Understanding BPPV: Dizziness and Vertigo

woman experiencing dizziness and vertigo from bppv


Dizziness is a common complaint seen by physical therapists who treat vestibular dysfunction. In fact, millions of people in the United States develop dizziness from vertigo. Vertigo is a feeling that you or your surroundings are spinning, which can increase fall risk. There are many different causes of dizziness, and therefore, many different treatments. One of the most common causes of dizziness seen by physical therapists is benign paroxysmal positional vertigo, or BPPV.

If you have BPPV, you should not feel alone. Reportedly, nine out of every 100 older adults are affected by it. The good news is that BPPV is very much treatable – with physical therapy. Your therapist will use tests to confirm vertigo, teach you specific exercises to treat/prevent symptoms, and use special maneuvers to help you get back to the activities that you enjoy.

Understanding BPPV

BPPV is a disorder of the inner ear. It occurs when otoconia (which are calcium-carbonate crystals) become dislodged and travel into one of the semicircular canals. These semicircular canals are filled with fluid they help our body sense movement, allowing the body to respond appropriately to maintain our balance. When these crystals are introduced into the semicircular canals, the displacement of this fluid changes, causing the body to send an abnormal signal to the brain.

What happens in a person with BPPV when they lay down, get up, or roll over in bed for example is they will get movement of these crystals inside the canals. The crystals are more dense than the fluid inside the canals and therefore will fall to the bottom of the canal. Imagine throwing a rock into a lake, you will see ripples across the surface of the water. The ripples do eventually stop, as long as you stop throwing rocks. In the same way while these crystals make their way to the bottom of the canal, it causes fluid displacement in the canal. Until the fluid returns to its resting position, you will experience dizziness.


Symptoms of BPPV

Common symptoms of BPPV include brief episodes of dizziness, often described as room-spinning, that is brought about by motion. These episodes of dizziness may or may not be associated with nausea and/or vomiting as well as light-headedness. The most common complaint of people diagnosed with BPPV is dizziness with lying down or getting out of bed and rolling over in bed. Dizziness that is associated with BPPV is generally brief, lasting a few seconds to a minute at a time.

Diagnosis and Treatment of BPPV

Diagnosis of BPPV can be made through a clinical examination. During a therapy visit to evaluate dizziness, your therapist will talk with you regarding your symptoms and do a series of tests to determine the cause of your dizziness. Testing for BPPV includes a series of positional testing to help your therapist identify whether the issue is on the right or left side as well as which canal is affected.

If your physical therapist determines BPPV to be the cause of dizziness, treatment will be initiated at the same time. This treatment includes using gravity and moving through a series of positions to guide the crystals back into place. The type of therapies or treatments is directed by findings from the results of testing. Treatment should be initiated only by a trained physical therapist, as performing the wrong maneuver can cause the crystals to move into a different canal.

Prognosis for BPPV

Overall prognosis for someone with BPPV is very good. Most patients see improvements in just 1-3 visits, although some do require more treatment. Some patients do experience a recurrence of BPPV after their initial diagnosis and recovery. If your symptoms have reoccurred, it is important to seek out care from your trained therapist at each recurrence, as other conditions can mimic BPPV.

If you or a loved one are dealing with vertigo or any form of dizziness, schedule a free screening with a physical therapist. An Axes physical therapist will always put you on a plan that best suits your needs so you can rest assured that you are receiving the best care for your individual case.
Kelsey was born and raised in Hermann, MO. She graduated from Maryville University in 2013 with her Doctorate in Physical Therapy and has been practicing in outpatient orthopedic settings for her entire career. She has had the opportunity throughout her career to impact the lives of hundreds of patients and she enjoys getting to know her patients on a greater level by spending time with them and getting to know the whole person. Additionally, she is a vestibular therapist and a certified ASTYM provider. In her spare time, Kelsey enjoys playing volleyball and fishing, along with raising her daughter.

To schedule an appointment with Kelsey or any of our expert physical therapists, request an appointment online today.