Physiotherapists are trained to perform tests to determine the possible cause of dizziness. These tests include screening to rule out serious conditions that require urgent medical attention. Vestibular physiotherapists treat dizziness caused by vestibular system dysfunction.

The vestibular system is made up of two vestibular apparatus (one in each inner ear). Each apparatus has three components: the utricle, the saccule, and the semicircular canals. The utricle and saccule collect information about linear movement, and the semicircular canals collect information about rotational movements. Information collected by each vestibular apparatus is passed to the brain and the eyes by the vestibulocochlear nerves.

Dizziness due to a problem in the vestibular system can be caused by many different conditions. Some examples of these conditions are:

• benign paroxysmal positional vertigo (BPPV)
• vestibular neuritis
• labrynthitis
• Ramsay Hunt Syndrome
• acoustic neuroma
• Meniere’s disease
• concussion
• traumatic brain injury (TBI)

BPPV is responsible for dizziness in up to 50% of people. Onset is usually sudden and described as a feeling of spinning. It is caused by incorrect information being passed from the inner ear (where the vestibular apparatus is located) to the brain. Treatment is a simple manoeuvre that rights the vestibular apparatus and often leads to immediate relief.

The other conditions listed above are less common but can damage the vestibular system resulting in vestibular hypofunction. Symptoms of vestibular hypofunction may include dizziness, imbalance, and visual disturbance during head movements. A course of vestibular rehabilitation exercises prescribed by a physiotherapist can reduce symptoms and optimise function. If vestibular function is permanently affected a vestibular physiotherapist can help identify and practice strategies to compensate for this loss.

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