In short
Labyrinthitis is inflammation of the inner ear, usually after an infection. It combines vertigo and imbalance with hearing changes such as hearing loss or ringing. After medical evaluation, vestibular rehabilitation treats the balance side of recovery.
Reviewed by Dr. Manan Patel, PT, DPT, TPS. Updated October 17, 2026.
Common symptoms
- Sudden vertigo and nausea
- Hearing loss or muffled hearing in one ear
- Ringing in the ear (tinnitus)
- Unsteadiness that lingers after the spinning settles
Not sure this matches? Take the 60-second dizziness self-check.
What causes labyrinthitis?
Labyrinthitis usually follows a viral infection such as a cold or flu. Bacterial labyrinthitis is rarer and needs urgent medical treatment.
Secondary BPPV can develop after labyrinthitis as the inflamed inner ear recovers, so we check for it at follow-up visits. Labyrinthitis is closely related to vestibular neuritis, which affects the balance nerve but usually spares hearing.
How we test
Your first visit is a full 60-minute, 1-on-1 evaluation, and treatment often starts the same day. Depending on your symptoms, testing can include:
- Head impulse and positional testing
- Infrared video goggles to observe nystagmus
- Dynamic visual acuity and balance testing
- Referral to an ENT or audiologist for hearing evaluation when needed
Understanding Labyrinthitis
Unlike vestibular neuritis (which spares hearing), Labyrinthitis is an inflammatory condition affecting the entire membranous labyrinth—both the vestibular balance canals and the cochlea. It presents with severe continuous vertigo and gait unsteadiness coupled with unilateral hearing loss, aural fullness, or tinnitus.
Comprehensive Sensorimotor Integration & Secondary BPPV Screening
While medical management salvages cochlear function in the acute window, physical therapy drives central vestibular compensation. In addition, 10% to 15% of labyrinthitis patients develop secondary BPPV as inflammation loosens utricular crystals—which we immediately identify and clear using Infrared Video Goggles.
Evidence-Based Rehabilitation Continuum
- VOR Adaptation & Saccadic SubstitutionProgressive VOR x1 and VOR x2 gaze stabilization paired with active eye-head saccadic shifts and Cervico-Ocular Reflex (COR) training to reduce visual blurring.
- Somatosensory Grounding & Dynamic GaitModified Romberg on compliant foam with eyes closed, tandem stance with pitch/yaw head turns, and Dynamic Gait Index locomotion drills.
- Optokinetic Exposure & Dual-Task ConditioningDesensitizing visual motion intolerance ("supermarket syndrome") and automating balance under cognitive load.
Ready to Reclaim Your Balance & Confidence?
Looking for relief? Schedule a 60-minute 1-on-1 evaluation at our Alpharetta Clinic (Inside GBSPT) or our Cumming Clinic, or call (470) 380-7007.
Your treatment plan
Medical care and early movement
Your physician or ENT evaluates the cause and any hearing change. We start gentle, guided movement as soon as it is safe.
Gaze stabilization and habituation
Exercises that steady your vision and gradually reduce sensitivity to head and visual motion.
Balance and return to activity
Progressive balance and walking training until daily activities feel normal again.
Recovery and what to expect
Balance symptoms usually improve with vestibular rehabilitation over several weeks. Hearing recovery depends on the cause and is managed by your physician or ENT. Sudden hearing loss needs prompt medical evaluation.
Tips for daily life
- Get prompt medical care for any sudden change in hearing
- Use anti-nausea medication only short term, as directed
- Rest in a dim, quiet room only in the first days, then start moving
- Return gradually to screens and busy places
When to get urgent care
Questions about labyrinthitis
Can physical therapy help my hearing?
No. Physical therapy treats the balance and dizziness side. Hearing changes should be evaluated by an ENT or audiologist, promptly if the loss was sudden.
Why do I still feel off weeks later?
Your brain needs time to recalibrate to the change in inner-ear signals. Targeted exercises speed up that process.
Related guides
Browse all guides in our learning center
Related conditions
- Vestibular neuritisInflammation of the balance nerve causing sudden, prolonged vertigo.
- Ménière's diseaseSudden vertigo with ear fullness and fluctuating hearing.
- Unilateral hypofunction (UVH)Weakness in one inner ear, often after a viral infection.
- Vestibular rehabilitationHow testing and treatment work for every type of dizziness.
References
- Hall CD, et al. Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline. Journal of Neurologic Physical Therapy. 2022.
Where to get treated
Book at either clinic. Same phone number, same team, same 60-minute visits.
Cumming clinic
Off GA-400 Exit 13 on Peachtree Parkway
Cumming, GA 30041
Alpharetta clinic
Inside Georgia Brain & Spine Physical Therapy
Alpharetta, GA 30022
Also serving Johns Creek, Milton, Roswell, Suwanee and nearby communities.
