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  • Writer's pictureSam Kelokates

Does Vestibular Rehab Work for Vestibular Migraine

Vestibular migraine (VM) is a neurological condition that blurs the lines between migraine, headache, and vertigo. If you've ever experienced a spinning sensation that makes you feel like you're not just dizzy but at the mercy of a merry-go-round, you might be familiar with vertigo.

Combine that with the throbbing, pulsating pain of a typical migraine, and you have vestibular migraine. Symptoms vary but often include sensitivity to motion, light, and sound, alongside the classic signs of migraine such as intense headaches and nausea.

physical therapist leading a female patient through vestibular exercises for vestibular migraine in a clinic setting

While medications are commonly prescribed to manage vestibular migraine, there's another effective approach that doesn't rely on drugs: vestibular rehabilitation.

This specialized practice of physical therapy is designed to help the brain recalibrate its responses to sensory information that affects balance and movement. Through a series of targeted exercises, vestibular rehabilitation aims to reduce the frequency and intensity of vertigo and migraine symptoms, providing a non-pharmacological pathway to relief.

Whether you're seeking alternatives to medication or looking to complement your current treatment plan, vestibular rehabilitation offers a promising solution to regain stability in a world that often seems like it won't stop spinning.


Benefits of Vestibular Rehab for Vestibular Migraine

Vestibular rehabilitation, a specialized form of physical therapy, offers a natural treatment option for those struggling with vestibular migraine. This therapy is not just about managing symptoms—it's about enhancing your quality of life.

Here’s how it can make a significant difference:

Does Physical Therapy Help with Vestibular Migraine

One of the primary goals of vestibular rehabilitation is to decrease how often and how intensely you experience vestibular migraine attacks!

Through a tailored exercise program, these sessions work on retraining your brain to correctly process the signals from your inner ear and your surroundings.

This retraining helps to stabilize your internal sensors, making you less prone to the disorienting and often debilitating effects of vertigo. As vertigo episodes decrease, the associated headaches often diminish in frequency and severity as well.

Evidence of Effectiveness for Vestibular Migraine

The support for vestibular rehabilitation comes from numerous studies and clinical experiences. Research has shown that patients who engage in this form of therapy report a significant reduction in the number of vertigo attacks and a decrease in the intensity of migraine headaches.

In one study, patients undergoing vestibular rehabilitation saw their monthly vertigo attacks significant drop from daily disturbances to just a few episodes a month. Similarly, these patients also experienced fewer migraine days per month, demonstrating the dual benefit of this approach.

These improvements are not just numbers on a chart. They translate into real-world benefits. Patients often report being able to return to daily activities that they previously had to stop due to their symptoms.

This could mean going back to work, engaging in social activities, or simply performing daily tasks without the fear of a vertigo or migraine attack.

A Closer Look at the Exercises for Vestibular Migraine

The exercises used in vestibular rehabilitation vary but generally include activities that challenge balance, enhance visual stability, and improve coordination.

For example, you might perform exercises that involve focusing on a fixed point while turning your head or walking along a straight line. These exercises are designed to be progressive, starting from simple tasks and gradually increasing in complexity as your tolerance improves.

Through consistent practice, your brain learns to use other senses (like vision and proprioception) more effectively to compensate for any vestibular system deficiencies. This adaptation is crucial in reducing the overwhelming sensations of dizziness and imbalance that are characteristic of vestibular migraine.

By participating in vestibular rehabilitation, you're not just treating symptoms. You're fundamentally retraining your brain to bring about lasting changes.

This approach provides a hopeful outlook for many who suffer from vestibular migraine, offering a path to reclaim their lives from the clutches of this challenging condition.

What to Expect During Vestibular Rehab for Vestibular Migraine

Starting vestibular rehabilitation is a proactive step towards managing your vestibular migraine, and knowing what to expect can help you maximize the benefits of this therapy. Here's a breakdown of what a typical session might look like, the commitment involved, and why consistency is key to your progress.

Typical Session Format

Vestibular rehabilitation sessions are tailored to your specific needs, but they generally follow a structured format:

  • Duration: Each session typically lasts between 30 to 60 minutes, depending on the intensity and type of exercises prescribed.

  • Types of Exercises: Your therapist will guide you through various exercises designed to address your unique symptoms. These might include:

  • Balance Training: Exercises that challenge your ability to maintain stability, which might involve standing on different surfaces or in different stances.

  • Gaze Stabilization: Techniques to help you focus on a single point while moving your head, improving your ability to control eye movements and reduce dizziness.

  • Habituation Exercises: Tasks that involve repeated exposure to movements that provoke dizziness, with the aim of decreasing your sensitivity over time.

  • Frequency of Sessions: The frequency can vary widely, but a common regimen might involve sessions two to three times a week at a clinic, supplemented by daily exercises you perform at home.

Commitment and Consistency in Vestibular Rehab

The success of vestibular rehabilitation hinges significantly on your commitment and the consistency of your participation. Here’s why:

  • Active Participation: During sessions, your engagement and effort in performing exercises as directed by your therapist are crucial.

  • Homework Exercises: You will likely be assigned exercises to practice at home. These are integral to your progress and help reinforce the work done during in-clinic sessions.

  • Regular Attendance: Consistently attending scheduled sessions ensures you receive ongoing guidance, adjustments to your exercise program, and support from your therapist.

The Importance of Consistency

Consistency in attending sessions and adhering to prescribed exercises is paramount. Regular practice helps your brain adapt to the changes more effectively and can lead to more sustainable improvements in managing symptoms of vestibular migraine.

If you're just starting to explore the idea of physical therapy for migraine or headache, or if you're preparing for your first evaluation, you might find valuable insights in our related blog article: What to Expect on Evaluation for Migraine. This resource is designed to give you a comprehensive look at the initial assessment process and how it sets the stage for your personalized therapy plan.

Beginning vestibular rehabilitation is not just about attending sessions. It's about integrating these practices into your daily life to achieve lasting relief and a better quality of life.

With the right approach and a commitment to consistency, you can take significant strides towards managing and potentially reducing your vestibular migraine symptoms.

Treatment Integration and Common Challenges of Vestibular Migraine

Combining therapy and medical management, and understanding the challenges of vestibular rehabilitation are crucial aspects of managing vestibular migraine through physical therapy.

Here’s how integrating different treatments can enhance outcomes and what you might expect in terms of challenges.

Combining Treatments for Enhanced Results

Vestibular rehabilitation is powerful on its own, but when combined with other treatments, such as medication, its effectiveness can increase significantly. Collaborating closely with your neurologist or headache specialist to coordinate your care is essential.

This integrated approach allows you to:

  • Address Multiple Aspects: While vestibular rehabilitation works by training your body to manage symptoms physically, medications can help by reducing the frequency and intensity of migraine attacks, providing a more comprehensive treatment strategy.

  • Tailored Treatment Plans: Your healthcare providers can tailor both your medication and physical therapy to your specific needs, potentially leading to quicker and more significant improvements, and fewer attacks during treatments.

Managing Expectations and Challenges with Vestibular Rehab

While the benefits of vestibular rehabilitation are significant, there are challenges and adjustments along the way:

  • Initial Worsening of Symptoms: It’s common for some patients to experience an increase in dizziness or headache symptoms initially. This temporary worsening is part of the adjustment process as your body learns to cope with and eventually reduce these sensations.

  • Stick With it: Due to the demanding nature of the rehabilitation exercises and the initial worsening of symptoms, some patients may feel discouraged and discontinue the therapy. It's important to stay motivated and understand that these challenges are often temporary.

  • Importance of Patient Motivation and Regular Follow-ups: Success in vestibular rehabilitation heavily depends on your commitment. Regular follow-up appointments are crucial to monitor your progress, make necessary adjustments to your treatment plan, and provide support and motivation.

Navigating Through the Process

Here are a few tips to help manage these challenges:

  • Set Realistic Goals: Discuss with your therapist what realistic improvements you can expect and the timeline for these improvements.

  • Stay Engaged: Keep in regular contact with your healthcare team and report any concerns you have. We're here to support you and adjust your treatment as needed.

  • Support System: Lean on family, friends, or support groups, especially during tough phases of your therapy. Knowing you’re not alone in this can make a big difference.

By understanding and preparing for these aspects of vestibular rehabilitation, you can better manage your vestibular migraine, reduce symptoms, and improve your overall quality of life. Combining treatments and navigating through the challenges with a proactive approach and the right support can lead to the best possible outcomes.

Getting Started with Vestibular Rehab for Vestibular Migraine

Starting on vestibular rehabilitation is a significant step toward reclaiming your life from the grips of vestibular migraine. Here’s how you can get started and what to expect as you move forward with treatment.

Step-by-Step Guide to Starting Vestibular Rehabilitation

  1. Consult Your Healthcare Provider: The first step is to talk with your primary care doctor or neurologist about whether vestibular rehabilitation is appropriate for your situation. They can provide a referral to a specialist in vestibular rehabilitation.

  2. Choosing a Specialist: As a local provider specializing in non-pharmacological treatments for headache disorders, including vestibular rehabilitation, I am here to help. You can reach out directly to our practice to discuss your symptoms and treatment options.

  3. Scheduling Your First Session: Once you decide to proceed, scheduling your first session is simple. You can contact our office or visit our website to book your appointment.

  4. Preparing for Your First Session: To make the most of your initial visit, bring a list of your symptoms, any medical history relevant to your condition, and a list of questions you may have. Wearing comfortable clothing is advisable as you’ll be engaging in physical activities.

The Path to Improvement

Vestibular rehabilitation offers a promising route to not only manage but potentially reduce the symptoms of vestibular migraine. This therapy has helped many patients decrease the frequency and severity of their vertigo and migraines, leading to a better quality of life.

If you're struggling with vestibular migraine, don't hesitate to schedule your FREE HEADACHE CONSULTATION

Discuss this treatment option with your healthcare provider or contact our office to schedule your free headache consultation.

It’s time to take control of your symptoms and start on the path to recovery. Together, we can work towards a solution that allows you to live your life to the fullest, free from the debilitating effects of vestibular migraine.

About Me:

Hi, my name is Sam Kelokates, PT, DPT. I am a licensed physical therapist and owner of Kelos Physical Therapy, located in Philadelphia, PA. I specialize in the non-pharmacological management of headache and migraine disorders.


This blog post is for informational purposes only and should not replace professional medical advice or treatment. Always consult with a qualified healthcare provider for personalized guidance and recommendations.

I may earn commissions for purchases made through the links in this post

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