BPPV: How Physio Can Help
What Is BPPV?
BPPV is one of the most common causes of vertigo (a spinning sensation). It occurs when tiny calcium carbonate crystals—officially known as otoconia- become dislodged from their normal location in the inner ear.
These crystals normally sit in a part of the inner ear that helps detect gravity and movement. When they move into one of the inner ear’s semicircular canals, they disrupt the normal signals sent to the brain about head position. This results in brief episodes of vertigo when the head changes position. Commonly, vertigo symptoms last up to 30 seconds before resolving, until the head moves again.
Although BPPV can affect people of any age, it is more common in adults over 40. Most of the time there is no clear cause for the onset of BPPV, although it can also develop after a minor head knock or illness.
Common Symptoms of BPPV
Symptoms are typically triggered by specific head movements. These may include:
Sudden spinning sensations when rolling in bed
Vertigo when looking up (for example, hanging out the washing or washing your hair)
Dizziness when bending forward or tilting the head back
Brief episodes of nausea
Unsteadiness or feeling off balance
Symptoms that last seconds to about a minute
How Physiotherapy Can Help
The great news is that BPPV is highly treatable with physiotherapy.
A physiotherapist trained in vestibular rehabilitation can assess your symptoms and perform specific positional tests to determine which semicircular canal is affected. Once identified, treatment typically involves a sequence of guided head movements designed to move the displaced crystals back to their correct position.
One of the most well-known and effective treatments is the Epley manoeuvre. This manoeuvre addresses BPPV in the posterior semi-circular canal, which accounts for between 60-90% of all types of BPPV.
The Epley manoeuvre is a safe and evidence-based treatment that uses a series of gentle head and body movements to guide the displaced crystals out of the posterior semicircular canal and back to the area where they belong. Each position is held briefly to allow gravity to help move the crystals through the inner ear.
Many people experience significant improvement after just one or two treatments, although some cases may require additional sessions.
What to Expect After Treatment
After an Epley manoeuvre, it is common to feel a bit off (or much of the same) for the rest of the day. Most of the time, people notice improvements within the next few days.
When to Seek Help?
If you are experiencing repeated episodes of positional dizziness or vertigo, it is worth having it assessed by a physiotherapist. Proper diagnosis is important, as not all dizziness is caused by BPPV. With the right assessment and treatment, most people are able to return quickly to normal daily activities.