What Is Vestibular Rehabilitation Therapy?
Key takeaways:
Vestibular rehabilitation therapy (VRT) is an exercise-based therapy program that uses repetitive movements to treat vestibular injuries.
Common symptoms of vestibular injury include vertigo, dizziness, and impaired balance.
To address these symptoms, VRT exercises train your body to use other senses like touch and vision.
Table of contents
If you’ve ever felt dizzy all of a sudden, you’re not alone. Dizziness is very common. It can cause uncomfortable feelings of lightheadedness and nausea. Thankfully, it often goes away as quickly as it starts — and you can thank your vestibular system for that.
Located in your inner ear, this complex system sends sensory signals to your brain. When it isn’t working properly, you can experience symptoms like vertigo (a spinning sensation) and dizziness — both of which can lead to dangerous falls.
Vestibular rehabilitation therapy (VRT) can help. VRT is an exercise-based form of treatment that helps your brain adapt to abnormal signals from your vestibular system.
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What conditions can vestibular rehab therapy (VRT) treat?
Different conditions can harm your vestibular system. Common causes of vestibular injuries include inner ear infections, inflammation or fluid buildup in your inner ear, and head or neck traumas.
Vestibular injuries can lead to symptoms like:
Vertigo
Loss of balance
Vision changes
No matter the cause, there are ways to reduce your symptoms. VTR can treat dizziness due to conditions like:
Benign paroxysmal positional vertigo (BPPV): BPPV is a balance disorder caused by tiny crystals in your inner ear moving out of their normal position. It’s one of the most common causes of vertigo.
Ménière’s disease: This inner ear disorder can lead to dizziness and hearing loss.
Stroke: A stroke occurs when a blocked artery stops the flow of oxygen-rich blood to your brain.
Traumatic brain injury (TBI): A TBI usually results from a blow to your head that damages your brain.
You can work with a specialist to customize VRT exercises that target vestibular symptoms related to these conditions. Here’s how it works.
Feeling dizzy? Dizziness is a common symptom with lots of possible causes. Here’s how to know when it might be serious.
Common causes of vertigo: Vertigo makes it feel like the room is spinning around you. Learn about what can cause it.
Looking to improve your balance? Check out these balance exercises for better stability, strength, and coordination.
How does vestibular rehabilitation therapy work?
Vestibular rehabilitation therapy is designed to treat problems caused by vestibular injuries. When the vestibular system is damaged, it sends abnormal signals to your brain. VRT uses specialized movements to help your brain adapt to these signals.
Through VRT exercises, your brain learns to rely more heavily on cues from other parts of your body. This allows your body to use different senses, like vision and touch, to overcome symptoms.
For example, if you have BPPV, you may work with a vestibular rehab (VR) therapist. They may use the Epley maneuver — a series of controlled movements — to return displaced crystals in your ear to their normal position. In rare cases, the crystals may move to a different spot. When that happens, VR therapists can use another series of body and head turns they call the “barbecue roll.”
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Different specialists can treat vestibular disorders. But physical therapists with advanced training usually provide VRT. Most people do outpatient VRT, which involves going to a clinic or doctor’s office. But there’s also inpatient VRT. For example, vertigo caused by a stroke may need treatment in a hospital.
What exercises are used in vestibular rehab?
Your therapist will recommend exercises based on your condition and symptoms. Vestibular rehab exercises typically fall into one of three categories.
1. Habituation exercises
“Habituation” means to become used to something. Habituation exercises involve repeating specific movements to relieve symptoms. For example, a therapist may recommend habituation exercises if you get dizzy when you move your head. Over time, these exercises help your brain tolerate the movement and ignore abnormal signals that lead to vertigo and dizziness.
2. Gaze stabilization
Gaze stabilization exercises strengthen eye muscles to keep your vision steady when you move your head. These exercises are helpful for people who experience “eye jumping” sensations or double vision when focusing on an object.
3. Balance training
Balance exercises are designed to help improve your stability. VR therapists create exercise programs to improve balance during daily activities like walking. These balancing training programs may include walking challenges across uneven surfaces, navigating obstacle courses, and performing tasks that involve head tilts and bends.
Benefits of VRT
VRT helps your vestibular system recover after an injury or disorder. Benefits of VRT can include:
Improved balance and stability
Increased body strength
Reduced symptoms like dizziness, vertigo, and vision changes
Lower risk of falls
How long does vestibular rehab take to work?
The length of time it takes VRT to work depends on the cause and severity of your symptoms. Your therapist will create a personalized rehabilitation plan. Generally, therapists recommend VRT 1 to 2 times a week for 6 to 8 weeks.
Your care team might also include home exercises. So, how long it takes for VRT to work can also depend on how consistent you are with the at-home exercises.
How to find a physical therapist who offers vestibular rehab therapy
Your primary care provider can recommend a physical therapist who offers vestibular rehab. You can also check online directories for a therapist in your area. Be sure to check their credentials and training in vestibular care.
Vestibular therapy costs
The cost of VRT depends on your health insurance coverage. If your insurance plan includes physical therapy, it’ll likely cover vestibular rehabilitation. Ask your health insurance representative about copays and out-of-pocket fees before your first appointment.
If you’re uninsured or underinsured, each session may cost around $100 to $150. Some therapists offer sliding scale rates, allowing you to pay what you can afford.
Are there other treatments for vestibular injury?
Vestibular rehab isn’t the only way to treat the symptoms of a vestibular injury. Over-the-counter and prescription medications, like antihistamines and anticholinergics, may effectively reduce nausea associated with vertigo.
It’s important to note that these medications don’t treat the underlying cause of the vestibular injury. But they may relieve your symptoms for a bit.
Frequently asked questions
Yes, there’s quality evidence to show that vestibular rehabilitation therapy helps treat vestibular disorders and injuries. But how well it works depends on a few things, including the type of injury, the specific therapies used, and how soon you start therapy.
More research is needed to understand how well VRT works in children.
Yes, your therapist will likely give you vestibular therapy exercises to work on at home. If they recommend at-home exercises, be sure to follow the instructions and keep up with their recommendations. This will help make sure you have the smoothest recovery possible.
If you think you have a vestibular injury, first connect with a healthcare professional before you try vestibular therapy exercises at home by yourself. VRT exercises are specific to the cause and severity of your condition.
The bottom line
Injury to your vestibular system can cause vertigo, dizziness, visual changes, and impaired balance. Vestibular rehabilitation is an exercise-based therapy that trains your brain to overcome these symptoms. Therapists who specialize in vestibular rehab customize exercise treatment plans based on the cause and severity of your condition.
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References
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Kerber, K. A., et al. (2017). Dizziness symptom type prevalence and overlap: A US nationally representative survey. The American Journal of Medicine.
Kim, J. S., et al. (2013). Vertigo due to posterior circulation stroke. Seminars in Neurology.
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Vestibular Disorders Association. (n.d.). What type of vestibular specialist is right for me?
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