Vertigo Treatment in Burlington

What causes vertigo?

Vertigo is the sensation that you or your surroundings are spinning or moving when they're not. It's not a diagnosis in itself — it's a symptom of an underlying condition, most often involving the vestibular system in your inner ear. The most common causes of vertigo we treat at our Burlington clinic include:

• BPPV (Benign Paroxysmal Positional Vertigo) — the single most common cause of vertigo. Tiny calcium crystals become displaced in the inner ear, triggering brief but intense spinning episodes with head movements.
• Vestibular neuritis — inflammation of the vestibular nerve, usually following a viral infection. Causes sudden, severe vertigo that can persist for days or weeks, often leaving residual imbalance.
• Vestibular migraine — a common but under-recognized cause of episodic vertigo, often occurring with or without headache. Episodes can last minutes to days and may be triggered by stress, sleep changes, or dietary factors.
• Ménière's disease — characterized by episodic vertigo lasting 20 minutes to several hours, along with fluctuating hearing loss, tinnitus, and a feeling of fullness in the ear.
• PPPD (Persistent Postural-Perceptual Dizziness) — a chronic functional vestibular disorder causing persistent dizziness, unsteadiness, and sensitivity to visual motion. Often develops after an initial vestibular event such as BPPV or vestibular neuritis.

Each of these conditions requires a different treatment approach, which is why accurate diagnosis is the essential first step in effective vertigo treatment.

How we diagnose vertigo

Vertigo treatment starts with a thorough vestibular assessment. At our Burlington clinic, your initial assessment takes approximately 60 minutes and uses a combination of clinical tests to pinpoint the cause of your symptoms:

• Dix-Hallpike test — the gold-standard positional test for BPPV. Your physiotherapist moves you through specific head and body positions while observing your eye movements for characteristic nystagmus patterns.
• Head impulse test — a quick, targeted assessment of the vestibulo-ocular reflex that helps identify vestibular neuritis and other peripheral vestibular losses.
• Nystagmus assessment — careful observation of involuntary eye movements in different gaze positions. The direction, pattern, and behaviour of nystagmus provide critical diagnostic information about which part of the vestibular system is affected.
• Balance and gait testing — standing and walking assessments under various conditions (eyes open, eyes closed, altered surfaces) to evaluate how well your vestibular, visual, and proprioceptive systems are working together.

You'll leave your first visit with a clear explanation of what's causing your vertigo and a personalized treatment plan. In many cases — particularly with BPPV — treatment begins at the same appointment.

How we treat vertigo

Treatment depends entirely on the cause. Our vestibular physiotherapists use evidence-based techniques tailored to your specific diagnosis.

Repositioning manoeuvres for BPPV

BPPV is treated with canalith repositioning manoeuvres — specific sequences of head and body movements that guide displaced calcium crystals back to their correct location in the inner ear. The most well-known is the Epley manoeuvre (sometimes spelled Epley maneuver), but your physiotherapist may also use the Semont manoeuvre, BBQ roll, or other techniques depending on which semicircular canal is affected. BPPV is often completely resolved in just one to three treatment sessions.

Vestibular rehabilitation for neuritis and PPPD

When vertigo is caused by vestibular neuritis or PPPD, the brain needs to recalibrate how it processes balance signals. A structured vestibular rehabilitation program helps your nervous system compensate for the damaged or altered vestibular input, gradually reducing dizziness and improving stability.

Habituation exercises

Habituation therapy involves repeated, controlled exposure to the specific movements or visual environments that trigger your dizziness. Over time, your brain learns to reduce its abnormal response. This approach is particularly effective for visual vertigo, motion sensitivity, and the persistent dizziness seen in PPPD.

Gaze stabilization

Gaze stabilization exercises retrain the vestibulo-ocular reflex so your vision stays clear and steady during head movements. These are a core component of treatment for vestibular neuritis, labyrinthitis, and post-concussion vestibular dysfunction. Your physiotherapist prescribes progressively challenging exercises as your system recovers.

How long does vertigo treatment take?

Treatment timelines vary depending on the underlying condition:

• BPPV: Typically resolved in 1 to 3 visits. Many patients experience significant relief after a single repositioning manoeuvre.
• Vestibular neuritis: Recovery usually takes 6 to 12 weeks of vestibular rehabilitation, with exercises progressing in difficulty as compensation improves.
• Vestibular migraine: Requires ongoing management, often combining vestibular exercises with trigger identification, lifestyle modifications, and sometimes medication prescribed by your physician.
• PPPD: Typically responds well to a combination of habituation therapy and graded exposure over several weeks to months.
• Ménière's disease: Management is ongoing and focuses on vestibular exercises, lifestyle strategies, and coordination with your medical team.

Most patients begin to notice improvement within the first few sessions. Your physiotherapist will give you a realistic timeline and adjust your treatment plan as you progress.

When should you see a specialist?

Vestibular physiotherapy is effective for the majority of vertigo cases. You should consider seeing a vestibular physiotherapist if:

• You experience spinning with position changes (rolling in bed, looking up, bending forward)
• Your vertigo started after an illness or viral infection
• You've had dizziness for weeks or months that isn't improving on its own
• You feel unsteady or have difficulty walking in busy environments
• You've been told your vertigo is "just anxiety" or that there's nothing wrong

However, some symptoms require urgent medical attention. Go to the emergency department or see your doctor immediately if your vertigo is accompanied by:

• Sudden severe headache unlike anything you've experienced before
• Double vision, slurred speech, or difficulty swallowing
• Weakness or numbness on one side of the body
• New onset hearing loss
• Loss of consciousness

These could indicate a central nervous system cause that requires immediate investigation. In most cases, though, vertigo is a peripheral vestibular issue that responds very well to physiotherapy.

Book your vertigo assessment

If you're dealing with vertigo in Burlington or the surrounding area, you don't need to wait for a referral. Our vestibular physiotherapists can assess you directly, identify the cause, and begin treatment — often at the same visit. Most extended health benefit plans cover vestibular physiotherapy, and we offer direct billing to many major insurers.

Book your vestibular assessment online or call us at 905-635-5711 to get started.