Feeling Dizzy or Off-Balance? How Vestibular Physiotherapy Can Help

Not all dizziness is vertigo. They have different root causes and hence treatments too.

Dizziness can be unsettling, and at times, be quite confronting if it hits you all of a sudden. It is a non-specific term used to describe a variety of sensations such as light-headedness, disorientation and presyncope, spatial disorientation or vertigo. 

Vertigo is a specific type of dizziness characterised by the illusion of movement in the environment (e.g., spinning, whirling), with the most common being Benign Positional Paroxysmal Vertigo (BPPV) caused by dislodged calcium crystals in one of more of the three semi-circular canals. 

Both dizziness and vertigo are purely subjective phenomena - meaning there are no objective means of measuring them, which can be frustrating for many patients when they are sent for scans only to be told that they are unremarkable or “normal”. 

Their symptoms are distinctly different and cannot be used interchangeably.

Understanding the unique symptoms of each scenario will give patients the best chance at being directed to the right healthcare professional for treatment.

If this sounds familiar, vestibular physiotherapy may be the missing piece. It focuses on how your balance system works as a whole — rather than chasing symptoms in isolation.

What Is Vestibular Physiotherapy?

Vestibular physiotherapy is a specialised area of physiotherapy that helps to manage dizziness, vertigo, motion sensitivity, balance and postural control issues that occur due to dysfunction of the vestibular system, which involves the brain, inner ear, and eyes in some cases.

Balance is not controlled by one structure alone. It relies on constant communication between:

• The inner ear, which senses movement and position

• The eyes, which provide visual reference

• The neck and body, which give proprioceptive feedback about posture and movement

• The brain and nervous system, which process and coordinate all this information

When one part of this system isn’t functioning well — or when communication between systems breaks down — you may feel off-balance, or disoriented, even if medical tests don’t show anything wrong.

Common Dizziness Symptoms People Often Ignore

Dizziness doesn’t always feel dramatic or severe. Many people experience symptoms such as:

• Feeling “off” or unsteady

• Light-headedness or head pressure

• Dizziness when turning the head or changing positions

• Spinning sensations when rolling in bed

• Poor balance or fear of falling

• Headaches combined with dizziness

• Difficulty focusing visually, especially after long periods of screen use

Because these symptoms can come and go, they’re often dismissed as stress, fatigue, or ageing. Over time, however, they can reduce confidence in movement and impact quality of life.

Dizziness, Light-Headedness or Vertigo: What’s the Difference?

One of the most common reasons people struggle to get the right help is confusion around terminology. Many people use the word “dizzy” to describe very different sensations.

Understanding the difference matters — because different sensations often point to different contributing factors.

Dizziness

Dizziness is a broad, umbrella term. It may include:

• Feeling off-balance

• Feeling disoriented

• A general sense that something isn’t right

It doesn’t always involve spinning, and it doesn’t always come from the inner ear.

Light-Headedness

Light-headedness often feels like:

• Feeling faint or woozy

• Head heaviness or pressure

• A sensation that you might pass out

This can be linked to fatigue, stress, dehydration, or sudden posture changes. While often dismissed as minor, recurring light-headedness can still affect balance, confidence and daily functioning.

Vertigo

Vertigo is more specific and usually more intense. People with vertigo may experience:

• A spinning sensation

• The room or bed moving when they roll over

• Sudden spinning when turning the head

• Nausea or loss of balance during episodes

Vertigo is commonly associated with the inner ear, but that doesn’t mean the inner ear is the only system involved.

Why This Distinction Matters

Although these sensations feel different, they often overlap. Many people experience a combination of dizziness, light-headedness, and balance issues at the same time.

If treatment focuses only on one system — such as the inner ear — while ignoring the neck, eyes, posture, or nervous system, symptoms may persist or return. Vestibular physiotherapy looks at the full picture, not just the label attached to the symptoms.

Why Dizziness Can Happen Even When Scans Are Normal

As dizziness is a purely subjective phenomenon without any objective measures, it doesn’t always come from structural damage, which is why it may not appear on scans. Common contributing factors include:

Inner Ear Changes

Altered signals from the inner ear can affect how movement and position are perceived.

Neck Stiffness and Posture

Prolonged desk work, screen use, and forward head posture can disrupt balance information coming from the neck.

Previous Injuries

Past concussions, falls, or whiplash injuries can affect how the brain processes balance, even long after the injury.

Nervous System Overload

Stress, poor sleep, and mental fatigue can increase sensitivity to movement and visual input, making dizziness more noticeable.

In many cases, dizziness isn’t caused by one single issue — but a combination of factors.

How Vestibular Physiotherapy Helps

Vestibular physiotherapy uses targeted, progressive exercises to retrain the balance system and restore confidence in movement.

Depending on your assessment, treatment may include:

• Balance retraining to improve stability and coordination

• Eye–head coordination exercises to reduce visual dizziness

• Habituation exercises to help the brain tolerate movement again

• Neck mobility and control work

• Nervous system regulation strategies

Exercises are carefully progressed so your system adapts without unnecessarily provoking symptoms.

What Our Physiotherapist Checks First When You Feel Dizzy

A vestibular assessment looks beyond symptoms alone. We may assess:

• Eye movements and visual tracking

• Head and neck mobility

• Balance reactions and postural control

• Movement tolerance

This helps identify where communication within the balance system is breaking down, allowing treatment to be targeted and effective.

Who Can Benefit from Vestibular Physiotherapy?

Vestibular physiotherapy can help a wide range of people, including:

• Office workers experiencing screen-related dizziness or neck tension

• Older adults with balance changes or fear of falling

• Athletes returning to activity after concussion or injury

• Anyone whose dizziness affects daily confidence, work, or independence

If dizziness is limiting how you move or live, it’s worth addressing.

You Don’t Have to Live With Dizziness

Dizziness is common — but persistent dizziness is not something you need to accept as normal.

With the right assessment and a structured treatment plan, many people experience meaningful improvements in symptoms, balance, and confidence.

If you’ve been feeling off-balance, light-headed, or frustrated by recurring dizziness, your vestibular physiotherapy customised plan with us may be the missing piece.