Vestibular Migraine Treatment Melbourne | Keilor Road Physiotherapy
▫️Written by John Keller
✅ Reviewed by Dr. Jenny Hynes on December 15, 2025
How to manage vestibular migraine: Best treatment options in Melbourne
Why choose Keilor Road Physiotherapy for treatment of vestibular migraine
Dizziness, vertigo and migraine symptoms can be unsettling—especially when they occur without warning. One of the most commonly overlooked causes of recurrent dizziness is vestibular migraine. At Keilor Road Physiotherapy, we regularly assess and treat people experiencing vestibular migraine, helping them regain confidence, balance and control over their symptoms.
What is vestibular migraine?
Vestibular migraine is a neurological condition where migraine mechanisms affect the vestibular system, which controls balance and spatial orientation. Unlike classic migraine, headaches may be mild or absent. Instead, people experience episodes of dizziness, vertigo, imbalance, nausea or visual disturbance. Physiotherapy plays a key role in reducing symptoms and improving daily function.
Vestibular migraine is now recognised as one of the most common causes of recurrent vertigo, particularly in adults aged 20–60 (Smyth et al, 2022).
Common symptoms include:
Spinning or swaying sensations
Light-headedness or “foggy” head
Sensitivity to light, sound or motion
Nausea or vomiting
Visual disturbances
Neck pain or stiffness
Difficulty concentrating or fatigue
Symptoms may last minutes, hours or even days and may occur with or without a headache.
Causes and triggers for vesitbular migraine
Vestibular migraine occurs when migraine pathways interfere with how the brain interprets balance signals. Common triggers include stress, poor sleep, hormonal changes, visual overload, neck tension, dehydration and skipped meals.
Vestibular migraine is driven by central nervous system sensitivity, rather than damage to the inner ear.
Common contributing factors include:
Abnormal sensory processing in the brainstem
Heightened sensitivity to visual and motion input
Mismatch between balance, vision and body position signals
Common Vestibular Migraine Triggers
Stress or emotional overload
Poor sleep or irregular sleep patterns
Hormonal fluctuations
Dehydration
Skipped meals or low blood sugar
Bright lights or screen exposure
Busy visual environments (shopping centres, scrolling)
Neck tension or prolonged poor posture
Caffeine, alcohol, or certain foods
A key concept in vestibular migraine management is trigger stacking.
Rather than one trigger causing symptoms, episodes often occur when multiple factors combine, such as:
Poor sleep + stress
Neck tension + screen exposure
Dehydration + visual overload
Understanding this helps vestibular migraine sufferers reduce fear and regain control over their symptoms.
Melbourne's best vestibular migraine management.
Risk factors for vestibular migraine
People with a personal or family history of migraine, motion sickness, high stress levels, poor sleep or neck pain are at higher risk. Vestibular migraine is more common in women, particularly during hormonal changes.
Vestibular migraine tends to affect people with a more sensitive nervous system (Liu et al, 2020).
Key risk factors include:
Personal or family history of migraine
Female sex and hormonal fluctuations
History of motion sickness
High stress or anxiety levels
Poor sleep quality
Neck pain or postural strain
Previous vestibular conditions such as BPPV or vestibular neuritis
These factors help explain why symptoms can persist despite normal scans or tests.
Why Identifying Risk Factors Matters
Understanding individual risk factors allows for more accurate diagnosis and targeted treatment. At Keilor Road Physiotherapy, we assess these contributors as part of a comprehensive vestibular evaluation, ensuring management addresses both symptoms and underlying drivers.
How to Manage Vestibular Migraine: Best Treatment Options in Melbourne
Vestibular migraine is managed using vestibular physiotherapy, trigger management and, in some cases, medication. Physiotherapy improves balance, reduces dizziness and builds tolerance to movement and visual stimuli (Byun et al, 2021).
Vestibular Physiotherapy
At Keilor Road Physiotherapy, treatment may include:
Comprehensive vestibular assessment
Differentiation from BPPV and other vestibular disorders
Vestibular rehabilitation therapy (VRT)
Gaze stabilisation and balance exercises
Visual motion desensitisation
Neck assessment and treatment
Postural retraining for desk and screen work
Education on pacing and flare-up management
Physiotherapy aims to reduce:
Frequency and intensity of dizziness
Fear of movement
Avoidance behaviours
Impact on work and daily life
Medical Management of Vestibular Migraine
Medical management of vestibular migraine aims to reduce the frequency and severity of symptoms by calming migraine activity in the nervous system. Medication may be recommended by a GP or neurologist when symptoms are frequent or significantly affect daily life. While physiotherapy plays a central role in managing vestibular migraine, medical management may be appropriate for some people, particularly when symptoms are frequent, severe or not settling with conservative care alone.
Preventative Migraine Medications
Preventative medications aim to reduce the frequency and intensity of vestibular migraine episodes, rather than treating symptoms once they start. These may include:
Certain blood pressure medications
Antidepressants used at low doses for migraine prevention
Anti-epileptic medications
These medications are taken regularly and are typically trialled over several weeks to assess effectiveness.
Acute (Abortive) Medications
Some people may also be prescribed medications to take during an acute migraine episode, particularly if headache or severe migraine symptoms are present. These are used selectively and under medical guidance.
Medication Is Not Always Required
Importantly, not everyone with vestibular migraine needs medication. Many people achieve good symptom control through:
Vestibular physiotherapy
Trigger identification and management
Sleep regulation
Stress management
Postural and neck-based treatment
Medication is often considered when symptoms significantly interfere with daily life or remain persistent despite conservative strategies.
Physiotherapy and Medical Care Work Best Together
At Keilor Road Physiotherapy, we work alongside GPs and specialists when required. Physiotherapy complements medical management by:
Improving balance and movement tolerance
Reducing visual and motion sensitivity
Addressing neck pain and postural contributors
Helping patients safely return to daily activities
This combined approach leads to better long-term outcomes and reduces reliance on medication alone.
When to Seek Professional Help for Vestibular Migraine?
You should seek professional assessment if dizziness or vertigo is recurrent, worsening or affecting daily activities. Early diagnosis improves symptom control and recovery.
Seek assessment if you:
Have recurring or persistent dizziness
Feel unsteady when walking or turning your head
Experience dizziness triggered by visual environments
Have migraine symptoms with or without headache
Are avoiding activities due to fear of dizziness
How to decrease vestibular migraines.
Why Choose Keilor Road Physiotherapy for Vestibular Migraine?
Keilor Road Physiotherapy provides expert assessment and evidence-based vestibular migraine treatment focused on reducing dizziness, improving balance and restoring confidence. Care is personalised, thorough and delivered by physiotherapists experienced in vestibular and migraine-related conditions.
Experienced Vestibular Physiotherapists
At Keilor Road Physiotherapy, your assessment is conducted by physiotherapists trained in vestibular and dizziness management, including vestibular migraine. We understand how migraine, balance, vision and the neck interact, allowing for accurate diagnosis and targeted treatment.
Comprehensive One-on-One Assessment
Vestibular migraine can mimic other conditions such as BPPV or cervicogenic dizziness. We take time to:
Rule out other vestibular disorders
Identify migraine-related drivers
Assess balance, eye movements and neck function
Understand symptom patterns and triggers
This ensures treatment is specific, not generic.
Individualised Treatment Plans
No two cases of vestibular migraine are the same. Your treatment plan may include:
Vestibular rehabilitation exercises
Visual motion and gaze stabilisation work
Balance retraining
Neck and postural treatment
Education on pacing, triggers and flare-ups
Programs are progressed gradually and tailored to your tolerance and goals.
Neck and Posture Expertise
Many people with vestibular migraine also experience neck pain or stiffness. Our physiotherapists assess and treat cervical contributors, which can significantly reduce dizziness severity and frequency.
Education and Reassurance
Understanding vestibular migraine is critical for recovery. We focus on:
Explaining what is happening in your nervous system
Reducing fear around movement and dizziness
Teaching strategies to manage symptoms long-term
This empowers patients and improves outcomes.
Collaborative Care When Needed
We work alongside GPs and specialists where appropriate, ensuring physiotherapy and medical management complement each other for optimal results.
Convenient Location for Melbourne’s North-West
Keilor Road Physiotherapy is easily accessible for patients from Essendon, Niddrie, Keilor East, Airport West and surrounding suburbs, with flexible appointment times and a supportive clinic environment.
Frequently asked questions about vestibular migraine
Vestibular migraine commonly causes dizziness without headache and responds well to physiotherapy-led management.
Is vestibular migraine the same as vertigo?
No. Vertigo is a symptom. Vestibular migraine is a neurological condition that can cause vertigo.
Can vestibular migraine occur without headache?
Yes. Many people experience dizziness without significant headache.
Is vestibular migraine dangerous?
It is not life-threatening, but it can significantly impact quality of life if untreated.
Can physiotherapy help vestibular migraine?
Yes. Vestibular rehabilitation and neck-based physiotherapy are evidence-based treatments.
Do I need a referral?
No referral is required to see a physiotherapist at Keilor Road Physiotherapy.
References
Byun, Y. J., Levy, D. A., Nguyen, S. A., Brennan, E., & Rizk, H. G. (2021). Treatment of vestibular migraine: a systematic review and meta‐analysis. The Laryngoscope, 131(1), 186-194.
Liu, W., Dong, H., Yang, L., Zhao, H., Dong, W., & Yang, Y. (2020). Severity and its contributing factors in patients with vestibular migraine: a cohort study. Frontiers in Neurology, 11, 595328.
Smyth, D., Britton, Z., Murdin, L., Arshad, Q., & Kaski, D. (2022). Vestibular migraine treatment: a comprehensive practical review. Brain, 145(11), 3741-3754.
Article by
John Keller
Clinical Director | Sports & Musculoskeletal Physiotherapist
John graduated as a Physiotherapist from the Auckland University of Technology with the John Morris memorial prize for outstanding clinical practise in 2003. John has since completed Post Graduate Diplomas in both Sports Medicine and Musculoskeletal Physiotherapy with distinction, also collecting the Searle Shield for excellence in Musculoskeletal Physiotherapy.
Reviewed by
Dr. Jenny Hynes FACP
Clinical Director | Specialist Musculoskeletal Physiotherapist
Jenny sat extensive examinations to be inducted as a fellow into the Australian College of Physiotherapy in 2009 and gain the title of Specialist Musculoskeletal Physiotherapist, one of only a few physiotherapists in the state to have done so.