Vestibular Rehabilitation: What to Expect at Your First Appointment

In this blog post, Rachel Allen, vestibular rehabilitation specialist at Mid West Physiotherapy, Limerick, explains vestibular rehabilitation: what to expect at your first appointment with her. 


What should I expect? 

The initial consultation can take up to 1 hour, depending on the assessment and treatment needed. The first portion of the assessment will involve a lot of talking! I want to hear every detail or vague description you have of your dizziness – this is all very important to getting to the bottom of what’s going on. 

Some questions I’ll ask will be about when your symptoms started, how severe they were, what past medical professionals you have seen, and what medications you take. 

Our brains have a difficult time describing what exactly is happening – so don’t worry if you have to use “weird” phrases like your head is in a washing machine; there are marbles or mud in your head; it feels like the room is spinning; or your head feels heavy. These all make a lot of sense to me! 


What is the physical assessment like?

The physical assessment has a few parts – depending on where it sounds like the vertigo is coming from. The first part will feel like an eye test. Another part with involve balancing with your eyes open or closed. Walking tests to look at your balance are common as well. 

If it sounds like you have benign “BPPV” (benign paroxysmal positional vertigo) – where specific head movements cause vertigo – we will do a position test that involves laying down or turning over quickly. 

The purpose of the physical assessment is to detect exactly where your vertigo is coming from. Because of this, some of the tests are designed to bring on your symptoms. Thankfully, once you have an accurate diagnosis, we can work towards helping you get better which makes it worth it in the end. 


How are these tests different from any other scans? 

These tests look at how well your inner ear is working – and what it is telling your head and eyes to do. Our inner ear acts as a sensor that tells us about balance and movement. 

If your doctor has sent you other scans, these are important to rule out other causes of vertigo. But a lot of people’s scans are “normal,” despite not feeling well. I liken this to taking a picture of a fire alarm to see if it is working – the picture can tell you if the batteries are in, but a picture can’t tell you if that fire alarm goes off whenever you cook!  


What to wear?

Any clothes you are comfortable in. As part of a balance assessment, you will need to remove your shoes. 


What to bring?

Any letters from past appointments you have attended, or written reports from doctors, GPs, ENTs or neurologists you have seen.

Some people like to bring a bottle of water. 


Is there any follow up?

The number of follow up appointments and weeks depends on your condition – at the end of your initial consultation I will have a good answer for this. 

  • Conditions such as BPPV (link to page) may only take 1-2 treatment sessions over the course of 4-5 days. 
  • After a short, severe bout of vertigo you would need vestibular rehab for 6-10 weeks (link to guideline)
  • For longer term issues, vestibular rehabilitation is recommended for a minimal of 12 weeks.


Will I need to do exercise outside of the appointments?

Most likely. These will be simple to start and get progressively more difficult. This type of exercise has been shown to improve people’s dizziness, daily life, balance, and vertigo (link to guidelines)


Enquiries and bookings 

If you are seeking help or advice for your or someone you know who is experiencing dizziness, imbalance or vertigo-type symptoms, I would be delighted to help. You can contact our Reception team on 061-201444 or email to make a booking, or you can also book an in-clinic consultation through our online booking system.


More Information

Click here for information from the HSE on vertigo. 

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