Vestibular therapy treats dizziness, vertigo, and balance problems that start in the inner ear and the brain's balance system. It is for the spinning that hits when you roll over in bed, the unsteadiness that has you touching walls, and the falls you have stopped mentioning. Most BPPV cases resolve in 1 to 3 visits.
Your balance runs on three inputs: the inner ear, your vision, and the pressure sensors in your feet and joints. When the inner ear signal goes wrong, you get vertigo, motion sensitivity, or a floating unsteadiness that no amount of "being careful" fixes. Vestibular therapy retrains that system with specific, measured exercises and repositioning techniques.
The most common cause we see is BPPV: loose crystals in the inner ear canals that spin the room when you roll over, look up, or bend down. BPPV is mechanical, which is why it responds to a mechanical fix. Canalith repositioning (the Epley maneuver is the best known version) resolves about 80 percent of cases in a single session.
The words matter, because treatment differs. Vertigo is the room spinning. Lightheadedness is the almost fainting feeling. Imbalance is steady vision with unsteady feet. You may have more than one, and the first visit sorts which is which, because each points to a different system and a different fix.
Who it is for: anyone with vertigo, dizziness after a concussion, growing unsteadiness with age, or a fall in the last year. If you have been told it is "just anxiety" or "just age," a measured vestibular exam is how you find out whether that is true. The full education on causes and symptoms lives in our balance and vestibular guide.
Plan on about 60 minutes, one on one. If your dizziness is easily triggered, have someone drive you to this one.
When it hits, how long it lasts, and what triggers it. The pattern usually names the diagnosis before testing confirms it.
We test eye movements and head positions, including the Dix-Hallpike test for BPPV. The testing can briefly bring on the dizziness; that is the diagnostic point.
Standardized balance measures with real numbers, so your fall risk is scored, tracked, and compared visit to visit.
If BPPV is confirmed, repositioning starts immediately. Many patients feel the difference before they leave the building.
Gaze stabilization or habituation exercises with exact doses: how many repetitions, how many times a day, and what symptom level is acceptable.
The full guide to vertigo, BPPV, and unsteadiness, reviewed by our neurological specialist.
Read the guide LibraryWhy falls climb after 65 and what vestibular therapy changes. Our Lindale falls article.
Read the article PillarDizziness that rides along with a stiff neck sometimes starts in the neck, not the ear. We test for both.
Read the guideNot all dizziness is BPPV. When the vestibular signal itself is weakened (after vestibular neuritis, with age, or after a concussion), the fix is gaze stabilization: exercises that recalibrate how your eyes and inner ear work together, progressed in measured doses over 6 to 8 weeks. Done at the right intensity, the system adapts; done casually, it does not, which is why "just give it time" so often fails.
Falls are the other half of this service. About 1 in 4 adults over 65 falls each year, and most tell no one until an injury forces the conversation. Fall prevention here is not a handout about grab bars; it is measured balance training with your scores tracked visit to visit, so you and your family can see the risk number moving.
Concussion belongs on this page too. Lingering dizziness, fogginess in busy rooms, and screen intolerance after a head knock are frequently vestibular and oculomotor problems, and they respond to the same graded retraining. Athletes from Friday night football to the jiu jitsu mats see us for exactly this.
And if a parent has started holding the wall on the way to the bathroom, do not wait for the first fall to make the call. The evaluation produces a fall risk score you can see, and 6 to 8 weeks of training moves it. Come with them; family in the room is welcome and useful.
A word on safety: not every dizzy spell belongs in a PT clinic. Dizziness with chest pain, sudden severe headache, slurred speech, facial droop, or new weakness needs emergency care, not an appointment. Part of the first visit is screening for exactly that, and when the pattern points to a physician instead of a physical therapist, we say so and refer the same day.
Logan Merritt, PT, DPT, NCS, CDN is a Board Certified Neurological Clinical Specialist, a credential that requires residency training or 2,000 hours of neurological practice plus a national board exam, and one that is rare in East Texas. He received his Doctor of Physical Therapy from the University of Texas Medical Branch in 2015 and has treated balance and vestibular disorders for 10 years.
The NCS credential changes what the first visit can rule in and rule out. Board certified neurological training means stroke screening, oculomotor testing, and central versus peripheral differentiation happen in house, before treatment starts, instead of after a misfired month of it.
Most dizziness in this region gets a motion sickness prescription and a long referral chain. Under Texas direct access (HB 4099) you can skip the chain: up to 30 days of care without a referral, often starting the same week the vertigo does. Visits are one on one at 2 clinics: 140 E Eagle Spirit Dr, Lindale, TX 75771 inside Fusion Athletic Club, and 6421 South Broadway Avenue, Suite 600, Tyler, TX 75703 inside B-Fit Tyler. Call or text 903.492.5215 or email hello@physioplustx.com.
BPPV typically resolves in 1 to 3 visits; about 80 percent of cases respond to a single repositioning session. Gaze stabilization programs run 6 to 8 weeks.
Briefly, yes, if BPPV is present. The dizziness settles within a minute or so, and provoking it is how we confirm which canal is involved.
The evaluation runs about 60 minutes. Follow ups run 45 minutes, one on one with your doctor of physical therapy.
Comfortable clothes you can lie down in; positional testing happens on a treatment table. Have someone drive you to the first visit if dizziness is easily triggered.
Some people do. The failure mode is treating the wrong canal or the wrong side, and a video cannot test you. One session confirms the canal and treats it.
We are in network with most major plans. Plan details, self pay rates, and HSA and FSA options are on our insurance page.
No. Texas allows up to 30 days of care without a referral under HB 4099, so you can book directly. Details on our direct access page.
60 minutes with a doctor of physical therapy. If it is BPPV, treatment can start the same visit. If it is something that needs a physician, we tell you that too and send you to the right one.
Strength and mobility work that backs up balance training, especially after a fall.
See the service ServiceHands on neck work when a stiff cervical spine is feeding the dizziness.
See the service PillarThe complete patient education guide behind this service.
Read the guide