Stop the Spin.
Reclaim Your Balance.

Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo, caused by displaced calcium crystals in the inner ear. Physiotherapy — specifically the Epley maneuver and other canalith repositioning techniques — is the gold-standard first-line treatment recommended by clinical guidelines. Success rates exceed 90%, and symptoms often resolve within 1–3 sessions.

BPPV often resolves within 1–3 sessions using repositioning maneuvers. More complex vestibular disorders such as vestibular neuritis, PPPD, or chronic imbalance typically require 6–12 sessions of structured vestibular rehabilitation exercises. Your physiotherapist will provide a realistic timeline after your initial assessment.

Yes. Vestibular rehabilitation is performed by registered physiotherapists and is typically covered under extended health benefit plans. RCP Health offers direct billing to most major insurance providers, making the process as seamless as possible. Contact us to verify your coverage before your first appointment.

No referral is required to book a vestibular physiotherapy assessment at RCP Health in Ontario. You can contact us directly to schedule your appointment. A physician referral may be required by some insurance plans for reimbursement — we recommend checking with your provider before your visit.

Vertigo is a specific type of dizziness — the false sensation of spinning or rotation (either you or your surroundings moving). General dizziness is a broader term that includes lightheadedness, floating sensations, unsteadiness, and disorientation. Identifying which type you experience is a key part of our vestibular assessment.

Vertigo is a symptom — the false sensation of spinning or movement. A vestibular disorder is the underlying condition that causes it. Vestibular disorders are a broad category of conditions affecting the inner ear and its connections to the brain, including BPPV, vestibular neuritis, Ménière's disease, and PPPD. Importantly, not all vestibular disorders cause classic spinning vertigo — some produce general imbalance, brain fog, or sensitivity to motion instead. A proper vestibular assessment is necessary to identify which disorder is present and what treatment is most appropriate.

Vertigo can be either peripheral (inner ear or vestibular nerve) or central (brain or brainstem) in origin. The vast majority of vertigo cases — including BPPV, vestibular neuritis, and labyrinthitis — are peripheral, meaning they originate in the inner ear rather than the brain itself, and are highly treatable with physiotherapy. Central vertigo, caused by conditions such as stroke, multiple sclerosis, or acoustic neuroma, is less common but more serious, requiring medical management alongside rehabilitation. Distinguishing between the two is a key part of the initial vestibular physiotherapy assessment.

A genetic component has been identified in certain vestibular conditions. Vestibular migraine and Ménière's disease both show familial clustering and are thought to have genetic risk factors. BPPV may also occur more frequently in people with a family history of the condition, as well as in those with low vitamin D levels or osteoporosis. However, most cases of vertigo are not directly inherited — environmental, lifestyle, and physiological factors all play a significant role. Having a family history of vertigo is worth mentioning at your initial assessment.

Duration depends heavily on the underlying cause. Individual BPPV episodes typically last seconds to under a minute, though the condition recurs with position changes until treated. Vestibular neuritis causes intense vertigo lasting days, with residual imbalance that may persist for weeks. Vestibular migraine episodes can range from minutes to hours. PPPD and other chronic vestibular disorders can persist for months or even years without appropriate treatment. The good news: most causes respond well to physiotherapy, and the sooner treatment begins, the faster recovery tends to be.

Some strategies can help manage symptoms between appointments, but home treatment is not a substitute for professional assessment. General measures — staying well hydrated, avoiding sudden head movements, and sleeping with your head slightly elevated — can reduce episode frequency. Brandt-Daroff exercises are sometimes recommended for BPPV, but performing repositioning maneuvers at home without a confirmed diagnosis and canal identification can worsen symptoms if applied incorrectly. We recommend seeing a physiotherapist first to confirm the diagnosis, then receiving guidance on a safe, personalized home program.

BPPV has a recurrence rate of approximately 15–50% within one year. However, if symptoms return, they typically respond just as quickly to repeat treatment. Our team will teach you self-repositioning techniques (such as the modified Epley) for use at home if symptoms recur, and provide guidance on lifestyle factors that reduce recurrence risk.

Over-the-counter antihistamines such as dimenhydrinate (Gravol) and meclizine can temporarily reduce the sensation of dizziness and associated nausea during an acute episode. However, these medications only mask symptoms — they do not treat the underlying vestibular disorder. For BPPV specifically, medication provides no lasting benefit and may even slow central compensation by suppressing the vestibular system. Always consult a physician or pharmacist before starting any medication, particularly if you take other prescriptions. Physiotherapy remains the recommended first-line treatment for most forms of vertigo.