More than 90 million Americans will experience a balance disorder in their lifetime, and balance-related falls account for more than half of all accidental deaths among older adults. Many of these issues can be effectively treated through vestibular therapy, a specialized form of physical therapy designed to reduce dizziness, vertigo and imbalance.
The vestibular system, located in the inner ear, plays a critical role in maintaining balance, stability and clear vision during movement. When this system is disrupted, patients may experience symptoms such as spinning sensations, lightheadedness, blurred vision with head movement or unsteadiness while walking.
Vestibular rehabilitation is an exercise-based approach that evaluates a patient’s symptoms, balance, gait and head and body movements to develop an individualized treatment plan. Therapy focuses on retraining the brain and body to adapt to vestibular deficits, improve stability and restore confidence during daily activities.
“Vestibular rehab is a specialized type of physical therapy we use to treat dizziness, vertigo, and imbalance,” Miranda Hose, P.T., physical therapist at WVU Medicine J.W. Ruby Memorial Hospital, said.
Vestibular therapy is commonly used to treat conditions like benign paroxysmal positional vertigo (BPPV) and vestibular neuritis, also known as vestibular hypofunction. BPPV occurs when tiny calcium crystals in the inner ear become displaced, triggering brief episodes of vertigo with certain head movements.
Through positional testing and a sequence of guided head and body movements, therapists can often reposition these crystals back where they belong, frequently resolving symptoms in just one or two visits.
“With BPPV, we can often correct the problem quickly and help patients return to their normal activities,” Hose said.
Vestibular neuritis, by contrast, involves inflammation of the vestibular nerve, which can disrupt communication between the inner ear and brain. This condition may result from viral infections, trauma or unknown causes and can lead to persistent dizziness, balance difficulties, motion sensitivity and visual instability during head movement.
Treatment for vestibular neuritis and hypofunction includes gaze stabilization exercises, habituation techniques, balance training and gait therapy. These exercises are designed to retrain the vestibular-ocular reflex, gradually desensitize the brain to symptom-provoking movements and improve overall safety and mobility.
Unlike many medical treatments, vestibular rehabilitation relies primarily on therapeutic exercise rather than medication. While medication may be used temporarily to manage severe nausea, prolonged use can interfere with the brain’s ability to adapt and recover.
The length of treatment varies depending on diagnosis and severity. Some patients require only a few visits, while others may benefit from six to eight weeks of therapy. Consistency with prescribed home exercises plays a key role in recovery.
Patients are also encouraged to continue balance, strength and walking programs post-therapy to reduce fall risk and support long-term health.
“Many people think dizziness is just part of getting older or something they have to live with,” Hose said. “But there are effective treatments that can significantly improve safety and quality of life.”
In the latest episode of the Live Healthy West Virginia podcast, Vestibular Therapy: Getting Back on Your Feet & Keeping You There, Hose discussed vestibular therapy, common balance disorders and the importance of early evaluation and treatment.
To learn more about WVU Medicine, visit WVUMedicine.org.
