What is vestibular rehabilitation?
Vestibular rehabilitation is a technique that can be used to manage dizziness or balance problems caused by damage to the balance organs of the inner ear, called the vestibular organs. It involves performing a programme of exercises designed to improve your dizziness or balance problems. Some departments also provide advice on how to reduce the effect of your dizziness or balance problems on your everyday life.

How do I know if I need vestibular rehabilitation?
You may be suitable for the treatment if your dizziness or balance problems are caused by a problem with the vestibular organs. However, certain fluctuating inner ear conditions (such as perilymph fistula or active Ménière’s disease) cannot be treated with vestibular exercises, although people with these conditions may find advice on how to manage their dizziness helpful.

Most people with dizziness caused by a vestibular problem find their symptoms get better over time without treatment. However vestibular rehabilitation may be beneficial for people who find they have had little or no improvement in symptoms after several months.

How does it work?
If there has been some damage to one (or both) of the balance organs in the inner ears the brain has difficulty interpreting the signals from the balance organs. A vestibular rehabilitation exercise programme is designed to teach your brain to interpret the signals from your balance organs correctly, and coordinate your balance more effectively. It is essential that the exercises are carried out on a daily basis, and you may be told to carry them out more than once a day. If the exercises are not carried out regularly you may not notice any effect at all on your dizziness or balance problem.

How long does it take for the exercises to have an effect?
This varies from person to person and depends on the cause of the dizziness, how bad the dizziness is to start off with, whether or not you are taking any medication for your dizziness, and so on. You should think in terms of several weeks although it can take much longer, and the effects may be very gradual so you may not immediately notice them.

Are there any side-effects?
It is quite likely that the exercises will make you slightly dizzy when you are doing them, and sometimes for a short time afterwards. This is quite normal and is necessary for the brain to relearn how to interpret the balance information correctly. Some people also notice an overall worsening in their dizziness during the first few weeks of doing the exercises, which is due to the exercises making the balance system work harder; this should get better if you continue the exercises. You should not notice any other effects.

What happens if I stop doing the exercises?
If you forget one of your exercise sessions every now and again then don't worry. If you stop doing the exercises completely for a period of time (for example if you are unwell) then it is possible that your dizziness will get worse. If you start the exercises again as soon as you can, your dizziness should improve again, although you may have to start off with some of the easier exercises.

Further information: What exercises should I do?

General advice for people with dizziness:

Many people whose dizziness is caused by damage to one or both of their balance organs find that they suffer from side-effects caused by their dizziness. These often include headaches, tiring easily, being unable to concentrate, having difficulties reading and/or using computer screens, and absentmindedness. These side-effects are very common because the damage to the balance organs means that more concentration and effort is needed to carry out everyday activities (such as walking, and shopping etc).

It is also quite common to have difficulties in supermarkets, crowds, rooms with busy patterns on the walls (brightly coloured stripes for example) and other situations where there is a lot of visual movement. Often people find that travelling as a passenger in a car, train or bus can be difficult, and veering off to the side when walking (particularly where lighting is poor) is very common. To try and improve your balance in these situations try to look at something which does not move; for example, concentrate on the shop signs in a shopping centre or on the road signs in the street (be careful to check what is in front of you, now and again, so you do not trip over!). If you have difficulties walking, try to touch things such as walls, fences, lampposts, railings etc as you move past them; this should help to stop you veering to the side.

You may well find that your dizziness is worse on some days than others, and you may find it is particularly worse at times when you are tired, stressed or unwell. Make sure that you get enough rest, and that you try to reduce your stress levels. Try to keep active as this will help reduce the effects of your dizziness - it is best to get some exercise every day if you are able to, even if it is only a short walk.

Further information: What exercises should I do?

Medical management

© 2003 Balance Interest Group