Why dizziness becomes chronic
After an inner ear infection, a bout of BPPV, a concussion or a vestibular migraine, the brain normally recalibrates over weeks. Sometimes it does not: the person avoids head movement because it provokes symptoms, the brain never gets the input it needs to adapt, and dizziness persists. In others, the nervous system becomes hypersensitive to motion and visual stimulation, a condition now called persistent postural-perceptual dizziness, or PPPD, which is one of the commonest causes of chronic dizziness and is often undiagnosed.
What vestibular rehabilitation does
Assessment first, to rule out ongoing BPPV, which can be fixed directly, and to identify the pattern. Then a programme of exercises that deliberately provoke mild dizziness in a controlled, graded way: eye and head movement exercises, balance tasks, and gradual exposure to the environments that trigger symptoms, such as supermarkets or screens. This retrains the brain to trust its balance signals again. For PPPD, this is combined with education and sometimes psychological approaches.
Vestibular rehab exercises: what they involve
A programme is built from a few types of exercise, chosen and progressed for you after assessment:
- Gaze stabilisation. Keeping your eyes on a fixed target while moving your head side to side or up and down, to retrain the reflex that keeps vision steady.
- Habituation. Repeating the specific movements or visual situations that bring on mild dizziness, so the brain gradually stops overreacting to them.
- Balance training. Standing with your feet closer together, on a softer surface or with your eyes closed, with support nearby.
- Walking practice. Walking while turning your head, then in busier settings, to rebuild confidence.
Each session is short, usually a few minutes several times a day. Exercises should provoke only mild, short-lived dizziness. For a broader overview, read what is vestibular rehabilitation.
The evidence
Systematic reviews show vestibular rehabilitation reduces dizziness and improves balance and quality of life in chronic vestibular disorders, and it is recommended as first-line treatment. For PPPD, rehabilitation combined with education has the best evidence of any approach.
What to expect
Six to twelve weeks of home exercises, done daily, with reviews every one to two weeks. Symptoms often increase slightly at first as the exercises provoke them, then reduce. Improvement is gradual and depends on consistency.
When to see a doctor first
New dizziness with double vision or loss of vision, hearing loss, difficulty speaking, or weakness, numbness or tingling in an arm or leg needs urgent medical assessment: call 999 or go to A&E. If dizziness comes with a severe headache, being sick or a very high temperature, ask for an urgent GP appointment or call NHS 111. At Omnia in Chiswick, Vestibular First screens for these before treating.
Vestibular rehabilitation in Chiswick
At Omnia Lifestyle, Vestibular First starts with an assessment that checks for BPPV, which can often be treated in the same session, and identifies the pattern behind ongoing dizziness before a home exercise programme is set. Vertigo and BPPV assessment and treatment costs £50. See what happens at a vestibular assessment, or book online.
8 to 9 Bedford Corner, The Avenue, Chiswick W4 1LZ, close to Turnham Green station, on bus routes 94, E3 and 272. Limited parking is available on request when booking.