Dizziness

What is dizziness?

Dizziness refers to sensations of physical unsteadiness, imbalance, or light-headedness. It is often linked to balance disorders, issues in the inner ear, or neurological conditions. Physiotherapy can be an effective treatment for dizziness, particularly when it's related to vestibular (inner ear) dysfunction, postural instability, or muscle imbalances. A structured physiotherapy program can help improve balance, coordination, and overall confidence in movement.

What can cause dizziness?

Dizziness can result from a variety of causes, which are generally grouped into two main categories:

  • Vestibular causes – originating from issues in the inner ear (not middle ear), such as vestibular neuritis, benign paroxysmal positional vertigo (BPPV), or Ménière’s disease.
  • Non-vestibular causes – related to factors outside the inner ear, including low blood pressure, medication side effects, visual disturbances, or neurological conditions.

Vestibular dizziness

Each inner ear, also known as the labyrinth, contains the vestibular organs, which play a crucial role in maintaining balance. These structures act like the body’s natural three-dimensional spirit level, detecting head position and movement to help you stay upright and steady.

When both inner ears are functioning correctly, they send matching balance signals to the brain. This allows the body to maintain stability and spatial awareness. However, if one side sends conflicting or inaccurate information—due to injury, infection, or dysfunction—the brain receives a mismatch. This imbalance in signals can lead to sensations of dizziness, vertigo, or unsteadiness.

  • BPPV is the most common form of vestibular dizziness. It causes brief but intense episodes of vertigo, typically triggered by specific head movements. People with BPPV often experience severe dizziness when looking upwards, tilting the head, or rolling over in bed, making daily activities difficult and disruptive. The condition is caused by tiny calcium crystals (otoconia) becoming dislodged and settling in one or more of the semicircular canals in the inner ear. When the head moves, this debris shifts, sending false signals to the brain about head position and motion, resulting in a sensation of spinning or imbalance.
  • Other causes of vestibular dizziness are; head trauma, labyrinthitis, vestibular neuronitis, otitis media, Meniere's disease and endolymphatic hydrops.

Non-vestibular dizziness

Dizziness can also be caused by structures outside the vestibular system, including:

  • Cardiovascular issues – such as low blood pressure, irregular heart rhythms, or poor circulation
  • Neurological conditions – including migraines, multiple sclerosis, or stroke
  • Visual disturbances – poor vision or eye coordination can affect balance and spatial awareness
  • Medications – certain drugs can have dizziness as a side effect, especially those affecting blood pressure or the nervous system
  • Anxiety and stress – which can cause hyperventilation and feelings of light-headedness or unsteadiness
  • Dehydration or low blood sugar – both of which can impact brain function and balance

Physiotherapy for dizziness.

Physiotherapy for dizziness is known as Vestibular Rehabilitation Therapy (VRT). This specialised form of therapy is designed to improve balance, reduce dizziness, and enhance overall stability.

Physiotherapy has a high success rate in treating dizziness, particularly in conditions like Benign Paroxysmal Positional Vertigo (BPPV). In fact, up to 90% of individuals with BPPV experience complete relief within just three treatment sessions. There are various physiotherapy techniques used depending on the cause, but the most common and effective for BPPV is the Epley manoeuvre. This gentle, guided head movement sequence is designed to reposition the displaced calcium crystals (otoconia) within the inner ear canals, restoring normal balance signals and significantly reducing dizziness.

If the vestibular system is not functioning properly, an individual’s balance and ability to maintain posture may become overly reliant on visual input and sensory feedback from muscles and joints (known as proprioception). This compensation can make balance more challenging in low-light conditions or on uneven surfaces, increasing the risk of unsteadiness or falls.

Individuals with reduced balance often develop secondary symptoms as a result of compensatory movement patterns. These may include headaches, neck pain, muscle stiffness, general fatigue, and even a reduced ability for the brain to adapt to the vestibular dysfunction. Left unaddressed, these secondary issues can actually worsen the sensation of dizziness over time.

Vestibular rehabilitation is an exercise-based therapy designed to help the brain retrain how it processes balance signals from the vestibular system, in coordination with input from the eyes, muscles, and joints. By promoting this integration, vestibular rehabilitation improves balance, reduces dizziness, and helps individuals regain confidence in movement.

Other physiotherapy treatments for dizziness include:

  • Ergonomic Assessment
  • Soft Tissue Treatment
  • Balance Exercises
  • Proprioceptive Exercise

To arrange a physiotherapy appointment for dizziness, please email us at admin@acephysiosports.com or call +65 81535374.

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