Labyrinthitis is inflammation of the inner ear (the labyrinth), which houses both the balance organs and the hearing organ. It typically causes sudden, constant vertigo with nausea and imbalance, often together with hearing loss or ringing in the ear. Hearing changes need prompt medical and audiology assessment, and once the acute phase settles, vestibular rehabilitation is strongly supported by clinical practice guidelines to help the brain compensate for the balance loss. At McKelvie Physiotherapy in Pickering, we assess your balance system with infrared video goggles and build a one-on-one rehab program around your results.
At a glance
- What it is
- Inflammation of the inner ear, affecting both balance and hearing on one side
- Key symptoms
- Sudden, constant vertigo with nausea and imbalance, often with hearing loss or tinnitus
- Common causes
- Most often viral; bacterial labyrinthitis is less common and needs urgent medical treatment
- Hearing
- New or sudden hearing loss should be assessed by a doctor promptly, with a hearing test
- Treatment
- Medical treatment for the cause, then vestibular rehabilitation for lingering dizziness and imbalance
- At McKelvie
- 60-minute vestibular assessment with infrared video goggles ($180) in Pickering; no referral needed
What is labyrinthitis?
Labyrinthitis is inflammation of the labyrinth — the inner ear. The labyrinth contains both the vestibular system, which senses head movement and helps you balance, and the cochlea, which handles hearing.
Because both are affected, labyrinthitis typically causes sudden vertigo together with hearing changes in the same ear. When only the balance nerve is inflamed and hearing is spared, the condition is called vestibular neuritis.
What causes labyrinthitis?
Labyrinthitis is most often viral, and it sometimes follows a cold or flu-like illness. Bacterial labyrinthitis is less common and can develop from a middle ear infection or, rarely, meningitis — it is a medical emergency and needs urgent treatment by a doctor. Less often, labyrinthitis is linked to autoimmune or other systemic conditions.
Whatever the cause, inflammation can damage the inner ear’s balance organs. Even when that damage doesn’t fully heal, the brain can learn to compensate — and vestibular rehabilitation is designed to support that process.
What are the symptoms of labyrinthitis?
- Sudden, constant vertigo that lasts hours to days
- Nausea and vomiting
- Hearing loss in one ear
- Ringing, buzzing or other noise in the ear (tinnitus)
- A feeling of pressure or fullness in the ear
- Imbalance and unsteadiness, sometimes lasting weeks after the vertigo settles
- Blurred vision or dizziness with quick head movements
When to get urgent medical help
If vertigo comes on suddenly with a severe headache, trouble speaking, facial drooping, weakness, numbness or loss of vision, call 911 — these can be signs of a stroke.
A new, constant, severe vertigo should be assessed by a doctor the same day, even without those signs. See a doctor urgently, too, for sudden hearing loss, fever, a stiff neck, ear discharge or severe ear pain — these can point to a bacterial infection or other problem that needs medical treatment.
How is labyrinthitis treated?
Treatment depends on the cause, and different clinicians play different roles.
Diagnosis and acute treatment are a physician’s job. Your doctor will rule out stroke and other causes, decide whether an infection needs treatment, and may prescribe short-term medication to ease vertigo and nausea. Hearing loss needs medical and audiology assessment — a hearing test tells you how much hearing has been affected, and some treatments for sudden hearing loss are time-sensitive. You may also be referred to an ENT specialist.
Recovery of balance is where physiotherapy comes in. Once the acute phase settles, vestibular rehabilitation helps the brain compensate for the inner ear’s reduced balance function. The clinical practice guideline from the Academy of Neurologic Physical Therapy strongly recommends vestibular rehabilitation for people with peripheral vestibular hypofunction (Hall et al., 2022). A program typically includes:
- gaze stabilization exercises to keep your vision clear while your head moves
- balance exercises to rebuild steadiness when standing and walking
- habituation exercises to reduce sensitivity to the movements and environments that provoke dizziness
Assess
A full vestibular assessment with infrared video goggles to measure how your balance system is working, and to check for related problems such as BPPV.
Rehabilitate
A personalized program of gaze stabilization, balance and habituation exercises, paced to your symptoms and coordinated with any medical or hearing care you’re receiving.
Return to life
Regular re-testing and progressively harder exercises to get you back to work, exercise and busy environments with confidence.
If dizziness or imbalance has lingered for weeks or months after labyrinthitis, vestibular rehabilitation can still help.
Why choose McKelvie Physiotherapy for labyrinthitis?
- Advanced vestibular expertise — our lead physiotherapist is an Advanced Vestibular Physical Therapist (AVPT), and dizziness is our clinical focus, not a sideline.
- Advanced diagnostic technology — we use infrared video goggles (video-oculography) to record eye movements the naked eye can’t see, so your diagnosis is based on evidence, not guesswork.
- Accurate, one-on-one assessment — in a private room, with time to get to the bottom of your symptoms.
- Connected care — we work closely with local ENT specialists, which matters when hearing is involved.
- Care that comes to you — in person in Pickering, at home across the GTA, or virtually anywhere in Ontario.
- Direct billing to many major insurers — and no referral needed.
Sources
- Labyrinthitis. StatPearls Publishing (Barkwill D, et al.), 2025.
- Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association. Journal of Neurologic Physical Therapy (Hall CD, et al.), 2022.