The vestibular system helps us control balance, eye movements, and our sense of position in space. The peripheral vestibular apparatus is located in the inner ear and consists of the bony labyrinth—made up of three semicircular canals, the utricle, and the saccule. Conditions affecting this part of the system are referred to as peripheral vestibular disorders. When the vestibular system is disrupted, people may experience vertigo—commonly described by patients as dizziness, spinning, swaying, or disequilibrium. Common Peripheral Vestibular Conditions There are many medical causes of dizziness, so it is important that a medical evaluation by a GP, neurologist, or ENT specialist is undertaken. Some of the most common vestibular-related conditions include: Benign Paroxysmal Positional Vertigo (BPPV) Caused by dislodged calcium carbonate crystals (otoconia) moving into the semicircular canals. This leads to brief episodes of vertigo triggered by changes in head position such as rolling in bed or looking up. Menière’s Disease Thought to result from an abnormal build-up of endolymphatic fluid in the inner ear, causing episodes of vertigo, fluctuating hearing loss, tinnitus, and a sensation of fullness in the ear. Labyrinthitis Inflammation of the entire inner ear (labyrinth), usually viral, affecting both balance and hearing. It typically presents with acute vertigo, nausea, and hearing loss. Vestibular Neuritis Inflammation of the vestibular nerve, usually viral, impairing balance but not hearing. It is characterised by sudden onset of severe vertigo, nausea, and unsteadiness that may last for days. Physiotherapy and Vestibular Care Physiotherapists who have completed additional vestibular training play a vital role in the assessment and management of peripheral vestibular conditions. The most common cause of vertigo seen in physiotherapy practice is BPPV. BPPV and the Modified Epley Manoeuvre BPPV is typically diagnosed with a positional test (e.g. Dix-Hallpike), in which vertigo is reproduced and nystagmus (involuntary, repetitive eye movement)…