Dizziness, loss of balance (treatment offered at our South Norfolk clinic only)

Dizzy Symptoms

If you are worried about Dizziness, vertigo, the room spinning or a woozy head, Sarah in our South Norfolk Clinic offers treatment for these conditions.  People describe the feeling of being unsteady, lightheaded, disorientated or unbalanced.  During an appointment with Sarah, she will discuss your symptoms extensively before carrying out an assessment involving eye movements, head movements and balance. From here she will discuss her findings and treatment plan, making sure you are fully aware of your condition before starting treatment.

Sarah will be assessing your vestibular system, an area within your inner ear that is responsible for balance and spatial orientation; and your proception, how we perceive the position and movement of our body.  From here she will know if your condition is related to your inner ear, muscles and joints or if she needs to refer you onwards for further tests.

Benign Paroxysmal Positional Vertigo (BPPV)

Benign paroxysmal positional vertigo (BPPV) is the most common cause for dizziness, people will experience short episodes of intense dizziness described as the room spinning when they move their head in certain directions.  It is caused when calcium crystals (otoconia) are dislodged from their normal positions and moved elsewhere within a canal in your inner ear.  Treatment for this involves an Epley maneuver to reposition the otoconia, which can be carried out by Sarah at our South Norfolk Clinic.


Vestibular rehabilitation therapy (VRT)

Many inner ear (vestibular system) conditions are very treatable using vestibular rehabilitation therapy (VRT).  Not every physiotherapist is trained to treat these conditions, but Sarah has been on post graduate courses, is an active member of ACPIVR and has been treating these symptoms successfully for years.

The symptoms are often caused by a mismatch of information between what your eyes are seeing and what the inner ear is telling you.  For example, when sitting on a train, we all experience the feeling that we are moving when the train beside us moves.  However, in a person with no inner ear problems, the brain very quickly gets told by the muscles in the neck and the structures in the ear that they are stationary.  If the vestibular system isn’t functioning fully then this response will be slower.

The purpose of VRT is to improve and promote your brains ability to compensate for the inner ear defects.


Possible inner ear diagnosis that can be helped with VRT:

Vestibular neuritis is an infection of your vestibular nerve, causing sudden severe dizziness, nausea, vomiting and balance problems.

Labyrinthitis is an inner ear infection which causes inflammation to the labyrinth.  This gives you the same symptoms to vestibular neuritis but also affects your hearing.

Vestibular Migraines is a type of migraine that may or may not cause a headache but can affect vision and balance. The main symptom is episodic dizziness, but you may also feel nausea, unbalanced, disoriented, motion sensitive and sensitive to sound.  Like traditional migraines, they are more common in women than men, you can suffer with migraines for years before the vestibular symptoms begin.

Visual Vertigo and motor sensitivity are used to describe feeling sick or dizzy when you move your head, eyes or body.  You may also become pale, tired, disorientated and unbalanced.  Symptoms are usually provoked by passive locomotion (such as riding in a car or traveling by boat or plane), or movement of the visual field while being still, for example watching traffic, clouds, watching films at the cinema.

Persistent postural-perceptual dizziness (PPPD) describes people who have chronic dizziness and often coincides with other conditions.

Mal de Debarquement (MDD) results in the phantom perception of self-motion, typically after a cruise, sufferers feel like they are still on the boat, rocking, bobbing or swaying. The symptoms tend to worsen when you stop moving.

Meniere’s disease is a long term, progressive condition affecting the balance and hearing. Symptoms are acute attacks of severe dizziness, fluctuating tinnitus, increasing deafness, and a feeling of pressure in the ear.  In between the acute attacks, vestibular rehabilitation can be useful if you still feel some carry over of symptoms.

Concussion or a head injury can cause temporary headaches, poor concentration, memory, balance and coordination.  Sometimes a blow to the head can cause BPPV so if the symptoms of your concussion do not settle with appropriate rest then it is worth contacting us.


Loss of Balance

Balance is maintained by three systems within each of us, our eyes tell us where we are in space, our movement sensors (proprioception) informs our muscles and joints where they are and what they are doing and the vestibular system (inner ear) gives us information as to how our head is moving.  A problem or weakness in any one of these areas can cause a lack of balance and control in standing and can often lead to falls.  Whether this problem is due to the vestibular system, as above, or after an injury, surgery or general ageing, at Total Care Physio we are able to detect which system is affected and teach you exercises to improve.



The degree to which people improve depends on their diagnosis, medication, other health problems, motivation, family support and other psychological factors.
Based on the findings from the examination, a home exercise programme (HEP) is usually developed. The length of time seen, and number of visits needed to improve can vary. Most of the improvement occurs due to the performance of the HEP.  During follow-up visits your HEP will be progressed based on your symptoms and tolerance to the exercises.
The frequency of visits can vary, and duration of VRT can last from as little as 1 to 2 weeks to several months. Your symptoms largely dictate how long the exercises last. People with dizziness can get worse if they are prescribed exercises that are too advanced, so it is important to make sure they are appropriate for your condition and stage of recovery.

Total Care Physio, the Physiotherapists for Norwich & South Norfolk contact details:

South Norfolk Clinic
School Lane
NR14 6SL

01508 548535 or
07976 009524

Norwich Clinic
14 Jordan Close

07786 515646

More helpful information:




Total Care Physio are accredited to these professional bodies