PPPD (Persistent Postural-Perceptual Dizziness) Treatment in Calgary
Caring, Individualized Vestibular Physiotherapy at Home
What is PPPD?
Persistent Postural-Perceptual Dizziness (PPPD) is a chronic functional dizziness condition. It’s not caused by ongoing damage in the inner ear or brain, but by the way the brain processes balance and visual information after an initial trigger.
People with PPPD often feel persistently “off-balance” or “rocking,” especially when upright or in visually busy environments.
Common Symptoms of PPPD
Persistent dizziness or unsteadiness (most days for 3+ months)
Rocking, swaying, or “floating” sensation (not spinning)
Worse when standing or walking, in busy visual environments (grocery stores, crowds, scrolling screens), and with quick head or body movements
Difficulty focusing or feeling “foggy”
Increased anxiety related to symptoms
What Causes PPPD?
PPPD often follows a trigger such as inner ear problems (for example, BPPV, vestibular neuritis, or vestibular migraine), concussion or mild head injury, panic attacks or major stress, or an illness affecting balance. Instead of returning to normal, the brain relies too much on vision, keeps the body tense and on high alert, and learns a persistent pattern of dizziness.
How is it diagnosed?
There’s no single test for PPPD; diagnosis is clinical and based on meeting specific diagnostic criteria. It’s also important to rule out other causes of dizziness.
Treatment for PPPD
PPPD responds best to multimodal, active approach that includes:
Vestibular Rehabilitation (core treatment)
Tolerance retraining
Patient education to reduce fear and symptom amplification
Cognitive strategies (CBT) when needed
Medication when needed
Recovery time for PPPD
Many people improve within 6–12 weeks of consistent vestibular therapy. Full recovery can take 3–6 months, and sometimes longer (years) depending on the duration and severity of symptoms. Progress is gradual rather than linear, so flare-ups are a normal part of the recovery process. Vestibular rehabilitation under guidance of an expert can improve outcomes and quality of life.
When to Seek Help
You should seek help if you experience ongoing dizziness, unsteadiness, or balance problems that are affecting your daily life or not improving over time. It’s also important to get assessed if you feel unsteady when walking, have difficulty with head movements, or are at risk of falling.
Early vestibular physiotherapy can help identify the cause and start targeted treatment to improve balance and reduce symptoms more quickly.
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Yes. Persistent Postural-Perceptual Dizziness (PPPD) is a recognized chronic vestibular disorder (defined 2017; in ICD-11). It’s a functional brain condition causing persistent dizziness, rocking, or unsteadiness, often after inner-ear issues, concussion, or panic attack — not imaginary or merely psychological.
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While it is a chronic condition and rarely improves overnight, PPPD can significantly improve or even go away. However, it rarely goes away on its own without intervention. Commitment to the right, individualized treatments is crucial.
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It is a very common cause of chronic dizziness, making up to 15–20% of cases in specialty dizziness clinics. It is the second most common vestibular disorder, with estimates showing it affects roughly 4% of the general population. It frequently affects people in their 30s-50s and is more common in women.