Short answer
Vestibular rehabilitation therapy (VRT) is exercise-based treatment that retrains how your brain uses signals from the inner ear, eyes and body. Specific head, eye and balance exercises help the brain compensate for an inner ear problem, and repositioning maneuvers clear BPPV. Clinical practice guidelines strongly recommend vestibular rehabilitation for inner ear (peripheral vestibular) hypofunction1.
Answered by Dr. Manan Patel, PT, DPT, TPS, Certified Vestibular Specialist and Therapeutic Pain Specialist. Updated October 18, 2026.
What problems does vestibular rehabilitation treat?
VRT helps when the balance system sends the brain mismatched signals. Common reasons people come to us include:
- BPPV, the loose inner ear crystals that cause brief spinning when you roll over or look up
- Vestibular neuritis, labyrinthitis and other causes of reduced inner ear function on one or both sides
- Vestibular migraine and persistent postural-perceptual dizziness (PPPD)
- Dizziness after a concussion or whiplash, including neck-related (cervicogenic) dizziness
- Age-related balance decline and falls
A Cochrane review found moderate to strong evidence that vestibular rehabilitation is safe and effective for one-sided peripheral vestibular disorders2.
How is a vestibular evaluation different from a general balance check?
Your first visit is 60 minutes, one-on-one. We record your eye movements with infrared video goggles, which remove visual fixation so subtle nystagmus (involuntary eye movement) becomes visible. That shows which inner ear canal is involved in BPPV, or whether the pattern points away from the inner ear. BioSway computerized balance testing then measures how well you use vision, the inner ear and foot sensation to stay upright, giving a baseline we re-test as you improve. We also screen the neck and check for warning signs that need a physician.
What does a vestibular rehabilitation program include?
- Repositioning maneuvers such as the Epley, Semont, Gufoni or BBQ roll when testing confirms BPPV3
- Gaze stabilization (VOR x1 and VOR x2) so vision stays clear when your head moves
- Habituation: graded exposure to the movements and busy visual scenes that provoke symptoms
- Balance and gait training on varied surfaces, with head turns and in low light, and at our Cumming clinic inside the Zero-Fall overhead harness
Exercises are dosed carefully. Too little does not drive adaptation, and too much flares symptoms, which is one reason generic online routines often stall.
How long does vestibular therapy take for patients in Cumming and Alpharetta?
It depends on the cause. Typical BPPV often clears in one to three visits once the right canal is treated. Recovery from vestibular neuritis, hypofunction, vestibular migraine, PPPD or concussion usually takes several weeks of progressive exercise, and we measure progress with repeat goggle and BioSway testing. Patients come to us from Alpharetta, Johns Creek, Milton, Roswell, Cumming and Suwanee, and urgent appointments are available within 48 hours.
Where can I get help in Alpharetta, Cumming and nearby?
Dr. Manan Patel, PT, DPT, TPS and our team of physical therapists see patients from Alpharetta, Johns Creek, Milton, Roswell, Cumming, Suwanee, Sugar Hill, Buford, Duluth and Forsyth County at two North Atlanta clinics. Every visit is 60 minutes, one-on-one, and urgent appointments are available within 48 hours. We are in-network with Traditional Medicare, BCBS / Anthem and Tricare, and offer a $129 rate per visit for self-pay and out-of-network plans. Not sure where to start? Take the free symptom self-check, or visit our Alpharetta clinic or Cumming clinic page.
Cumming clinic
Off GA-400 Exit 13 on Peachtree Parkway
Cumming, GA 30041
Alpharetta clinic
Inside Georgia Brain & Spine Physical Therapy
Alpharetta, GA 30022
Related care
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References
- Hall CD, et al. Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline. Journal of Neurologic Physical Therapy. 2022.
- McDonnell MN, Hillier SL. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database of Systematic Reviews. 2015.
- Bhattacharyya N, et al. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update). Otolaryngology–Head and Neck Surgery. 2017.
This answer is general education, not a diagnosis or a substitute for an examination. If you have new or worsening symptoms, contact your doctor. Call 911 for sudden severe dizziness with trouble speaking, weakness, numbness, double vision or a severe headache.
