Sensitivity: Symptoms may worsen with movement.
Blurred Vision: Vision may feel unstable during severe dizziness.
Abnormal Eye Movements: Some causes of vertigo may produce involuntary eye movements called nystagmus.
Ear Fullness: A feeling of pressure or fullness may occur with some inner-ear conditions.
Hearing Changes: Certain causes may be associated with reduced or fluctuating hearing.
Tinnitus: Ringing or other sounds in the ear may occur.
Headache: Headaches may occur in some conditions associated with dizziness or vertigo.
Sudden severe vertigo with new weakness, facial drooping, difficulty speaking, double vision, severe headache, loss of coordination, or inability to walk requires emergency medical assessment.
What Are The Causes Of Vertigo?
Vertigo can have several causes.
Benign Paroxysmal Positional Vertigo (BPPV)
BPPV is a common cause of vertigo.
It occurs when tiny calcium crystals in the inner ear become displaced and move into areas where they can incorrectly stimulate the balance system.
Symptoms are often triggered by:
Turning in Bed
Looking Up
Bending Down
Getting Into or Out of Bed
Vestibular Neuritis
This involves inflammation affecting the vestibular nerve.
It can cause sudden and prolonged vertigo and imbalance.
Labyrinthitis
Inflammation of the inner ear can cause vertigo and may also affect hearing.
Ménière’s Disease
This inner-ear condition can cause episodes of vertigo along with symptoms such as hearing changes, tinnitus, or a feeling of fullness in the ear.
Vestibular Migraine
Some people experience vertigo or dizziness associated with migraine.
Head or Ear Injury
An injury may affect the inner ear or vestibular system.
Certain Medications
Some medicines can cause dizziness or affect balance.
Neurological Conditions
Conditions affecting the brain or nervous system can sometimes cause vertigo.
Reduced Blood Flow or Stroke
Certain serious vascular or neurological problems can cause sudden vertigo and require urgent medical assessment.
The exact cause should be identified by an appropriately qualified healthcare professional.
Diagnosis Of Vertigo
Medical History: A healthcare professional will ask about when symptoms started, how long episodes last, triggers, associated symptoms, hearing changes, headaches, and medical history.
Symptom Description: The pattern of dizziness is important because not all dizziness is vertigo.
Neurological Examination: Strength, coordination, sensation, walking, and other neurological functions may be assessed.
Eye Movement Assessment: Eye movements and nystagmus may provide important information about the cause.
Balance Assessment: Standing balance, walking, and movement responses may be assessed.
Positional Testing: Specific tests, such as the Dix-Hallpike test, may help diagnose BPPV.
Supine Roll Test: This may be used to assess certain forms of positional vertigo.
Head Impulse Test: This may help assess vestibular function.
Hearing Tests: Hearing may be assessed when symptoms suggest an inner-ear condition.
Audiometry: Formal hearing testing may be required.
Imaging: MRI or CT scans may be considered when central or other serious causes are suspected.
Blood Tests: Tests may be used when another medical cause of dizziness is suspected.
The diagnosis depends on identifying the type, pattern, trigger, and underlying cause of the vertigo.
Treatment Of Vertigo
Treatment depends entirely on the underlying cause.
Canalith Repositioning Manoeuvres: Specific manoeuvres, such as the Epley manoeuvre, may be used for certain forms of BPPV.
Vestibular Rehabilitation: Specialised exercises can help improve balance and reduce movement-related dizziness in suitable conditions.
Medication: A doctor may prescribe medication for nausea or specific underlying conditions when appropriate.
Treatment of Inner-Ear Conditions: Conditions such as Ménière’s disease or labyrinthitis may require specialist medical management.
Migraine Management: Vestibular migraine may require lifestyle measures and medical treatment.
Hydration: Maintaining appropriate fluid intake may be important, depending on the underlying cause.
Medication Review: A doctor may review medications that could contribute to dizziness.
Balance Rehabilitation: Exercises may help improve stability and confidence with movement.
Fall Prevention: Safety strategies and environmental modifications can help reduce falls risk.
Treatment of Neurological Causes: Vertigo caused by neurological conditions requires appropriate specialist management.
Physiotherapy: Vestibular physiotherapy can be particularly beneficial for selected causes of vertigo.
What Is The Physiotherapy Treatment Of Vertigo
Physiotherapy treatment depends on the type and cause of vertigo. Vestibular rehabilitation is only provided after an appropriate assessment.
Detailed Vestibular Assessment: At Pure Physio, we assess the pattern of symptoms, triggers, balance, walking, eye movements, and the effect of head and body movements.
Positional Assessment: Specific tests may help identify positional vertigo when clinically appropriate.
Canalith Repositioning Manoeuvres: For appropriately diagnosed BPPV, specific repositioning manoeuvres may be performed to help move displaced inner-ear crystals.
Gaze Stabilisation Exercises: Exercises may help improve the ability to maintain stable vision while moving the head.
Habituation Exercises: Gradually repeated exposure to selected movements may help reduce sensitivity to movements that trigger symptoms.
Balance Training: Exercises may improve stability during standing, walking, and functional activities.
Walking Training: Rehabilitation can address unsteadiness and improve confidence while walking.
Head Movement Exercises: Carefully graded exercises may help the vestibular system adapt to movement.
Visual-Vestibular Exercises: Selected activities may help improve coordination between visual and balance systems.
Fall Prevention Strategies: We provide guidance to reduce falls risk at home and during daily activities.
Functional Movement Training: Therapy focuses on movements such as getting out of bed, turning, looking up, bending, walking, and navigating everyday environments.
Home Exercise Programme: A personalised programme may support continued vestibular rehabilitation between sessions.
Progress Monitoring: Your treatment plan is reviewed and adjusted according to changes in dizziness, balance, and function.
Not every type of vertigo requires the same physiotherapy treatment, and certain causes require medical or specialist management rather than vestibular rehabilitation alone.
Why Choose Pure Physio?
Detailed Vestibular Assessment: We carefully assess your symptoms, triggers, balance, movement, and functional difficulties.
Cause-Specific Approach: Treatment is selected according to the suspected or diagnosed cause of your vertigo.
Personalised Vestibular Rehabilitation: Your programme is adapted to your symptoms, tolerance, balance abilities, and recovery goals.
BPPV Management: When clinically appropriate, specific assessment and repositioning techniques may be used for positional vertigo.
Focus on Balance and Stability: Rehabilitation aims to improve steadiness and confidence during standing and walking.
Gradual Symptom Adaptation: Exercises are carefully progressed to help the body adapt without unnecessary symptom aggravation.
Fall Prevention Focus: We provide practical strategies to improve safety during everyday movement.
Functional Recovery: Treatment focuses on activities affected by vertigo, including getting out of bed, turning, bending, walking, and returning to normal routines.
Home Exercise Guidance: You receive practical exercises and advice to support progress between physiotherapy sessions.
Integrated Care Approach: When symptoms suggest an ear, neurological, migraine-related, or other medical cause, we support appropriate referral and work alongside the wider healthcare team.
Focused on Restoring Confidence: Our goal is to help you move with greater stability, reduce the impact of dizziness, and return safely to the activities that matter to you.
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