On-Balance Vestibular Physiotherapy

Your initial consultation typically takes up to 60 minutes. It includes a detailed discussion of your symptoms and history, as well as a full vestibular physiotherapy assessment (including specific testing for BPPV, along with assessment of your balance, neck, head and eye movements). We will explain the most likely cause/causes of your symptoms and begin a tailored management plan. This may include the Epley manoeuvre for BPPV, a home exercise program, gait and balance training, or manual therapy for your neck. If your symptoms resolve and you have a new episode six months after your initial appointment, you will need to book an extended appointment so your clinician has enough time to thoroughly investigate the reason for your recurrence.

This varies from person to person and depends on the cause of your symptoms and how you respond to treatment. Some people with straightforward BPPV may need only two sessions, while others with more persistent or complex conditions may need a longer rehabilitation program. Your physiotherapist will give you an expected timeframe after your first assessment and adjust this as needed.

No referral is required for private patients. If you are a WorkCover, CTP, DVA or insurance-funded patient, a referral is generally required, please call our clinic before booking online if you are third-party funded.

Wear comfortable clothing and flat shoes (or bring socks), since you will be moving during your assessment. Bring any referral, relevant test results (hearing tests, vestibular function tests, imaging), specialist letters, and a list of your current medications.

Not necessarily, but it can happen. Whilst your physiotherapist will try to minimise your discomfort, assessment and treatment can involve movements or positions that provoke dizziness or nausea. Any increase in symptoms is usually mild and settles afterwards. You should arrange a lift following your appointment and aim to have anti-nausea medication from your doctor on hand if you need it.

Mild, short-term symptom provocation is common and often expected, since vestibular exercises are designed to challenge your balance system just enough to promote adaptation. This increase in symptoms should be manageable and settle down again afterwards. If the exercises are exacerbating your symptoms too strongly, let your physiotherapist know so your program can be adjusted.

Vertigo and dizziness are both descriptions of symptoms rather than a diagnosis. Vertigo is the feeling that you or the world around you is moving when it isn’t. It is usually linked to dysfunction of the inner ear balance system. Dizziness is a broader term that can describe a range of feelings including lightheadedness, wooziness, unsteadiness or near-fainting, which can have many other causes. Whether you describe your symptoms as vertigo or dizziness, it is important to be properly assessed as there is a wide range of causes that can produce these symptoms. 

The neck plays a pivotal role in balance by providing crucial sensorimotor control, which in turn contributes to optimal postural and gaze stability. Neck stiffness or dysfunction can therefore contribute to, or worsen, dizziness. Even if the neck is not the initial cause of symptoms, patients experiencing dizziness/vertigo/imbalance will often reduce their head movement resulting in neck dysfunction. We therefore provide manual and exercise therapy for the neck as required depending on your presentation. 

Yes. We use a combination of vestibular rehabilitation exercises, broader balance exercises, and falls prevention strategies to help improve confidence, balance and safety for older adults.

Often, yes. Persistent dizziness can involve more than one contributing factor — for example, ongoing vestibular hypofunction, neck stiffness, general deconditioning, migraine features, PPPD, or a learned fear of movement after symptoms first started. A thorough assessment helps identify what is driving your particular presentation, so a graded, individualised plan can build your tolerance without overloading your symptoms. Usually a combination of vestibular rehabilitation, medications, and psychology work well together to help you move well again.

Vestibular physiotherapy is a specialised subset of physiotherapy focused specifically on the inner ear balance system, and its relationship with your eyes, brain, neck, and body. It uses specific assessment techniques (such as positional testing for BPPV and eye movement/gaze stability testing) and targeted exercise-based treatments not typically used in general musculoskeletal physiotherapy.

Although telehealth appointments will limit the assessment we’re able to complete, it remains a viable option for those in regional or remote areas and those with limited access to specialist vestibular services. Please call us to discuss your particular needs so we can determine if a telehealth appointment would be beneficial.

Seek urgent medical attention if dizziness comes on suddenly with uncontrolled vomiting, severe headache, double vision, chest pain, fainting, new weakness, numbness, slurred speech, or major difficulty walking.

We offer on-the-spot private health insurance claims at each clinic through the HICAPS system. We can also provide a receipt for you to claim a rebate through your private health insurer after your appointment. The exact gap amount you pay depends on your level of extras cover — check with your insurer to confirm rebate amounts.

If your GP has issued you a Chronic Disease Management Plan or an Enhanced Primary Care Plan (EPC) before your appointment, Medicare funding can subsidise your treatment for a limited number of appointments. Your GP determines your eligibility for this. At Simba Health, you will be required to pay for your appointment in full on the day of your appointment and we will submit your Medicare claim on your behalf. Medicare will rebate a portion of the fee, typically within 48 hours but it can take up to 7 days for Medicare to process your rebate. You cannot claim through both private health insurance and a Medicare CDM plan for the same visit.

Vestibular Physiotherapy appointments involve a fee for late cancellations (less than 48 hours’ notice) or no-shows, since that time could otherwise be offered to another patient. These fees are usually payable by the patient even under compensable schemes such as DVA or WorkCover.

No. You can book directly with one of our clinicians. If your symptoms suggest another medical condition requires further assessment, we’ll work closely with your GP or specialist to ensure you receive the most appropriate care.

Yes, we see paediatric patients for vestibular and balance conditions. Children can experience BPPV, vestibular migraine, and other balance disorders. Please mention when booking if the appointment is for a child so we can prepare appropriately.

We recommend having someone drive you to your first appointment if your symptoms are severe or if you are experiencing active vertigo. Following assessment and initial treatment, some patients find their symptoms temporarily increase before improving. Your physiotherapist will discuss this with you at the time of your appointment.

General physiotherapy focuses primarily on musculoskeletal conditions — muscles, joints, and movement. Vestibular Physiotherapy is a subspecialty that specifically addresses conditions of the inner ear and balance system. It uses specialised assessment tools such as Vestibular Function Tests (VFTs) and targeted neurological rehabilitation techniques not typically offered in general physiotherapy practice.

Balance and inner ear conditions can sometimes recur for various reasons. When this happens, and we haven’t seen you in over a year, we conduct an appointment with a similar duration to the first appointment you had with us. While we know this can seem redundant, it is very important for our physiotherapists to have enough time to reassess you, as a previous diagnosis does not necessarily stay constant in the intervening time.