Injury type: Acute/ Chronic

Category: Allied Health Options

Rating: No Research

What is it?

One of the symptoms of whiplash is dizziness. As a result of a whiplash injury, the receptors in the neck can be damaged which creates dizziness and disturbances in control of posture and balance. One of the means of addressing these balance problems is Vestibular Rehabilitation. This is a specific form of physiotherapy that helps to develop compensatory strategies for various balance problems. Once the cause and source of the problem is correctly diagnosed, a variety of exercises are undertaken. These include head and neck exercises, eye exercises, balance exercises and walking exercises. During these activities patients may be instructed to keep their eyes open or closed. Usually, depending on the patient requirement, exercises are tailored to suit their injury and subsequent symptoms.

How does it work?

The goals of Vestibular Rehabilitation are to improve balance, minimise falls, and decrease feelings of dizziness. This is achieved by improving the function of the vestibular system and also addressing central (brain) adaptation and compensation. By tapping into alternate strategies within the nervous system, compensation can occur for deficits in the vestibular system. The nervous system uses the control of eye, head and body movements to ensure that people’s posture and position is adequately maintained.

Is it effective?

Research evidence to date has shown that Vestibular Rehabilitation is an effective treatment option for patients with dizziness in general. A recent systematic review1 demonstrated that Vestibular Rehabilitation is effective for improving self-reported dizziness, fall risk, balance and emotional status in patients with chronic dizziness, especially when compared to usual medical care or placebo eye exercise. Another systematic review and meta-analysis of randomised controlled trials2 supported this finding, and reported that Vestibular Rehabilitation is more effective than conservative treatment in reducing dizziness in the short term.

However, research studies specifically examining the effect of Vestibular Rehabilitation following whiplash have been less extensively conducted. An updated systematic review3 (used for revising a clinical practice guideline) found that Vestibular Rehabilitation is beneficial for improving short term difficulties resulted from dizziness, but not pain, in patients with chronic neck pain including whiplash. This finding arose from a single trial. A recent randomised controlled trial4 also demonstrated positive outcomes associated with Vestibular Rehabilitation, suggesting that the treatment can be effective for reducing dizziness and its associated disability, as well as increasing quality of life in patients with whiplash.   

Are there any disadvantages?

Provision of vestibular rehabilitation should be based on appropriate assessment and diagnostic standards. Not all patients with dizziness subsequent to whiplash are eligible for Vestibular Rehabilitation.

Where do you get it?

As Vestibular Rehabilitation is a specific form of physiotherapy, Physiotherapists who are specifically trained in the provision of Vestibular Rehabilitation can perform these treatment techniques. Contact the Australian Physiotherapy Association for Physiotherapists trained in Vestibular Rehabilitation.


While recent research findings are promising, the evidence base for Vestibular Rehabilitation following whiplash is limited. Therefore, this treatment should be considered with caution. More research is needed to strengthen current evidence and to identify if Vestibular Rehabilitation is useful as a stand alone therapy or used in conjunction with other physiotherapy treatments.