What are vestibular disorders? How do they affect balance?

with advice from Meghan Lass, PT, DPT

What are vestibular disorders? How do they affect balance?

The vestibular system, located in the inner ear, is integral to a person’s balance. It collects information on your position and location and works with the central nervous system to keep you balanced.

Out of the three systems that manage balance (the visual system, the somatosensory system, and the vestibular system), it is the slowest and last to react. When your vestibular system is not working properly, you cannot process your location in the space around you, causing unsteadiness, imbalance and dizziness. But physical therapy can help!

There are several types of vestibular disorders, explains Meghan Lass, a physical therapist who specializes in vestibular therapy at Conshohocken Physical Therapy, a Physiquality network member in Pennsylvania. One type, peripheral vestibular disorders, are problems in the inner ear. These can be caused by a number of things, including:

  • A virus, like labrynthitis or vestibular neuritis.
  • A tumor on the cranial nerve, known as acoustic neuroma.
  • Displaced otoconia (tiny fragments that float about in the fluid of the inner ear), as in benign paroxysmal positional vertigo (BPPV).
  • An imbalance of the fluid in the inner ear, which is thought to cause Meniere’s disease.

Central vestibular disorders, on the other hand, develop in the central nervous system. Often a result of a brain injury, they can be caused by a concussion, a cerebellar stroke, or even multiple sclerosis.

A physical therapist can retrain how a person processes sensory information, leading to better balance.Symptoms for both central and peripheral disorders can include dizziness and unsteadiness; nausea; headaches; sensitivity to motion, light or noise; and cognitive changes (like a sudden memory loss, or the inability to do something that was previously done with ease). Meghan points out that the symptoms for both central and peripheral vestibular disorders are similar but vary in intensity and duration. If a person has symptoms, particularly after a concussion, she should see her physical therapist or other healthcare provider in order to determine the cause and to receive proper treatment.

Once a patient has the proper diagnosis of what is causing their imbalance, Meghan says, “a physical therapist can help to ‘rewire’ how the patient’s vestibular system processes sensory information, thereby improving their balance. This often includes static and dynamic balance exercises on a variety of stable and unstable surfaces, or with eyes open and then closed.”

For many vestibular therapy patients, physical therapy greatly reduces or completely eradicates their symptoms. In addition, it often allows patients to treat their symptoms without medication. If you are curious about vestibular therapy and live in southeastern Pennsylvania, Meghan will be holding a seminar at Conshohocken Physical Therapy on October 6 at 6:30 p.m. For more information, contact Kelly Tornetta at ktornetta@conshypt.com.


Looking for a physical therapist to treat vestibular disorders?
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Meghan Lass, PT, DPT Meghan Lass, PT, DPT, a physical therapist, oversees vestibular therapy at Conshohocken Physical Therapy, a Physiquality network member in Pennsylvania. She specializes in acute care, outpatient orthopedics, and vestibular rehabilitation, with a focus in treating patients with Post-Concussive Syndrome.


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Mayo Clinic.

Benign paroxysmal positional vertigo (BPPV). Vestibular Disorders Association.

Neuroscience Online, University of Texas Medical School.



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