Brain & nerves Neurological Rehabilitation
Vertigo & Dizziness
- A spinning sensation, often triggered by head movement
- Brief intense episodes when rolling over in bed or looking up
- Nausea
- Unsteadiness
Quick answer
Vertigo is a spinning sensation, most often caused by BPPV — displaced crystals in the inner ear. BPPV is diagnosed with a positional test and treated with a repositioning manoeuvre that resolves it in one to three sessions. Other causes are treated with vestibular rehabilitation exercises.
Typical recovery
BPPV often resolves in 1–3 sessions; other causes 6–8 weeks
A typical range, not a promise — how long it takes depends on how long it has been going on, and on what you do between appointments.
Vertigo is the sensation that you or the room is spinning. It is not the same as light-headedness or feeling faint, and the distinction matters because the causes and treatments are entirely different.
BPPV — the most common cause, and the most satisfying to treat
Benign paroxysmal positional vertigo happens when tiny calcium crystals become displaced from one part of the inner ear into the semicircular canals, where they disturb the fluid and send false movement signals.
The pattern is distinctive: brief but intense spinning, lasting under a minute, triggered by specific head movements — rolling over in bed, lying down, sitting up, looking up at a shelf. Between episodes there is often nothing at all.
BPPV is confirmed with a positional test and treated with a repositioning manoeuvre — a specific sequence of head positions that guides the crystals back where they belong. A large majority resolve within one to three sessions. It is one of the few conditions in physiotherapy with an immediate, dramatic result.
Other causes
- Vestibular neuritis — sudden severe vertigo lasting days, following a viral illness, treated with progressive vestibular rehabilitation
- Ménière's disease — episodes with hearing loss and ringing, needing ENT management
- Cervicogenic dizziness — unsteadiness arising from the neck
- Persistent postural-perceptual dizziness — ongoing unsteadiness after an initial episode, maintained by anxiety and altered movement habits
How vestibular rehabilitation works
For causes other than BPPV, treatment uses graded exposure: exercises that deliberately provoke mild symptoms so the brain recalibrates. Symptoms increase slightly at first, which is expected and is the mechanism working. Most people improve over six to eight weeks.
When to see a doctor first
Vertigo accompanied by severe headache, double vision, slurred speech, limb weakness, numbness or difficulty walking needs emergency assessment — these suggest a cause in the brain rather than the inner ear. New hearing loss with vertigo warrants prompt ENT review.
Medically reviewed by Nasir Mughees, BPT, MPT, Orthopaedic Physiotherapy · Last reviewed September 2026