BPPV (Vertigo); and What Causes It?

May 19, 2022

ProActive Physical Therapy

by ProActive Physical Therapy

Are you experiencing a feeling of spinning, dizziness, imbalance, or nausea? Are these symptoms associated with movements like rolling over in bed, turning your head, moving from sitting to lying down, or bending forward? Does the feeling last less than a minute?

If you answered yes to any of the above questions, you may have a condition known as Benign Paroxysmal Positional Vertigo or BPPV. BPPV is the most common peripheral vestibular disorder, making up 50% of all vestibular cases. So what exactly does that mean? Let’s break it down:

  • Benign = Harmless
  • Paroxysmal = Sudden onset or increase in symptoms
  • Positional = Determined by position
  • Vertigo = Sensation of rotation

BPPV is a vestibular disorder, meaning it affects the parts of your body that help you balance. There are two forms of BPPV, but both are inner ear disorders that involve calcium carbonate crystals, or “ear rocks”, in the semicircular canals within the inner ear becoming displaced. These ear rocks are gravity-sensitive, so they relay information to the brain about where your head is located in relation to your body. When these crystals are displaced, they can generate symptoms including spinning and/or imbalance.

The first form of BPPV is cupulolithiasis. It is caused by ear rocks getting stuck in the wrong place within the ear. Symptoms occur when you move into a certain position and begin to feel symptoms immediately, and these symptoms are longer lasting.

The second type of BPPV is canalithiasis, and it is the result of ear rocks floating freely in the ear canals. With this form of BPPV, symptoms usually do not begin until 3-5 seconds after you’ve moved into an irritating position, and they usually resolve within 45 seconds.

A woman is holding her ear in pain.

Possible causes of BPPV include head injury or whiplash, recent dental work, history of inner ear disease, osteopenia/osteoporosis, prolonged immobility, and – perhaps the most common – idiopathic BPPV, meaning symptoms simply occur out of nowhere. Treatment options include the following:

  • Wait for symptoms to resolve on their own, which can take 6 months or more
  • Contact your physician and receive medication to suppress the vestibular system
  • See a physical therapist

There are several well-researched and effective hands-on techniques to promote rapid relief for patients. Research shows that when the goal of treatment is to reposition ear rocks, between 70-95% of patients experience permanent relief of symptoms after as few as 1-3 treatments. This means that someone with powerful vertigo could have permanent relief after just a few sessions of physical therapy.

The prevalence of BPPV may be higher than you think. According to research, it affects 11% of 75-year-olds and 9% of the geriatric population as a whole. This can be a serious problem if left untreated, as it can lead to decreased activity, a greater risk of falls, and even depression. Spreading awareness is essential. Physical therapists are educated and qualified to perform techniques and treatments that provide relief and can improve their quality of life. PTs are movement experts, and the vestibular system is an integral part of the movement. Vertigo can make it difficult to perform exercises and even do daily tasks.

BPPV can be easily and quickly treated by a physical therapist in only one or two visits if properly diagnosed.  A free assessment will direct you to the right course of treatment, or refer you to an MD if you have a sudden onset of dizziness or imbalance. BPPV is just one of many vestibular disorders, so talking to healthcare professionals about symptoms is extremely important.

Schedule a free consultation at ProActive today if you have questions or concerns about vertigo or any other issues we could help with. If you have problems with dizziness and/or balance and have not seen a professional, or have not been getting the results that you have hoped for, please call us to schedule an evaluation of your condition.

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