How long before vestibular rehabilitation works?

Often several weeks of regular exercises, and improvement is usually gradual. BPPV treated with a repositioning manoeuvre can improve much faster, sometimes in one or a few sessions.

Will the exercises make me feel worse at first?

A short-lived increase in dizziness during habituation exercises is expected as your brain adjusts. Persistent or severe worsening should be reported to your clinician.

Is the Epley manoeuvre the same as vestibular rehabilitation?

Not quite — the Epley is a repositioning manoeuvre for BPPV that moves inner-ear crystals, while vestibular rehabilitation is a set of exercises to retrain balance and gaze. They are sometimes used together.

Can I do these exercises without seeing a doctor first?

No — dizziness has many causes, some serious. Get a diagnosis first so the right treatment is chosen and dangerous causes are ruled out.

When is dizziness an emergency?

If it comes with slurred speech, face, arm or leg weakness or numbness, double vision or vision loss, a sudden severe headache, or follows a head injury — call 995. New hearing loss with vertigo needs urgent, not routine, review.

Vestibular Rehabilitation in Singapore: Dizziness & Balance

Written & reviewed by the BestDoctors.sg editorial team · Last updated 25 Aug 2026 · General information, not medical advice

Vestibular rehabilitation (VRT) is an exercise-based therapy that reduces dizziness, vertigo and balance problems caused by inner-ear (vestibular) disorders. It works by driving the brain to re-learn and compensate for a faulty or asymmetric balance signal, through repeated, graded head, eye and balance exercises. It is a therapy, not a diagnosis — and because dizziness has many possible causes, from the inner ear to blood pressure, the heart, medication or anxiety, an accurate diagnosis must come first, and exercises are never a substitute for excluding a serious cause.

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In a medical emergency, or for severe or sudden symptoms such as breathing difficulty, chest pain, fainting or stroke signs, call 995 immediately.

Call 995 if dizziness or vertigo comes with slurred speech, weakness or numbness in the face, arm or leg, double vision or vision loss, or a sudden severe headache — these suggest a stroke. New hearing loss with vertigo, or vertigo after a head injury, needs urgent (not routine) review.

What it is

Vestibular rehabilitation is a set of exercises that help restore balance and ease dizziness, nausea and the anxiety that often comes with them. The core idea is that the brain can compensate for an inner-ear problem when it is challenged with repeated, controlled movement. Because it treats diagnosed vestibular problems, the first step is always a proper assessment of what “dizzy” actually means for you.

Who it helps

VRT typically helps people with a diagnosed vestibular cause, such as vestibular neuritis or labyrinthitis once the acute phase has passed, unilateral vestibular loss (the classic best responder), Meniere’s disease as one part of its management, and vestibular migraine alongside migraine treatment. BPPV — brief spinning triggered by head-position change — is treated primarily by repositioning manoeuvres, with VRT as an adjunct. It also helps older adults with balance decline and falls risk, once cardiac and neurological causes are excluded. It helps less when dizziness is not vestibular at all.

What it involves

Assessment comes first: a clinician takes a careful history, checks eye movements, gaze and balance, and may perform positional testing such as Dix–Hallpike, hearing tests or specialist vestibular tests. The main techniques are gaze-stabilisation exercises (keeping the eyes on a target while moving the head, to retrain the reflex that steadies vision), habituation exercises (repeated, controlled exposure to provoking movements so the brain turns down the response), and balance and gait retraining of increasing difficulty. For BPPV specifically, a canalith repositioning manoeuvre such as the Epley moves displaced inner-ear crystals out of the canal and is often effective within one or a few sessions.

The programme and team

VRT is usually an individualised home-exercise programme done daily or several times a day, reviewed and progressed by the therapist over weeks, with adherence and gradual progression mattering more than intensity. The team may include an ENT doctor or otolaryngologist, an audiologist, a physiotherapist with vestibular training, and sometimes a neurologist, with a GP or polyclinic doctor for first assessment and referral.

Benefits and expectations

Health bodies present VRT as a standard option that can help restore balance and reduce dizziness, nausea and anxiety — helpful rather than guaranteed. Improvement is usually gradual over weeks, and symptoms can briefly feel worse when you first do provoking exercises, which is expected with habituation. Outcomes tend to be better for stable, one-sided losses than for fluctuating conditions, and this guide quotes no specific success rate. For BPPV, repositioning often works quickly, but it can recur and may need repeat treatment.

Red flags

Call 995 or go to A&E if dizziness or vertigo comes with slurred or difficult speech, weakness, numbness or tingling in the face, arm or leg, double vision or sudden vision loss, a sudden severe “worst-ever” headache, or fainting, chest pain or an abnormal heartbeat — these suggest a stroke or other serious cause. Get urgent, same-day review rather than starting exercises for new hearing loss (especially sudden loss in one ear) with vertigo, vertigo after a head injury, or dizziness with high fever, severe vomiting or a stiff neck. The key message is that exercises come after diagnosis, never before it.

Practical tips and support

Do the home exercises consistently and progress gradually; a mild, short-lived flare during exercises is normal, but persistent worsening should be reported. Reduce falls risk at home with good lighting, grab rails and sensible footwear, be cautious with driving, heights and swimming while symptomatic, stay hydrated, and note whether poor sleep, stress or certain foods worsen symptoms. Managing anxiety helps too, because dizziness and anxiety feed each other, and addressing both together often speeds progress. In Singapore, vestibular assessment and rehabilitation are available through restructured hospitals’ ENT, audiology and physiotherapy departments, with GPs and polyclinics able to assess and refer; HealthHub offers information and, for older adults, the Agency for Integrated Care (1800-650-6060) coordinates falls-prevention and community rehabilitation.

When to see a doctor

See a doctor to get a diagnosis before starting exercises, and act on the red flags above — call 995 for stroke-like features, and seek urgent review for new hearing loss with vertigo or vertigo after a head injury.

Related rehabilitation & therapy topics

Sources

NHS — Vertigo: nhs.uk
NHS — Labyrinthitis and vestibular neuritis: nhs.uk
NHS — Meniere’s disease: nhs.uk
HealthHub Singapore: healthhub.sg

General information only. This guide is general information about a rehabilitation topic and is not a diagnosis or personalised medical advice. See a doctor, rehabilitation physician or therapist for assessment and a plan suited to you. Call 995 for stroke warning signs (face drooping, arm weakness, slurred speech), for chest pain or severe breathlessness, or for any sudden, severe symptoms. If you have a spinal cord injury, a sudden pounding headache with a flushed, sweaty feeling can be autonomic dysreflexia — a medical emergency. Seek urgent care for signs of infection (spreading redness, fever) or a hot, swollen, painful calf. For emotional distress, the Samaritans of Singapore (SOS) are on 1767 and mindline.sg offers support.