Vertigo · Dubai Hills
Vertigo is not a feeling of faintness. It is the false sense that you, or the room around you, is moving when nothing is. Most people first notice it in bed. You roll onto one side, the ceiling swings, and you grip the mattress until it stops.
At KINETIKA in Dubai Hills, vertigo is one of the conditions we see most often. Our vestibular physiotherapist, Nour Salman, assesses the inner ear balance system with equipment most Dubai physiotherapy clinics do not have on site. Treatment depends entirely on which part of the system is misbehaving.
Senior Physiotherapist, vestibular and balance lead
Vertigo has a specific meaning. It is the illusion of movement, usually spinning, sometimes tilting or rocking. Your body may feel like it is turning while you sit still.
That differs from other things people call dizziness. Lightheadedness is the sense that you might faint, and it often comes from blood pressure, dehydration or a skipped meal. Unsteadiness is a feeling that your feet are unreliable, without any spinning. A floating, disconnected feeling points instead towards persistent postural perceptual dizziness.
Telling these apart is the first job of the assessment. The word you use in the first 30 seconds changes what we test.
True vertigo brings company. Nausea is common, and many people go pale or need to lie flat. Your eyes may also flick involuntarily, a movement called nystagmus, and that flicking is our most useful clue.
Deep inside each ear sit 3 fluid filled loops called the semicircular canals. They sense head rotation. Beside them sits the utricle, an organ that senses gravity and straight line movement.
The utricle is coated with tiny calcium carbonate crystals, known as otoconia. They are normal, and they help you feel which way is down.
Sometimes crystals break loose. They drift into a semicircular canal, where they do not belong. When you roll over, the crystals fall through the fluid and drag it with them. The canal then reports a large head rotation that never happened.
Your other ear and your eyes report the truth. Your brain receives 2 contradictory messages and reads the conflict as violent spinning.
That is benign paroxysmal positional vertigo, or BPPV. It explains why spinning starts a second after you move, then fades within a minute if you stay still. Rolling over, lying down, sitting up and looking up at a high shelf are the classic triggers.
Five conditions account for most vertigo seen in clinic, and the first three in this table are the ones we see most. They feel different, they last different lengths of time, and they need different treatment. Use this table to prepare for your appointment, not to label yourself. Several overlap, and 2 can be present at once.
| Cause | What it feels like | How long an attack lasts | Hearing affected | Typical trigger | What helps |
|---|---|---|---|---|---|
| BPPV | Short, intense spinning | A few seconds to under a minute, repeating with each movement | No | Rolling over, lying down, sitting up, looking up | Repositioning manoeuvres, usually 1 to 3 sessions |
| Vestibular migraine | Spinning, rocking or motion sensitivity, often with light sensitivity | 5 minutes to 72 hours | Usually not | Sleep loss, stress, hormones, certain foods, screens | Trigger management, medical care, graded vestibular rehabilitation |
| PPPD | Constant swaying or rocking, worse standing, walking or in busy visual places | Most of the day, for 3 months or more | No | Often begins after another vestibular event or a period of stress | Graded vestibular rehabilitation, habituation, medical care where needed |
| Vestibular neuritis | Sudden severe spinning without hearing change | Constant for 1 to 3 days, easing over weeks | No | Usually follows a viral illness | Medical review, then vestibular rehabilitation |
| Meniere's disease | Heavy spinning with fullness or pressure in one ear | 20 minutes to several hours | Yes, fluctuating hearing loss and tinnitus | Often none, sometimes salt, stress or poor sleep | Medical management, salt and diet advice, balance rehabilitation between attacks |
BPPV is the most common cause of vertigo in adults, and it responds fastest to treatment. It is also the cause most Dubai hospital pages skip, because it is treated by hand rather than by scan.
The pattern is distinctive. Spinning starts a moment after a head movement, peaks within 10 seconds, then settles inside a minute. Between attacks you may feel fine, or slightly foggy and cautious.
Crystals can land in any of the 3 canals in each ear. The posterior canal is involved in most cases, the horizontal canal is next, and the anterior canal is uncommon. Each produces a different pattern of eye movement, which is why we watch your eyes rather than rely on your description.
We identify the canal with positional tests, then treat it with a repositioning manoeuvre. That is a sequence of slow, held head and body positions that walks the crystals out of the canal and back into the utricle.
The Epley manoeuvre is the best known of these. We also use the Semont and the barbecue roll, depending on the canal involved. Most people feel a clear change the same day, and many resolve in 1 to 3 sessions.
Vestibular migraine is one of the most common causes of recurrent vertigo, and one of the most missed. Many people who have it never get a headache during an attack.
Instead you get spinning, rocking or intense motion sensitivity. Supermarkets, scrolling on a phone, patterned floors and car travel all become difficult. Attacks last from 5 minutes to 3 days.
Clues include a personal or family history of migraine, sensitivity to light or sound during attacks, and triggers such as poor sleep, missed meals and stress.
Management has 2 halves. A doctor addresses triggers and any medical treatment. Graded vestibular rehabilitation then reduces how strongly your system reacts to movement and visual patterns.
Persistent postural perceptual dizziness is a constant sense of swaying, rocking or unsteadiness that has lasted 3 months or more. It is worse when you stand or walk, and worse again in busy visual environments such as malls, supermarkets and traffic.
It often starts after something else, a bout of BPPV, a vestibular migraine attack, a virus or a period of intense stress. The original problem settles, but the brain stays on high alert and keeps treating normal movement as a threat.
Testing usually shows a balance system that works, which is why people with PPPD are so often told there is nothing wrong. There is, and it responds to a specific approach. Graded vestibular rehabilitation and habituation retrain the brain's response to movement and visual input, and where a doctor is involved, medical care runs alongside.
Meniere's disease is less common, and it feels quite different. Attacks arrive with little warning and often last 20 minutes to several hours.
Three symptoms travel together. There is spinning vertigo, hearing that comes and goes in 1 ear, and tinnitus, which is ringing or roaring in that ear. Many people also describe pressure or fullness in the ear.
The cause is thought to involve excess fluid in the inner ear. Diagnosis is medical, and it usually involves an ear, nose and throat doctor plus hearing tests. If your pattern points this way, we say so and refer you.
Physiotherapy does not stop Meniere's attacks. It helps with the part that lingers. Balance retraining, gaze stability work and graded exposure improve the unsteadiness between attacks and reduce falls risk.
These 2 conditions are often confused, and the difference is simple. Both involve inflammation of the balance nerve or the inner ear, usually after a viral illness. Vestibular neuritis affects balance only. Labyrinthitis affects balance and hearing.
The onset is dramatic. Spinning arrives suddenly and does not stop when you keep still. Most people spend 1 to 3 days in bed.
Anyone with sudden constant vertigo needs a medical review first, because a small number of cases are caused by a stroke rather than a virus. If your presentation has warning features, we send you for medical assessment rather than treating you.
Once the acute phase passes, the spinning stops but the unsteadiness stays. One ear now sends weaker signals than the other, and your brain has to recalibrate.
Vestibular rehabilitation has the strongest evidence at this stage. Gaze stabilisation exercises train your eyes to stay locked on a target while your head moves. Balance work rebuilds confidence on uneven ground and in the dark.
Some dizziness starts in the neck rather than the ear. It is called cervicogenic dizziness, and we test for it after ruling other causes out.
The neck is full of position sensors. Your brain combines their signals with information from your eyes and inner ear. When neck muscles and joints are stiff, injured or held in one posture for hours, those signals become unreliable.
The result is a floating, off balance feeling rather than true spinning. It often comes with neck stiffness, headaches at the base of the skull, and symptoms that worsen after long desk hours. Whiplash and post concussion presentations frequently include a neck component.
Treatment combines upper cervical manual therapy, deep neck muscle retraining and exercises that retrain position sense. Most people notice a change within 4 to 6 sessions.
At KINETIKA, a vestibular assessment is much more than simply checking whether you feel dizzy. We take the time to understand why you are experiencing your symptoms, how they affect your daily life, and what your body, eyes and balance system are telling us.
We start with a detailed history and symptom assessment. We want to understand when your symptoms started, what they feel like, what triggers or worsens them, how long they last, and whether they are associated with headaches, visual symptoms, hearing changes, nausea or imbalance. We also review your relevant medical history, investigations and medications.
We then assess your eye movements and visual vestibular function. Your eye movements provide us with important information about how your brain and inner ears are communicating. We look at how your eyes move at rest and during different tasks, as well as how they respond to changes in head and body position.
As part of the assessment, we also specifically screen for BPPV, one of the most common causes of positional vertigo. If the assessment indicates that BPPV is present, we can perform the appropriate repositioning manoeuvre during the same appointment to treat the affected canal, when clinically appropriate.
We then move on to functional balance and mobility testing. This allows us to understand how your vestibular system performs during everyday activities such as standing, walking, turning, changing positions and maintaining your balance under different conditions. The tests are adapted to your symptoms and tolerance.
We also use validated questionnaires and clinical outcome measures to understand how much dizziness, imbalance or visual sensitivity is affecting your daily life. These measures provide us with an objective baseline and allow us to monitor your progress throughout rehabilitation.
Where clinically indicated, we perform video head impulse testing, or vHIT. This uses high-speed cameras to assess how effectively your eyes and inner ears work together to keep your vision stable when your head moves. It can help us identify weakness in one or more of the semicircular canals and provides valuable information to guide your rehabilitation.
An important part of the assessment is understanding your goals. What would you like to get back to doing? Whether it is walking confidently, exercising, driving, working, travelling, moving without fear or simply getting through your day without constantly thinking about your dizziness, your goals help us shape your treatment plan.
At the end of the assessment, we explain our findings and what they mean for you. We provide education about your symptoms, discuss the factors that may be contributing to them and introduce the treatment approach. Depending on your presentation, rehabilitation may include vestibular exercises, gaze stabilisation, balance retraining, habituation, visual vestibular exercises and functional activities designed around your specific needs and goals.
Our aim is not simply to identify an abnormal test. It is to understand the whole picture, including your symptoms, clinical findings, functional limitations and personal goals, and use this information to develop an individualised treatment plan. Allow about 60 minutes for the first appointment.
Not all vertigo is treated the same way, and not all of it belongs to physiotherapy. Here is an honest split.
Repositioning manoeuvres are physiotherapy work, and they are the treatment for BPPV. They are done by hand, and where clinically appropriate, in the same session as the assessment.
Vestibular rehabilitation is also physiotherapy work. It is a structured exercise programme covering gaze stability, habituation, balance and walking. It is the main treatment after vestibular neuritis and labyrinthitis, and it helps in vestibular migraine, PPPD and age related balance loss.
Manual therapy for the neck sits with physiotherapy too, where a cervical component is present.
Medication is a doctor's decision, and we do not advise on it. Where you are under medical care, we coordinate with your doctor so that rehabilitation and medical treatment run together.
Scans have a narrow role. An MRI is useful when the pattern suggests a central cause. It does not show BPPV, and it may be normal in neuritis and vestibular migraine, which is why a normal scan does not rule out a treatable vestibular problem.
We are a DHA-licensed clinic, most insurances accepted, and we coordinate with a neurologist or ear, nose and throat specialist when needed.
Most vertigo is not dangerous. A small proportion is, and the difference is worth knowing.
Go to an emergency department if vertigo arrives with any of these. Sudden severe headache unlike your usual headaches. Double vision, or loss of vision. Slurred speech. Weakness or numbness in the face, arm or leg. Difficulty swallowing. New loss of coordination in an arm or a leg. Sudden hearing loss in 1 ear. Loss of consciousness. A fall with head injury.
Also seek same-day medical care for constant severe vertigo lasting more than 24 hours, especially the first time.
For vertigo that is brief, triggered by head position and settles when you stay still, see your doctor first, then book a vestibular physiotherapy assessment. We coordinate with your doctor.
Honest timelines help more than optimism, so here are the ranges we see.
BPPV commonly resolves in 1 to 3 sessions. Many people leave the first appointment noticeably better.
Vestibular neuritis and labyrinthitis usually settle over 6 to 12 weeks. The severe spinning stops within days. The unsteadiness is the part that takes the work.
Vestibular migraine is managed rather than resolved. Most people see a reduction in frequency and intensity over 8 to 12 weeks when medical care and rehabilitation run together.
PPPD often runs 8 to 12 weeks of graded rehabilitation, and progress is measured in how much of normal life comes back rather than in a single test.
Cervicogenic dizziness often improves within 4 to 6 sessions. Meniere's disease follows its own course, and rehabilitation improves balance between attacks rather than preventing them. Age, general health and starting early all influence the timeline.
Common questions
BPPV, loose crystals in the inner ear. Vestibular migraine and PPPD are the next most common causes we see at KINETIKA.
Yes, where the cause is vestibular. A vestibular physiotherapist tests the inner ear balance system and treats BPPV with repositioning manoeuvres, and other causes with vestibular rehabilitation. Where the cause is medical, we say so and coordinate with your doctor.
For brief, position-triggered vertigo, we recommend seeing your doctor first, and then booking an assessment. We work alongside your doctor. Sudden constant vertigo, or vertigo with any of the warning signs above, needs medical care first.
Through a detailed history, eye movement assessment with infrared goggles, positional testing for BPPV, functional balance testing, validated questionnaires and, where indicated, video head impulse testing. The assessment takes about 60 minutes.
Where clinically appropriate, yes. If BPPV is found, the repositioning manoeuvre can be performed in the same session. For other causes, treatment is initiated after the assessment.
From a few seconds to under a minute, and it repeats with each triggering movement. Attacks that last hours point to a different cause.
Do not drive during an active attack. After a repositioning manoeuvre, take care for the rest of the day and follow the precautions we give you. If your dizziness is triggered by head movement, arrange a lift to your appointment.
Rarely, but it can be. Vertigo with sudden severe headache, double vision, slurred speech, weakness or numbness, difficulty swallowing, loss of coordination, sudden hearing loss or loss of consciousness needs emergency care.
Yes. An MRI cannot show BPPV and may be normal in vestibular neuritis and vestibular migraine. Those conditions are identified through vestibular testing, not imaging.
Persistent postural perceptual dizziness, a constant swaying or rocking that lasts 3 months or more and worsens in busy visual environments. It responds to graded vestibular rehabilitation.
Neck problems more often cause a floating, off-balance feeling than true spinning. We test for a neck component after ruling out the inner ear, and treat it with manual therapy and neck retraining.
Yes. Our paediatric and vestibular physiotherapist, Jimy Haddad, assesses children with dizziness and balance concerns, with the assessment adapted to their age. Please call first so we can advise.
Yes. Unsteadiness and fear of falling respond well to structured balance and strength work, and we run these programmes at the clinic in Dubai Hills.
Our clinic is in Dubai Hills, at Unit 403, Park Heights Square 1 on Al Khail Road. We see patients from Dubai Hills, Meydan, Al Barsha, Business Bay and Downtown.
Related vestibular care
Dubai Hills
Allow 60 minutes for your first appointment. Unit 403, Floor 4, Park Heights Square 1, Al Khail Road, Dubai Hills.
Medically reviewed by the Kinetika Clinical Team · Last reviewed 29 September 2026