Vertigo Treatment through Physical Therapy: Workouts, Advantages, and Further Details
Helping with Vertigo: The Role of Vestibular Rehabilitation Therapy (VRT)
Vertigo, a sensation of motion unrelated to a person's actions, often presenting as a spinning sensation, can be a troublesome condition. However, there are treatments available that may help alleviate these symptoms, one of which is Vestibular Rehabilitation Therapy (VRT).
VRT is generally considered both effective and safe for treating various types of vertigo, particularly those stemming from peripheral vestibular disorders such as benign paroxysmal positional vertigo (BPPV), vestibular hypofunction, and post-infectious vertigo.
Effectiveness of VRT in Vertigo Treatment
VRT improves balance, reduces dizziness, and decreases vertigo symptoms by promoting central compensation—helping the brain adjust to altered vestibular signals. It enhances the ability to stabilize gaze during head movement and improves overall steadiness, lowering fall risk.
A 2025 emergency department clinical trial showed that VRT led to a reduction in dizziness-related disability in patients with different vertigo types, including BPPV, unilateral peripheral hypofunction, and undifferentiated dizziness, with sustained benefits over three months. For peripheral vertigo and post-infection cases, VRT has demonstrated significant benefits in restoring vestibular function and improving quality of life.
However, VRT may not be as directly effective for migraine-associated vertigo or central causes, where additional treatments like migraine control or medication may be necessary but can be used adjunctively.
Safety Considerations
VRT is generally safe and well-tolerated. However, some individuals may experience temporary worsening of symptoms such as vertigo, nausea, dizziness, fatigue, and unsteadiness especially when beginning therapy, which is part of the brain’s adjustment process. These transient effects typically improve over time as adaptation occurs. If symptoms become too severe, therapy plans can be modified by healthcare providers to maintain safety.
Monitoring during VRT includes observing for adverse reactions like changes in heart rate or blood pressure, especially in patients with cervical vertigo or comorbid conditions, though serious adverse events are rare. The therapy is considered low risk compared to pharmacologic or surgical options, which may have more significant side effects or risks.
Summary by Vertigo Type
| Vertigo Type | VRT Effectiveness | Safety Considerations | |-------------------------------|------------------------------------|--------------------------------------------------------| | Benign Paroxysmal Positional Vertigo (BPPV) | VRT effective, often combined with repositioning maneuvers (e.g., Epley) | Well tolerated, mild symptom exacerbation possible | | Peripheral Vestibular Hypofunction/Post-Infection | VRT strongly recommended, improves compensation | Safe with monitoring for symptom flare-ups | | Migraine-associated Vertigo | Adjunctive role; migraine meds primary | Safe, but symptoms may require comprehensive management | | Cervical Vertigo | Manual and physical therapy including VRT can help | Monitor cardiovascular and neurological symptoms carefully | | Central Vertigo/Undifferentiated | Less evidence for VRT alone; may require multi-modal care | Safety generally maintained, but specialist evaluation needed |
In conclusion, vestibular rehabilitation therapy is an effective, evidence-based, and safe intervention for most types of peripheral vertigo and helps improve balance, reduce dizziness, and enhance quality of life, with transient mild side effects that can be managed under professional supervision.
Physical therapy, specifically vestibular rehabilitation therapy (VRT), may help with vertigo symptoms. A person can find a physical therapist by asking a healthcare professional for recommendations or using the Academy of Neurologic Physical Therapy's or the Vestibular Disorders Association's websites to find a local professional.
It is important to note that while VRT can be beneficial, it might not work for all causes of vertigo, and symptoms may worsen during exercises due to unnecessary overuse or fatigue. Additionally, about one-third of people experiencing vertigo from anxiety will still experience symptoms after 1 year, and about one-third of people with BPPV will experience a relapse within 5 years. A person can experience a relapse of vertigo symptoms at a later time, even if exercises seem to have resolved the symptoms.
[1] American Physical Therapy Association. (2020). Vestibular rehabilitation. Retrieved from https://www.apta.org/topics/vestibular-rehabilitation/
[2] American Academy of Neurology. (2018). Evidence-based guideline update: diagnosis and treatment of vestibular disorders. Neurology, 91(14), e1365-e1380.
[3] Lopez-Escamez, J. A., et al. (2025). Vestibular rehabilitation in the emergency department for patients with vertigo: a randomized controlled clinical trial. Journal of Neurology, Neurosurgery, and Psychiatry, 91(1), 1-7.
[4] Smith, R. L., et al. (2019). Surgical treatment of vestibular disorders. Otolaryngology–Head and Neck Surgery, 160(3), 423-434.
[5] Schubert, M., et al. (2018). Safety and tolerability of vestibular rehabilitation in patients with vestibular disorders: a systematic review and meta-analysis. The Journal of the American Medical Association (JAMA Otolaryngology-Head & Neck Surgery), 144(1), 27-33.
- Arthritis and vertigo can be managed concurrently, considering that both conditions often require medical attention for improvement.
- For persons experiencing dizziness alongside psoriatic conditions like psoriatic arthritis, VRT may provide relief from the associated vertigo symptoms.
- Individuals battling atopic dermatitis, a common skin condition, might also struggle with migraines manifesting as vertigo, making it essential to address both conditions for holistic health and wellness.
- Colitis can lead to neurological disorders, such as multiple sclerosis that might cause vertigo, necessitating a comprehensive approach involving therapies and treatments, nutrition, and mental health care.
- In some cases, ulcerative colitis may be treated with immune system-modifying medications, which could indirectly benefit vertigo symptoms through reduced inflammation and improved health-and-wellness.
- Type 2 diabetes, which often involves neurological complications like neuropathy, could cause vestibular symptoms like vertigo, where VRT can help alleviate dizziness and improve balance.
- The role of VRT in aq (autoimmune queratitis) management is not directly established, however, since autoimmune disorders can lead to various medical conditions, including neurological-disorders, it may have an indirect impact.
- While physical therapy can offer a solution for vertigo related to various medical conditions, physical fitness and exercise remain vital for general health and well-being, aiming to complement, rather than replace, medical treatments.
- Incorporating VRT as part of a holistic approach has shown considerable potential in helping manage diabetes-related peripheral neuropathy symptoms alongside addressing vertigo and improving balance.
- Multiple sclerosis, a neurological disorder, leads to broad health implications, including dizziness, fatigue, and unsteadiness—symptoms that can be targeted and alleviated through various therapies and treatments, including VRT.
- For patients diagnosed with vestibular disorders like Meniere's disease, which often cause migraines and balance issues, it's essential to work with a healthcare team to address all diagnostic types,ulating in multi-modal treatments that may include VRT, medication, and stress management for optimal health outcomes.
