Vestibular assessment for vertigo and dizziness.

Vertigo and dizziness can cause spinning sensations, unsteadiness, floating feelings, or reduced walking confidence. These symptoms can come from the inner ear, balance system, neck, medical causes, or a mix of factors, so a clear assessment helps guide the safest next step.

Although people often use vertigo and dizziness interchangeably, they describe different sensations. Clear definitions help your clinician narrow down likely causes and decide whether you may benefit from vestibular physiotherapy, vestibular rehabilitation therapy (VRT), medical review, or a combined approach.

Vertigo and Dizziness: What Is the Difference?

Vertigo

Vertigo is the sensation that you or the room is moving or spinning when no movement is happening. It often links to the vestibular system in the inner ear, which helps your brain interpret head movement and position.

Common conditions associated with vertigo include:

• BPPV (Benign Paroxysmal Positional Vertigo)
• Meniere’s disease
• Vestibular migraine
• Cervicogenic dizziness

Dizziness

Dizziness is a broader term that may include light-headedness, faintness, unsteadiness, or feeling off. It does not always involve a spinning sensation. Causes can range from dehydration and low blood pressure to medication effects, anxiety, or inner ear problems.

Is vertigo and dizziness serious? It can be, depending on the cause. Seek urgent medical care if symptoms occur with chest pain, fainting, new weakness or numbness, facial droop, new speech problems, severe headache, or sudden vision changes.

If dizziness is persistent, recurrent, or affecting walking confidence, it is worth getting checked. You may also find it helpful to compare the four types of dizziness. For a plain-language overview, see MedlinePlus: Dizziness and Vertigo.

Why Do People Get Vertigo?

Vertigo commonly occurs when signals between the inner ear, eyes, and brain do not match. Several conditions can trigger this.

• BPPV: Small calcium crystals shift into the wrong inner-ear canal, triggering brief vertigo with head movement. Learn more about BPPV.
• Meniere’s disease: Fluid changes in the inner ear may lead to vertigo alongside hearing changes and tinnitus. See Meniere’s disease.
• Vestibular migraine: Migraine-related changes can affect balance and spatial processing. See vestibular migraine.
• Neck-related dizziness: In some people, neck irritation and altered input can contribute to dizziness. See cervicogenic dizziness.
• Vestibular neuritis or labyrinthitis: Inflammation of inner-ear structures, often after infection, can disrupt balance signals.

What Are the Most Common Causes of Dizziness?

Dizziness has many possible causes. Three common contributors include:

1. Low blood pressure: Especially when standing quickly, which can briefly reduce blood flow to the brain.
2. Dehydration or low energy intake: Reduced circulating volume can leave you light-headed and unsteady.
3. Inner ear disorders: Balance organs in the inner ear can trigger dizziness or vertigo when irritated or inflamed.

How Are Vertigo and Dizziness Assessed?

A vestibular physiotherapy assessment checks how your balance systems work together. This may include questions about symptom timing, head movement triggers, eye movements, walking balance, balance reactions, and neck movement when relevant.

For symptoms that sound like BPPV, your physiotherapist may use positional tests such as the Dix-Hallpike test. For more complex dizziness, assessment may also consider migraine history, neck symptoms, falls risk, medication changes, and whether medical review is needed.

Physiotherapy for Vertigo and Dizziness

A vestibular physiotherapy assessment checks how your balance systems work together, including eye control, head movement tolerance, gait stability, and, when relevant, your neck.

A physiotherapist may recommend:

• vestibular rehabilitation exercises to improve balance and reduce symptoms
• specific repositioning manoeuvres for BPPV
• walking and balance retraining for confidence and fall-risk reduction
• neck treatment and movement guidance when neck input contributes

What to Do Next

If vertigo or dizziness is affecting daily activities, driving confidence, sport, or work, an assessment can help clarify the likely cause and guide a practical plan.

If your symptoms keep returning, start with a vestibular physiotherapy assessment. Your physiotherapist can help decide whether your presentation suits vestibular rehabilitation, BPPV repositioning, balance retraining, neck treatment, or medical referral.

Related Vestibular Articles

1. Cervicogenic Dizziness & Cervical Vertigo
2. Vertigo Causes & Dizziness Causes
3. Vertigo and Dizziness Management
4. Vertigo Physiotherapy
5. Vestibular Physiotherapy
6. Vestibular Rehabilitation Therapy (VRT)
7. BPPV Treatment
8. Vestibular Migraine
9. Persistent Postural-Perceptual Dizziness (PPPD)
10. Vestibular FAQs
11. Meniere’s Disease

Vertigo and Dizziness FAQs

What is the difference between vertigo and dizziness?

Vertigo is a false sense of spinning or movement. Dizziness is a broader term that may include light-headedness, faintness, or unsteadiness without spinning. This difference helps guide assessment because causes and treatment options can vary.

Can physiotherapy help vertigo and dizziness?

Physiotherapy may help when dizziness relates to the vestibular system, balance control, or neck input. A physiotherapist can assess triggers and may recommend vestibular rehabilitation exercises, balance retraining, or repositioning manoeuvres for BPPV when appropriate.

How do you treat BPPV?

BPPV is often managed with canalith repositioning manoeuvres that aim to move displaced inner-ear crystals back to a less sensitive area. A trained clinician selects the manoeuvre based on which canal is involved and your symptoms.

When is dizziness a red flag?

Seek urgent medical care if dizziness occurs with chest pain, fainting, severe headache, new weakness or numbness, facial droop, new speech problems, sudden vision changes, or sudden trouble walking.

Why does vertigo happen when you turn over in bed?

Vertigo triggered by rolling in bed often occurs with BPPV. Head position changes can shift inner-ear crystals and briefly disrupt balance signals, which can create a short spinning sensation.

What should you do if vertigo or dizziness keeps coming back?

If vertigo or dizziness keeps coming back, arrange an assessment. Recurring symptoms may need vestibular testing, balance assessment, BPPV repositioning, vestibular rehabilitation, neck assessment, or medical review depending on the symptom pattern.

References

1. Hall CD, Herdman SJ, Whitney SL, et al. Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association. J Neurol Phys Ther. 2022;46(2):118-177.
2. Rezaeian A, Abtahi H, Moradi M, Farajzadegan Z. The effect of vestibular rehabilitation in Meniere’s disease: a systematic review and meta-analysis of clinical trials. Eur Arch Otorhinolaryngol. 2023;280(9):3967-3975.
3. Akula S, Reddy SB, Lakshmi AV, et al. Clinical study of BPPV and the effectiveness of canalolith repositioning manoeuver. J Family Med Prim Care. 2021;10(12):4599-4604.