You wake up in the morning and the room seems to be spinning. Or you stand up from a chair and feel momentarily "light-headed", as though you are about to lose your balance. Dizziness is one of the most common complaints a physiotherapist hears — and despite the worry it causes, in most cases it has a treatable cause.
This article does not replace a personalised assessment by a healthcare professional. If your dizziness is severe, sudden, or accompanied by other symptoms (e.g. double vision, limb weakness, difficulty speaking), seek medical attention immediately. For milder, recurring forms of dizziness, however, physiotherapy often provides significant relief.
What Exactly Is Dizziness — and Why It Is Not All the Same
The term "dizziness" covers very different experiences:
- Vertigo: the sensation that the space around you, or your own body, is spinning. It is usually related to the vestibular system (the inner ear or the nerves connecting it to the brain).
- Pre-syncopal dizziness: the feeling that you are about to faint, often caused by a drop in blood pressure or cardiovascular factors.
- Disequilibrium: a sense of unsteadiness whilst walking, without the surroundings necessarily appearing to spin.
- A "foggy" or "floating" sensation: mild dizziness that may be linked to anxiety, fatigue, or neck problems.
Distinguishing between these types helps the physiotherapist choose the most appropriate approach — or refer you to the right specialist, if needed.
The Role of the Neck: Cervicogenic Dizziness
One of the most underestimated culprits behind chronic dizziness is the neck. The proprioceptors located in the muscles and joints of the neck continuously send information to the brain about the position of the head in space. When this system is disrupted — due to muscle tension, joint dysfunction, or injury — the result can be a feeling of unsteadiness or dizziness.
Cervicogenic dizziness commonly occurs: • After a whiplash injury or neck trauma • In people with chronic neck pain or cervical arthritis • In people who sit for many hours in front of a screen • After periods of intense stress and muscle tension
Physiotherapy — and in particular chiropractic — can help restore normal neck mobility and improve proprioceptive signalling. Read more about managing neck pain.
Benign Paroxysmal Positional Vertigo (BPPV): The Most Common Cause of Vertigo
BPPV (also known as "crystal vertigo") is the most common cause of vertigo. It occurs when small calcium crystals (otoliths) move from their natural position in the inner ear and enter the semicircular canals, disrupting normal balance function.
The characteristic symptoms include: • Intense vertigo triggered by a change in position (e.g. lying down, lifting the head) • Duration of a few seconds to a few minutes • Involuntary eye movements (nystagmus) • Nausea, rarely vomiting
The good news: BPPV is treated effectively with specialist repositioning techniques, such as the Epley manoeuvre, carried out by a physiotherapist. In most cases, a few sessions are sufficient to achieve significant improvement.
Vestibular Rehabilitation: What the Physiotherapist Does
Vestibular rehabilitation is a specialist area of physiotherapy that addresses balance disorders and vertigo. It is based on the nervous system's ability to "reprogramme" itself and compensate for damage to the vestibular system.
The assessment includes: • A detailed symptom history • Examination of eye and head movements • Balance and gait tests • Provocation tests for BPPV
The treatment programme may include: • Repositioning manoeuvres (Epley, Semont) for BPPV • Gaze stabilisation exercises • Habituation exercises for movements that provoke dizziness • Balance training at various levels of difficulty • Exercises to improve postural control
When Dizziness Is Related to the Spine
Beyond the neck, the lumbar spine can indirectly contribute to a feeling of unsteadiness, particularly in older adults or people with chronic low back pain. A weakened core means less stabilisation during walking — something the brain perceives as feeling "unsafe" in space.
Clinical Pilates is particularly effective in these cases, as it focuses on core stabilisation, improving proprioception, and enhancing neuromuscular balance. You can also find out how physiotherapy helps with low back pain, which often coexists with walking instability.
Who Is Most at Risk of Balance Disorders
Balance disorders and dizziness can occur at any age, but some groups are more vulnerable:
- Older adults: vestibular system function, vision, and muscle strength all decline with age, increasing the risk of falls.
- People with chronic neck pain or following a whiplash injury
- People who have had a stroke or neurological episode
- Those taking medications that affect balance (antihypertensives, sedatives)
- People with diabetes mellitus (due to peripheral neuropathy)
- Those who sit for many hours or lead a sedentary lifestyle
If you belong to any of these groups, a preventive balance assessment by a physiotherapist can help prevent falls and injuries.
Home Physiotherapy as a Solution for People with Dizziness
For many people experiencing dizziness or balance disorders, travelling to a clinic can be difficult or even unsafe. Home physiotherapy offers significant advantages:
- Assessment in your real environment — the physiotherapist can identify fall hazards in your home
- A personalised balance programme tailored to the space you live in
- BPPV manoeuvres carried out without the need to travel
- Greater safety for older adults or people with additional health conditions
- Training for family members in how to provide appropriate support
Konstantinos Danalis offers home physiotherapy in Voula, Vouliagmeni, Vari, Glyfada, and Alimos, including assessment and treatment of vertigo and balance disorders.
When to Seek Immediate Medical Attention
Physiotherapy is effective for many forms of dizziness, but some symptoms require urgent medical assessment:
- Sudden, severe dizziness that you have never experienced before
- Accompanying symptoms: double vision, difficulty speaking, limb weakness, difficulty walking
- Hearing loss or intense tinnitus (ringing in the ears) that appeared suddenly
- Dizziness following a blow to the head
- Chest pain or shortness of breath
- Syncope (fainting)
In these cases, you need urgent medical care. The physiotherapist can work alongside doctors from other specialities for a comprehensive approach when this is deemed necessary.
First Steps: What You Can Do Today
If you are experiencing dizziness or a feeling of unsteadiness, follow these general guidelines:
- Keep a note of when the dizziness occurs (e.g. with a change in position, in the morning, after fatigue) — this is very helpful for diagnosis.
- Avoid sudden changes in position — rise slowly from lying down.
- Do not drive if you are having episodes of vertigo.
- Review your medications with your doctor — some can affect balance.
- Improve the lighting in your home and remove obstacles from corridors.
For a personalised assessment and treatment programme, contact us to book an appointment — at home or at our practice.