Vestibular Rehabilitation
Vestibular rehabilitation is an exercise-based program, designed by a specially trained
physical therapist, for people whose dizziness, vertigo, or unsteadiness stems from the
balance system of the inner ear or brain.⁶
What it is
The vestibular system — your inner-ear balance organs and their connections to the brain — can be retrained. Treatment draws on a toolkit that includes gaze-stabilization exercises (training steady vision while the head moves), habituation exercises (carefully repeated exposure to movements that trigger dizziness, so the brain adapts), balance retraining, and repositioning maneuvers for BPPV, in which the therapist moves your head through a sequence that returns loose inner-ear calcium crystals to where they belong.⁷
When we may recommend it
• Vertigo and BPPV (the most common cause of brief positional vertigo)
• Inner-ear disorders: vestibular neuritis, labyrinthitis, Ménière's disease, vestibular hypofunction
• Concussion, post-concussion syndrome, and traumatic brain injury
• Neurological conditions including stroke and multiple sclerosis
• Unexplained falls, motion sensitivity, or persistent unsteadiness
What a session involves
First comes a thorough assessment — balance, walking, strength, and how your symptoms respond to specific head movements — so the program matches your trigger profile rather than a generic recipe. Sessions are a partnership: your therapist coaches you through exercises in the clinic and prescribes a short daily home routine, because the brain adapts through repetition, not through being treated passively. Most people attend weekly sessions for six to eight weeks, though some need only one or two visits (for example, when BPPV repositioning resolves the problem) and others need several months.⁶
Expected outcomes
Realistic gains include reduced dizziness and nausea, steadier balance and walking, more stable vision when you move your head, and a lower fall risk.⁶⁷ Vestibular rehabilitation helps manage symptoms and restore function — it does not cure the underlying issue, and how much you improve depends partly on doing your prescribed exercises consistently.
Good to know
By design, some exercises provoke mild dizziness — habituation works by using positions that trigger dizziness so the body can adjust and the dizziness may decrease. Your therapist keeps the intensity tolerable and progresses it gradually. If you're doing home exercises and notice a sudden change in your hearing, painful ear pressure or fullness, new or increased ringing in your ear, or fluid from your ears, stop and contact your healthcare provider promptly.