Vestibular Rehabilitation Therapy in Spokane

If you've been told to live with the dizziness, you've been told wrong. Vestibular rehabilitation therapy (VRT) is the standard of care for most chronic dizziness and balance disorders. It works through specific exercises that retrain the brain's ability to compensate for vestibular system dysfunction. The evidence is strong, the protocols are well-established, and for the right diagnosis the results are often dramatic.

What vestibular rehabilitation actually is

Your vestibular apparatus is located deep within the inner ear and is responsible for providing your brain with information about head position, balance, motion, and spatial orientation. It’s how your brain knows where your head is in space and how fast it’s moving. It helps you stay upright and keeps your vision steady as you move. When the vestibular system is working, you don’t notice it.

When it isn’t, it’s common to feel off balance, dizzy, woozy, nauseated, lightheaded, or as if the world is spinning. When this happens, walking becomes risky because you’re more likely to fall, and even driving, reading, or scrolling on a screen can become difficult or trigger more symptoms.

Vestibular rehabilitation works to reduce dizziness and other symptoms and restore balance by leveraging the brain’s ability to compensate through three main neurological processes.

How Vestibular Rehabilitation Therapy Works

Habituation – Repeated exposure to provoking movements gradually reduces the brain’s response to them. Done correctly, symptoms are mildly provoked during exercise and diminish over time. Done incorrectly — without a specialist’s progression — the patient avoids the provoking movements and the brain never adapts.

Adaptation – The vestibulo-ocular reflex (which keeps your gaze stable when your head moves) can be retrained even when the underlying inner ear input is impaired. Specific gaze-stabilization exercises drive this adaptation.

Substitution – When part of the vestibular system can’t be recovered, the brain learns to rely more heavily on visual and proprioceptive input to maintain balance. This isn’t a workaround. It’s how the nervous system is designed to handle missing inputs, given the right training.

Each patient’s program is designed specifically for them, depending on their diagnosis and symptom pattern, and often includes balance and vision exercises.

Patient Support

Call Now

509-413-1630

Email Support

info@synergyspokane.com

Commonly Used Therapies:

We offer massage therapy and rehabilitation support for injuries related to auto accidents, work injuries, sports injuries, and chronic pain.

What a Session Looks Like

Your first visit is a full vestibular evaluation — typically 60–90 minutes. Mary will ask detailed questions about your symptom pattern, triggers, prior medical workup, and what you’ve tried. The physical exam includes positional testing (looking for BPPV), gaze stability and VOR testing, dynamic balance assessment, and motion sensitivity testing.

By the end of the first visit, you’ll have a working diagnosis, an explanation of what’s happening, and the start of your treatment plan.

Subsequent visits typically run 45–60 minutes and include:

Reassessment of progress and symptom patterns
In-clinic exercise execution with feedback on form
Repositioning maneuvers if BPPV is involved
Progression of home exercise prescription
Coaching on avoidance patterns and graded return to function

Most patients are seen weekly or every other week for 1–3 months. BPPV often resolves faster. PPPD and complex post-concussion cases often take longer.

Conditions vestibular rehabilitation treats

Most patients who come to Synergy for Pilates fall into one of these groups:

Benign Paroxysmal Positional Vertigo (BPPV)

The most common cause of vertigo — small calcium crystals in the inner ear become displaced into the wrong canal, producing brief, intense spinning episodes triggered by head position changes. BPPV responds to specific repositioning maneuvers (Epley, Semont, BBQ roll) performed by a trained therapist. Most cases resolve within 1–3 visits.

Vestibular neuritis and labyrinthitis

Inflammation of the vestibular nerve or inner ear, often following a viral infection, producing severe rotational vertigo for days to weeks. VRT accelerates recovery and reduces the residual imbalance that can persist if the brain doesn't fully compensate on its own.

Persistent Postural Perceptual Dizziness (PPPD)

A common functional dizziness condition where the original vestibular event has resolved but symptoms persist due to over-reliance on visual and proprioceptive cues. PPPD is increasingly understood as a discrete diagnosis with specific VRT and CBT-informed treatment approaches. Many patients with PPPD have been told for years that nothing is wrong; the diagnosis itself is often the turning point.

Post-Concussion Syndrome and post-traumatic vestibular dysfunction

After a head injury, vestibular impairment is one of the most common — and most missed — causes of persistent symptoms. Specific vestibular and ocular-motor assessment can identify the impairments and guide targeted recovery.

Meniere's disease

Episodic vertigo with hearing changes, ear fullness, and tinnitus. VRT addresses the residual balance and motion-tolerance issues between attacks and supports the long-term compensation process.

Vestibular migraine

Migraine that presents primarily as vertigo and motion sensitivity rather than headache. VRT combined with migraine-specific trigger management can substantially reduce frequency and severity.

Vestibular Discovery Call

Schedule a no-obligation discovery call. Our expert staff will reach out to discuss your circumstances and determine the best path forward.