What is vestibular physiotherapy?

Vestibular physiotherapy is a specialist area of physiotherapy focused on treating dizziness, vertigo, and balance problems caused by disorders of the inner ear or the brain's balance processing systems. Treatment involves specific exercises designed to retrain your brain's ability to process balance signals correctly, reduce sensitivity to movement, and improve your stability. It's evidence-based and effective for a range of vestibular conditions including BPPV, vestibular neuritis, and persistent postural-perceptual dizziness.

What is BPPV and can it be treated?

BPPV (benign paroxysmal positional vertigo) is the most common cause of vertigo. It happens when tiny calcium crystals in the inner ear become dislodged and move into one of the semicircular canals, sending false movement signals to the brain. This causes brief but intense spinning sensations triggered by specific head movements, typically rolling over in bed, looking up, or bending down. The good news is that BPPV can usually be resolved in one to two treatment sessions using a repositioning manoeuvre (such as the Epley manoeuvre) that guides the crystals back to where they belong.

How do I know if my dizziness is coming from my ear or my neck?

This is one of the most important diagnostic questions we address. Inner ear (vestibular) dizziness tends to involve true spinning sensations, is often triggered by specific head positions, and may come with nausea or visual disturbance. Neck-related (cervicogenic) dizziness is more of a vague unsteadiness or lightheadedness, often associated with neck stiffness or pain, and tends to be provoked by sustained neck positions rather than quick head movements. The two can also coexist. Our assessment includes specific tests to differentiate between vestibular, cervicogenic, and other causes of dizziness so we can target treatment accurately.

How long does vestibular rehabilitation take?

It depends on the condition. BPPV can often be resolved in one to two sessions. Vestibular neuritis or labyrinthitis typically requires 6 to 12 weeks of graded exercises to retrain the balance system. More complex conditions like persistent postural-perceptual dizziness (PPPD) or chronic vestibular migraine may take several months of consistent rehabilitation. We'll give you a clear expected timeline at your first appointment, and most people notice meaningful improvement within the first few weeks of starting the right exercises.

Can anxiety cause dizziness?

Yes, and the relationship between anxiety and dizziness is genuinely bidirectional. Anxiety can trigger dizziness through hyperventilation, muscle tension in the neck, and heightened sensitivity of the balance system. Equally, experiencing vestibular dizziness can cause anxiety, which then amplifies the dizziness further. This cycle is well recognised in vestibular medicine and is a core feature of persistent postural-perceptual dizziness (PPPD). Vestibular rehabilitation addresses both the physical and the behavioural components, helping you break the cycle through graded exposure and desensitisation exercises.

Should I see a GP or an ENT specialist before coming to vestibular physio?

You don't need to, though it can be helpful in some cases. If your dizziness came on suddenly with hearing loss, ringing in the ear, or severe nausea and vomiting, seeing your GP first is sensible to rule out conditions that need medical management. For most other types of dizziness, a direct referral to vestibular physiotherapy is the fastest route to an accurate diagnosis and treatment. We can always refer you on to an ENT specialist or audiovestibular physician if our assessment suggests you need further investigation.

Vestibular Physiotherapy & Dizziness Rehabilitation in Exeter

Do you feel dizzy, unsteady or off balance?

If you’re experiencing dizziness, vertigo, unsteadiness, motion sensitivity, or balance problems, it can feel unsettling — and at times scary. Many people worry they’ll just have to “live with it,” especially when symptoms come and go or have been present for a long time.

Vestibular physiotherapy is a specialist form of rehabilitation that helps your brain, inner ear, eyes and body work together again. With the right assessment and targeted exercises, many people see meaningful improvements in symptoms, confidence, and day-to-day function.

Vestibular Physiotherapy is now available at our clinic in Exeter, with Carmen Taylor.

Who this is for

Vestibular physiotherapy may help if you experience:

Dizziness or vertigo
Feeling unsteady, “off-balance,” or lightheaded
Motion sensitivity (symptoms when turning, bending, walking in busy places, scrolling, or travelling)
Poor balance, near-falls, or falls
Reduced confidence with walking, exercise, work, or everyday activities
Symptoms following illness, concussion, head trauma, or whiplash
Neck pain alongside dizziness

You don’t need a confirmed diagnosis to book. Identifying what’s contributing to your symptoms is part of the assessment.

Conditions we commonly help

We can help improve symptoms associated with:

Benign Paroxysmal Positional Vertigo (BPPV)
Recovery after vestibular neuritis or labyrinthitis
Ménière’s disease (post flare-up / fluctuating stage)
Vestibular migraine (post flare-up)
Persistent Postural-Perceptual Dizziness (PPPD)
Unilateral vestibular hypofunction
Bilateral vestibular hypofunction (symmetrical or asymmetrical)
Age-related balance decline
Labyrinthine concussion recovery
Post-concussion / head trauma or whiplash-related dizziness
Cervicogenic dizziness (neck pain with dizziness)
Acoustic neuroma (symptom management during monitoring phase, or post-surgery/radiation)
Motion sensitivity / visual–vestibular mismatch

If you’re unsure whether your symptoms fit, please contact us — we’ll guide you to the right appointment.

What happens in your vestibular assessment

Your initial appointment is unhurried and thorough. We take time to listen to your story and understand how symptoms affect your daily life.

Your session may include:

Detailed symptom history and appropriate medical screening
Identification of contributing factors
Cervical spine (neck) assessment when relevant
Eye movement (oculomotor) testing
Vestibular–ocular testing (how eyes and balance systems work together)
Coordination testing
Positional tests if vertigo is suspected (e.g. Dix–Hallpike and roll tests)
Balance and gait analysis
Further neurological and/or cranial screening if needed

Not every test is needed for every person — everything is explained as we go.

You’ll leave with clear next steps and a tailored plan.

How vestibular physiotherapy helps

Your rehabilitation programme is tailored to you and may include:

Canalith (crystal) repositioning manoeuvres (e.g. Epley, Semont, BBQ Roll) for BPPV where appropriate
Gaze stabilisation / adaptation training to improve visual clarity during head movement
Habituation exercises to reduce motion sensitivity through gradual exposure
Substitution strategies to improve stability when both inner ears are affected
Neck exercises to improve movement, strength and proprioception when the neck contributes
Balance and proprioception training to improve steadiness and reduce falls risk
Strength and conditioning for postural control to build endurance and overall function
Functional retraining to help you return confidently to walking, work, shopping, exercise and daily life

Exercises are progressed at a pace that feels challenging but safe.

Our goal

To reduce dizziness, enhance balance, and help you move with confidence again — using safe, research-backed physiotherapy tailored specifically to you.

Appointments & booking

Recommended starting point:
✅ Initial Vestibular Consultation (60 minutes)

Follow-ups:
✅ Vestibular Rehabilitation Follow-up (30 mins or 1 hour)

This is a specialist service and is separate from standard physiotherapy booking types to ensure you’re matched with the right clinician and appointment length.

Book online via our booking link, selecting:
Vestibular Physiotherapy & Dizziness Rehabilitation or Carmen Taylor MSc

If you’re not sure which appointment to choose, contact us and we’ll help.

FAQs

Do I need a referral from my GP?

No — you can self-refer and book directly.

What if my symptoms come and go?

That’s common. Vestibular symptoms often fluctuate. We assess patterns and triggers and build a plan around your current tolerance.

Is the assessment safe?

We screen carefully and only perform appropriate tests. Everything is explained as we go, and the assessment is paced to you.

Can you treat BPPV (“crystals”)?

Yes — if BPPV is identified, we can perform appropriate repositioning manoeuvres and provide guidance on recovery.

How many sessions will I need?

It varies depending on the cause, how long symptoms have been present, and your goals. Some conditions respond quickly; others need a phased rehab plan. We’ll set expectations after your assessment.

Ready to feel steadier?

If dizziness or balance problems are limiting your life, you don’t have to figure it out alone.

Book your Initial Vestibular Assessment or contact us if you’d like help choosing the right appointment.

Book appointment

Related conditions we treat

Neck Pain ·

Frequently Asked Questions About Vestibular Rehab

Vestibular physiotherapy is a specialist area of physiotherapy focused on treating dizziness, vertigo, and balance problems caused by disorders of the inner ear or the brain's balance processing systems. Treatment involves specific exercises designed to retrain your brain's ability to process balance signals correctly, reduce sensitivity to movement, and improve your stability. It's evidence-based and effective for a range of vestibular conditions including BPPV, vestibular neuritis, and persistent postural-perceptual dizziness.
BPPV (benign paroxysmal positional vertigo) is the most common cause of vertigo. It happens when tiny calcium crystals in the inner ear become dislodged and move into one of the semicircular canals, sending false movement signals to the brain. This causes brief but intense spinning sensations triggered by specific head movements, typically rolling over in bed, looking up, or bending down. The good news is that BPPV can usually be resolved in one to two treatment sessions using a repositioning manoeuvre (such as the Epley manoeuvre) that guides the crystals back to where they belong.
This is one of the most important diagnostic questions we address. Inner ear (vestibular) dizziness tends to involve true spinning sensations, is often triggered by specific head positions, and may come with nausea or visual disturbance. Neck-related (cervicogenic) dizziness is more of a vague unsteadiness or lightheadedness, often associated with neck stiffness or pain, and tends to be provoked by sustained neck positions rather than quick head movements. The two can also coexist. Our assessment includes specific tests to differentiate between vestibular, cervicogenic, and other causes of dizziness so we can target treatment accurately.

It depends on the condition. BPPV can often be resolved in one to two sessions. Vestibular neuritis or labyrinthitis typically requires 6 to 12 weeks of graded exercises to retrain the balance system. More complex conditions like persistent postural-perceptual dizziness (PPPD) or chronic vestibular migraine may take several months of consistent rehabilitation. We'll give you a clear expected timeline at your first appointment, and most people notice meaningful improvement within the first few weeks of starting the right exercises.
Yes, and the relationship between anxiety and dizziness is genuinely bidirectional. Anxiety can trigger dizziness through hyperventilation, muscle tension in the neck, and heightened sensitivity of the balance system. Equally, experiencing vestibular dizziness can cause anxiety, which then amplifies the dizziness further. This cycle is well recognised in vestibular medicine and is a core feature of persistent postural-perceptual dizziness (PPPD). Vestibular rehabilitation addresses both the physical and the behavioural components, helping you break the cycle through graded exposure and desensitisation exercises.
You don't need to, though it can be helpful in some cases. If your dizziness came on suddenly with hearing loss, ringing in the ear, or severe nausea and vomiting, seeing your GP first is sensible to rule out conditions that need medical management. For most other types of dizziness, a direct referral to vestibular physiotherapy is the fastest route to an accurate diagnosis and treatment. We can always refer you on to an ENT specialist or audiovestibular physician if our assessment suggests you need further investigation.