Vestibular disorders are conditions of the inner ear balance organs and their brain pathways that cause vertigo, dizziness and unsteadiness. They include BPPV, vestibular neuritis, Meniere’s disease and post-concussion dizziness. Vestibular rehabilitation helps most types. SportsMed Physical Therapy provides it at New Jersey and Connecticut locations.
What Are Vestibular Disorders?
The vestibular system sits inside each inner ear and includes three semicircular canals that sense head rotation plus two otolith organs, the utricle and saccule, that sense gravity and straight-line movement. Signals travel along the eighth cranial nerve to the brainstem, where they combine with vision and sensation from the feet. When part of that loop fails, you feel spinning or unsteadiness.
Vestibular disorders are common. Research suggests about 35 percent of American adults over 40 have measurable vestibular dysfunction, and dizziness is a leading reason adults over 65 see a doctor. Benign paroxysmal positional vertigo, or BPPV, is the most frequent cause and the most treatable.
What Causes Vestibular Disorders?
Causes differ by diagnosis, which is why identifying the type matters more than treating dizziness in general. In BPPV, calcium carbonate crystals called otoconia break loose from the utricle and drift into a semicircular canal, so position changes trigger short bursts of spinning. Vestibular neuritis follows viral inflammation of the vestibular nerve. Meniere’s involves excess inner ear fluid pressure, and concussion disrupts central processing.
Common causes include:
- Displaced inner ear crystals (BPPV)
- Viral vestibular neuritis or labyrinthitis
- Meniere’s disease and endolymphatic hydrops
- Concussion, whiplash and other head or neck trauma
- Vestibular migraine
- Ototoxic medications, including some antibiotics and chemotherapy
- Age-related loss of vestibular hair cells, and acoustic neuroma
What Are the Symptoms of Vestibular Disorders?
Timing tells you a great deal. BPPV produces intense spinning under a minute, set off by rolling in bed or looking up. Vestibular neuritis causes constant vertigo for one to three days, then weeks of imbalance. Meniere’s brings episodes of 20 minutes to several hours with hearing loss and ear fullness. Post-concussion dizziness is a foggy unsteadiness.
Symptoms commonly include:
- Spinning or rocking vertigo, or a floating sensation
- Unsteadiness, veering when walking, and falls
- Nausea, vomiting and sweating during episodes
- Blurred or bouncing vision with head movement (oscillopsia)
- Tinnitus, ear fullness or fluctuating hearing
- Trouble concentrating in stores or crowds
Seek prompt medical attention if vertigo comes with double vision, slurred speech, facial droop, limb weakness or sudden hearing loss, since these can signal a stroke.
How Are Vestibular Disorders Diagnosed?
Assessment begins with the timing and triggers of your symptoms. A vestibular physical therapist performs the Dix-Hallpike and supine roll tests to identify BPPV and which canal is involved, a head impulse test to check vestibular nerve function, and observation of nystagmus. Dynamic visual acuity, the Functional Gait Assessment and the Timed Up and Go quantify balance. Audiograms, ENT evaluation and MRI are appropriate when hearing loss or neurological signs are present.
How Physical Therapy Treats Vestibular Disorders
Vestibular rehabilitation is one of the most effective areas in physical therapy, and treatment is diagnosis-specific. BPPV is treated with canalith repositioning maneuvers such as Epley, Semont or the barbecue roll, which move the crystals out of the canal.
For vestibular neuritis and other one-sided losses, the brain must recalibrate. Gaze stabilization exercises such as VOR x1 and x2, habituation drills that repeat the movements bothering you, and balance work under changing surface and visual conditions drive that adaptation. Post-concussion patients follow a graded plan, and Meniere’s is managed by an ENT while therapy targets the imbalance between attacks. SportsMed delivers this through vestibular therapy and neurological rehabilitation, gait and balance training and in-home care. In-home therapy is available from our Brick, Englewood, Franklin Lakes and Jersey City McGinley Square locations.
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How Long Does Recovery Take?
Recovery depends on the diagnosis. BPPV often clears in one to three sessions, though it can recur. Vestibular neuritis usually improves over 6 to 12 weeks of consistent gaze and balance exercise. Post-concussion dizziness commonly settles in 4 to 8 weeks with graded activity. Long-standing bilateral loss takes several months and relies on compensation using vision and sensation. Daily home exercise speeds recovery; avoiding movement and prolonged suppressant medication slow it.
Vestibular Disorder Treatment Near You in New Jersey and Connecticut
SportsMed has clinics across New Jersey and Connecticut, serving Bergen, Essex, Hudson, Middlesex, Monmouth, Morris, Ocean, Passaic and Union Counties in New Jersey plus Fairfield and New Haven Counties in Connecticut. Shore patients come for vertigo therapy in Neptune, NJ, Red Bank, Middletown, Brick and Toms River. We treat Morris County patients in Mendham, Parsippany and Riverdale, and others in Maplewood, Belleville, Harrison, Mountainside and Perth Amboy. Connecticut care is available in Norwalk and West Haven. Explore our New Jersey clinics, Connecticut clinics or the full list of locations, then request an appointment.
Frequently Asked Questions About Vestibular Disorders
Q: What is the difference between BPPV and Meniere’s disease?
A: BPPV causes brief spinning under a minute, triggered by head position changes, with no hearing symptoms. Meniere’s causes episodes lasting 20 minutes to several hours with hearing loss, tinnitus and ear fullness. BPPV responds to repositioning maneuvers; Meniere’s needs ENT management.
Q: How many sessions does it take to treat BPPV?
A: Many people improve substantially after one to three visits, because canalith repositioning maneuvers move the displaced crystals out of the canal. Some cases need repeat attempts or involve more than one canal. BPPV can return later, so we teach you what to watch for.
Q: Can physical therapy stop Meniere’s attacks?
A: No. Meniere’s attacks are driven by inner ear fluid pressure and are managed medically with diet, medication and ENT care. Vestibular therapy addresses the imbalance, motion sensitivity and fall risk that build between attacks, and can improve walking confidence.
Q: Is dizziness after a concussion normal, and does it need treatment?
A: Dizziness is among the most common concussion symptoms and often improves on its own. When it persists beyond a couple of weeks, vestibular therapy with gaze stabilization, habituation and graded balance work usually shortens recovery. Worsening symptoms need physician reassessment.
Q: Should I rest and avoid movement when I feel dizzy?
A: Usually not. Beyond the first day or two of an acute episode, avoiding movement delays the brain’s ability to recalibrate. Gradually increasing exposure to movements that provoke mild symptoms is the mechanism behind vestibular rehabilitation, and your therapist sets a safe dose.
Q: Do I need a referral, and is there a vestibular clinic near me?
A: New Jersey and Connecticut allow direct access to physical therapy, though some plans still require a referral. SportsMed has clinics across nine New Jersey counties and two Connecticut counties, so vestibular care is typically nearby. We check coverage before your first visit.
Dizziness is treatable more often than people expect, and the right diagnosis changes the whole plan. Our vestibular-trained therapists test, treat and retrain your balance system.
Book an appointment at a SportsMed location in New Jersey or Connecticut.Reviewed by the SportsMed Physical Therapy clinical team. Last updated: August 2026.