Dizziness & vestibular rehabilitation
Dizziness is deeply unsettling, and most people respond by avoiding the movements that provoke it. Yet that avoidance is exactly what delays the balance system's ability to adapt. This article explains the basics and how vestibular rehabilitation works.
Vestibular rehabilitation is an exercise-based therapy that prompts the balance system to adapt through targeted gaze, head, and balance exercises, reducing dizziness and unsteadiness in everyday life.
How balance is created
Balance draws on three sources of information: the vestibular organ in the inner ear, the visual system, and proprioception from muscles and joints. The brain constantly compares these signals.
When the signals no longer match – because one inner ear is delivering less information, for example – dizziness results. The nervous system can adapt to such changes, but it needs movement to do so.
Common forms of dizziness
Positional vertigo (BPPV)
Brief, intense spinning attacks when the head changes position. After a medical diagnosis, specific repositioning maneuvers are well established.
Unilateral vestibular loss
Persistent dizziness with unsteadiness while walking. Treatment focuses on helping the brain compensate for the altered vestibular input.
Functional dizziness
A persistent rocking or swaying sensation that may be reinforced by heightened attention and movement avoidance. Education and gradual exposure are central to treatment.
Neck-related contributions
Neck pain can amplify unsteadiness. Manual therapy and movement training then round out the treatment.
What vestibular rehabilitation involves
- Assessment including gaze stabilization, gait, and balance testing
- Exercises for stabilizing your gaze during head movement
- Habituation to dizziness-provoking movements in increasing doses
- Balance and gait training on changing surfaces
- Transfer to daily life: grocery shopping, stairs, crowds, driving
Important before therapy begins
Dizziness needs to be assessed by a physician, especially when it appears for the first time, comes on suddenly, or is accompanied by neurological signs. Targeted training makes sense only after that.
Frequently asked questions
Further reading
- Every session is provided by the practice owner—never a rotating team of therapists
- Session length is based on your clinical needs rather than a rigid schedule
- Private practice for privately insured and self-pay patients—no prescription required
“Kompetente Behandlung, angenehme Atmosphäre und sehr freundlich. Ich habe mich bestens aufgehoben gefühlt. Absolut empfehlenswert!”
Original reviews in German.
The MICA Health Guide to a Stronger Back
Seven evidence-informed principles for building a stronger, more resilient back
- What actually builds physical resilience—and what does not
- How to adjust activity instead of avoiding it
- Exercises that fit into everyday life