Dizziness is one of the most common reasons people seek help, and one of the most poorly explained. It is not a single condition — "dizzy" can mean the room spinning, a feeling of floating, unsteadiness on your feet, or a disorienting sense that you are not quite connected to your surroundings. Each of those points somewhere different.
A physiotherapist trained in vestibular assessment can usually narrow down which one you are describing within a single session, because the tests are physical rather than blood-based or scan-based.
What vertigo actually is
Vertigo is the false sensation that you or your surroundings are moving. It is most often caused by a problem in the inner ear — the vestibular system — rather than the brain. The most common cause by a wide margin is benign paroxysmal positional vertigo (BPPV), where small crystals in the inner ear become dislodged and send the brain a false signal about movement. It typically triggers with specific head positions: rolling over in bed, looking up, bending forward.
Other causes include vestibular neuritis or labyrinthitis (often following a viral illness), vestibular migraine, and, after a head injury or concussion, persistent postural-perceptual dizziness (PPPD).
How a physiotherapy assessment works
An assessment starts with your history — when it began, what brings it on, how long it lasts, and what else was happening at the time. From there, a series of positional and balance tests reproduce the symptom deliberately and safely so the cause can be identified.
For BPPV, the treatment is a repositioning manoeuvre — a specific, guided sequence of head and body positions that moves the displaced crystals back where they belong. It is a mechanical fix for a mechanical problem, and it is often effective within one to three sessions. For other causes, the approach is vestibular rehabilitation: graded exercises that help the brain and inner ear recalibrate, plus balance retraining and gaze-stability work.
Dizziness after a head injury or concussion
Dizziness, visual disturbance and a sense of being "spaced out" are common after concussion and often persist well beyond the expected recovery window. In these cases the vestibular system is usually intact but the brain's processing of its signals is not — which is where the nervous-system work described under Functional Neuro Health overlaps with vestibular rehabilitation.
What a session involves
Initial consultations run 75 minutes. You will be asked to describe the dizziness in detail, then examined through positional testing and balance assessment. Treatment is hands-on and exercise-based, with clear home exercises where they help. Loose clothing is useful, and it is best not to drive yourself to the first appointment in case testing leaves you briefly unsettled.
When to seek urgent medical care instead
Most dizziness is not dangerous, but new dizziness alongside any of the following needs urgent medical assessment, not a physiotherapy appointment: sudden hearing loss, double vision, slurred speech, facial droop, weakness or numbness down one side, severe headache, or difficulty walking. If in doubt, call 000 or attend emergency.
Frequently asked questions
Can physiotherapy actually fix vertigo?
The most common cause, BPPV, is treated mechanically with a repositioning manoeuvre rather than managed indefinitely. Other causes such as vestibular neuritis and PPPD typically improve with graded vestibular rehabilitation over weeks to months. What is realistic for you depends entirely on which cause is identified at assessment.
How many sessions will I need?
BPPV often resolves in one to three sessions. Vestibular rehabilitation for other causes is usually a program of several weeks with exercises between appointments. Your likely course is discussed after the first assessment, once the cause is clear.
Do I need a referral or scans before I come in?
No referral is needed to see a physiotherapist. If you have already had imaging or seen a specialist, bring the reports — they are useful context. If you have not, the physical assessment is usually the more informative first step for positional vertigo.
Where is the clinic and how far from Byron Bay?
The clinic is at 18 Armstrong Street, Suffolk Park — about five minutes south of Byron Bay, and easily reached from Broken Head and Lennox Head. Appointments run Monday to Friday, 9am to 6pm, with HICAPS health fund rebates available on the day.