Conditions we treat
Ménière's Disease
Unpredictable vertigo attacks, ear pressure, and changes in hearing — and the imbalance that can linger in between.
What Is Ménière's Disease?
Ménière's disease is a chronic inner-ear disorder linked to a buildup of fluid in the inner ear. It tends to affect one ear (at least at first) and shows up as a distinctive cluster of four symptoms:
- Episodes of spontaneous vertigo, usually lasting from 20 minutes up to several hours
- Fluctuating hearing loss in the affected ear
- Tinnitus — ringing, roaring, or buzzing
- A sense of fullness or pressure in the ear
The hard part for many people is the unpredictability. Attacks can come without warning, knock you flat for hours, and leave you drained and off-balance for a day or two afterward. Over time, the hearing loss can become more permanent in the affected ear.
Ménière's is diagnosed and primarily managed by a physician — typically an ear, nose, and throat specialist (ENT) or neurotologist — because the core treatment involves medical and lifestyle strategies aimed at reducing the frequency and severity of attacks.
What It Feels Like
People with Ménière's often describe:
- "Out of nowhere the room starts spinning, and it goes on for hours."
- "My ear feels full and plugged, like it needs to pop."
- "There's a roaring or ringing that gets louder before an attack."
- "My hearing comes and goes."
- "I never know when one will hit, so I'm anxious about being far from home."
- "After an attack I'm wiped out and unsteady for a day or two."
Between attacks, some people feel completely normal; others carry a lingering sense of imbalance or unsteadiness, especially as the disease progresses.
First Step: Get an Accurate Diagnosis
Because Ménière's shares symptoms with other conditions — including vestibular migraine, which is often confused with it — an accurate diagnosis matters. If you're having attacks of vertigo along with hearing changes, ringing, or ear fullness, start with a physician or ENT. They can confirm the diagnosis, check your hearing, and guide the medical management that forms the foundation of Ménière's care, which may include dietary adjustments, medications, and other treatments tailored to you.
Vestibular physical therapy works alongside that medical care — not instead of it.
How Vestibular Therapy Can Help — and What It Can't
It's worth being straightforward: vestibular therapy does not cure Ménière's, stop the attacks, or restore hearing. The unpredictable, fluctuating vertigo of active Ménière's isn't something exercises can switch off, and during the fluctuating phase, rehab often isn't the right tool.
What vestibular therapy can do is address the balance and mobility problems that Ménière's leaves behind — and for the right person at the right time, that's a meaningful improvement in daily life:
- Balance and fall prevention. Repeated attacks and changes in inner-ear function can leave you less steady on your feet. Targeted balance training rebuilds stability and reduces fall risk — important at any age, and especially as the disease progresses.
- Compensation once things stabilize. When Ménière's reaches a later, more stable stage, or after certain medical procedures that intentionally reduce function in the affected ear, you may be left with a fixed inner-ear deficit. That's exactly the situation where vestibular rehabilitation shines — retraining your brain to rely on your other ear, your vision, and your body's position sense.
- Treating coexisting BPPV. People with Ménière's develop BPPV (the crystal-displacement type of vertigo) more often than average. BPPV is highly treatable with repositioning maneuvers — so part of our job is sorting out which of your symptoms are Ménière's and which might be a separate, fixable problem layered on top.
- Confidence and conditioning. Living with unpredictable vertigo understandably makes people cautious and less active, which can erode strength and steadiness over time. A guided program helps you stay safely mobile.
The honest summary: medical management leads, and vestibular therapy supports — improving your stability, safety, and confidence between and after attacks.
What to Expect in Treatment
Evaluation. We start with your history and the pattern of your symptoms, then assess your eye movements, inner-ear function, balance, and walking. Part of this is sorting out what's driving each of your symptoms — including screening for treatable contributors like BPPV.
A coordinated plan. Because Ménière's is a team effort, we'll work in step with your physician or ENT. If your evaluation suggests something needs their attention, we'll help coordinate it.
Your program. When vestibular rehabilitation is appropriate for your stage, you'll get a customized program focused on balance, gaze stability, and safe mobility — progressed at a pace that suits you. We time and tailor the work to where you are in the course of the disease.
Ménière's Disease FAQ
Will vestibular therapy stop my vertigo attacks?
No. The attacks themselves are managed medically. Vestibular therapy helps with the balance problems and unsteadiness that can persist between and after attacks, not with preventing the attacks.
Can it help my hearing or ear fullness?
No — those are handled by your physician or ENT. Vestibular therapy focuses on balance and movement.
Then is it even worth doing?
For the right person, yes. If you're left unsteady, fearful of falling, or carrying a fixed inner-ear deficit, rehabilitation can meaningfully improve your stability and confidence. The first step is an evaluation to see whether — and when — it's a good fit for you.
I was told exercises won't help during a flare. Is that true?
Largely, yes. During the active, fluctuating phase, the inner-ear signal keeps changing, so the brain can't settle into a steady adaptation. Rehab is usually most useful once your condition is more stable, or to treat a separate problem like BPPV. We'll help you figure out where you are.
Could some of my dizziness be something other than Ménière's?
Quite possibly. Ménière's can coexist with — or be mistaken for — other vestibular conditions. A careful evaluation helps tease them apart so nothing treatable gets missed.
Do I need a referral to be seen?
No. You can book directly. For Ménière's specifically, we'll also make sure you're connected with appropriate medical care.