Are you experiencing dizziness? Dizziness is a common complaint that people present to a physical therapy clinic with, and BPPV is a common culprit.

What is BPPV?

BPPV stands for Benign Paroxysmal Positional Vertigo. It is the most common vestibular disorder across the lifespan. People with BPPV often complain of dizziness and trouble with their balance. Your problems can range from feeling a mild sense of spinning or unsteadiness with movements to dizziness so debilitating you are unable to do your daily activities.

BPPV is a problem with your inner ear (behind the eardrum). BPPV is a BENIGN condition, meaning it is not a serious disorder that will threaten health or life. It is called positional vertigo – this means that you perceive things in your environment as moving or you perceive yourself as moving relative to the environment when nothing should be moving. This sensation happens when you change your head position – getting into bed, getting out of bed, looking overhead, etc. Although there is no definitive cause of BPPV, there is some evidence showing that head trauma (falling, fighting, hitting your head) or whiplash (car accidents) could result in BPPV. There is also some correlation with being female, being older, and having a history of BPPV previously. In addition, rate of recurrence increases with time since initial occurrence – if you’ve had BPPV before you are likely to have it again.

So what can you do if you experience this dizziness?

If you do not have a history of BPPV, and have any new dizziness, it is advisable to contact your primary care provider, go to urgent care, or go to the emergency room. Although BPPV is benign, many causes of dizziness are not, and delayed treatment can negatively impact your chances of recovery. After you have done this, you can schedule a physical therapy examination.

When you come in for an examination, your physical therapist will do testing to differentiate what type of dizziness you have, and to determine if it is BPPV or another cause of dizziness (many of which can also be treated with physical therapy). Once they have determined it is BPPV and localized where the problem is, your physical therapist will do a Canalith Repositioning Manuever (CRM). A CRM involves you moving through specific positions with guidance from your physical therapist to dislodge crystals and alleviate your symptoms.

Sometimes your symptoms can resolve in a single treatment. Sometimes it can take multiple treatment sessions. Your physical therapist will schedule a follow-up session with you in case you require additional repositioning maneuvers, and to confirm the crystals have been disposed of. It is important to follow up to confirm that the crystals have been disposed of, as without treatment it can take multiple months for spontaneous recovery to occur. Given the potential interruption to daily activities and work, it is worth coming in to be certain that it is resolved! If you are experiencing dizziness, reach out to schedule a PT examination today and let us help you feel good again!


Written by: Sierra Martin, DPT, NCS