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What is Vestibular Therapy?

Vestibular therapy is a type of physical therapy that uses specialized exercises to treat imbalance, vertigo, dizziness or falls due to disruptions to your vestibular system.

The therapy is usually designed and conducted by a certified vestibular therapist or a specialty-trained, licensed physical therapist.

Significance of the Vestibular System

The vestibular system, also called the labyrinth, is located in your inner ear. It comprises the semicircular canals that are involved in the sense of equilibrium. The vestibular system provides sensory information to the brain required for maintaining balance and performing coordinated movements.

When you have a problem with your vestibular (balance) system, the brain cannot rely on information from the vestibular system to assist with balance, leading to symptoms such as vertigo, imbalance, dizziness or difficulties with vision. These symptoms can impact all aspects of daily living and reduce the quality of your life.

Concept of Vestibular Therapy

Typically, the brain interprets information gained from the vestibular system. When there is a defect in the system, the brain needs to be taught to correctly interpret the information it receives.

Vestibular therapy focuses on your head, body, eyes and their specific movements. It aims to retrain the brain to recognize and process signals from the vestibular system in coordination with information provided by vision and the muscles/joints. The idea is to encourage the brain to compensate for problems within the vestibular system.

Indications for Vestibular Therapy

  • Feeling of unsteadiness on your feet
  • Imbalance while walking
  • Poor posture and coordination
  • Sensation of spinning or moving
  • Feeling fuzzy or out of focus
  • Generalized wooziness or dizziness
  • Suffering frequent falls
  • Blurry vision with head movements
  • Neck tightness, stiffness and/or pain
  • Headaches and extreme nausea

Balance-Disorder Manifestations

  • Benign paroxysmal positional vertigo (BPPV)
  • Vestibular hypofunction (balance disorder of the inner ear)
  • Labyrinthitis (inflammation of the inner ear)
  • Vestibular neuritis (inflammation of the auditory nerve’s vestibular portion)
  • Unilateral or bilateral vestibulopathy (damage of both inner ears)
  • Vestibular schwannoma (type of tumor)
  • Chronic Meneire's disease
  • Perilymph fistula
  • Brain injury and/or stroke
  • Age-related vestibular degeneration
  • Ototoxicity (drug toxicity to the ear)


Before the actual therapy, your therapist will evaluate the symptoms and review your medical history. The therapist may also perform different tests and screen the visual and vestibular systems to more objectively evaluate your problems.

Your assessment will typically include all or part of the following areas:

  • Balance and/or leg strength or flexibility
  • Gait (how you walk)
  • Visual stability and mobility
  • Neck mobility and neck and arm strength
  • Positional testing, including an inner ear exam

Based on the evaluation, a plan of care will be developed to improve any deficits that were identified.

Vestibular Exercises

Vestibular therapy is usually performed on an outpatient basis, although in some cases it can be initiated in the hospital. The type of exercises for vestibular disorders depends upon symptoms, your medical history, diagnostic test results and the disorder itself.

The recommended exercises include the following:

  • Eye and head-movement exercises
  • Vision-stability exercises
  • Walking and posture exercises
  • Stretching and strengthening exercises
  • Neck-mobility/stretching exercises
  • Gaze-stabilization exercises
  • Repositioning exercises
  • Balance-retraining
  • Habituation exercises

Most exercises involve head movement, which is essential in retraining your brain and helping it adjust to changes in your balance.

Your therapist will discuss each exercise before recommending an appropriate one. These exercises are not difficult to manage and can be performed regularly in the comfort of your home.

The length of the therapy depends on the nature of the condition, severity of symptoms, and response to therapy, and will be determined by your therapist.

However, the type of vestibular disorder, your lifestyle, and the presence of other medical conditions can impact the duration of recovery.

Benefits of Vestibular Therapy

  • Strengthens the vestibular system
  • Restores balance and improves mobility
  • Enhances vision and postural stability
  • Reduces dizziness and risk of falls
  • Decreases or eliminates vertigo
  • Improves quality of life

Good balance is essential for daily life. A healthy balance (vestibular) system is a prerequisite for a healthy living. If you are experiencing problems with your vestibular system, Rathna Nuti MD, Family Medicine & Sports Medicine Specialist can help you with advanced diagnostics and an individualized exercise plan in Mckinney, Lewisville, TX. Rathna Nuti MD, Family Medicine & Sports Medicine Specialist deals with every aspect of the condition, including any triggers that induce or worsen the symptoms and ensures a functioning vestibular system. Vestibular therapy with Rathna Nuti MD, Family Medicine & Sports Medicine Specialist means no spinning, no wooziness, and a return to your daily activities.