Understanding BPPV – Benign Paroxysmal Positional Vertigo

Have you ever felt the rush of dizziness when standing up too quickly, or looking up to the ceiling? Maybe you’ve experienced your eyes filling with ‘stars’ when you look up from tying your shoe.

This light-headed feeling could be BPPV (benign paroxysmal positional vertigo), a common inner-ear problem which causes vertigo and dizziness when you move your head.

In this blog, we investigate this pesky but common condition, and how you may be able to treat and prevent it with physiotherapy.

What is BPPV?

Benign paroxysmal positional vertigo (BPPV) is a common inner ear disorder causing brief episodes of dizziness or vertigo when you move your head.

By looking at the name itself, you can learn almost everything you need to know about BPPV and its symptoms:

Benign: non-life threatening

Paroxysmal – sudden and short lived

Positional vertigo – caused by movement or positioning of the head and inner ear area ^[1]

Our ear is a complex structure, with three main sections – the inner, middle and outer ear – each serving an important part in our hearing and also our balance. When a person suffers with BPPV, feelings of dizziness and nausea can also upset their balance.

What are the symptoms of BPPV?

BPPV symptoms are brought on by changes in head position, such as rolling over in bed, getting out of bed, lifting your head to look up or bending down. Some of the most common symptoms are:

• Dizziness
• Nausea
• Imbalance
• Vomiting

These symptoms usually last anywhere from a couple of seconds to a few minutes, and usually resolve themselves without treatment.

Things you won’t experience with BPPV include:

• Ringing in the ears (tinnitus)
• Hearing loss

If you experience BPPV symptoms coupled with the two above, or any others, speak to your doctor for advice.

What causes BPPV?

BPPV occurs when small crystals in the ear become dislodged and settle in the fluid-filled semicircular canals of the inner ear. These canals are part of our balance system. When a crystal is moving within these canals, it causes the feeling of dizziness.

There are several things which could cause BPPV including:

• Head trauma, including a knock to the head or concussion
• Recent inner ear infection
• Spontaneous with no known cause, with increasing risk as we age.

Given there are many potential causes for BPPV, there are also a number of treatment options – one popular but somewhat unthought-of option is physiotherapy. ^[1]

How can physio help BPPV?

You might be surprised to learn a physio may be able to assist with an inner ear problem. Although we can’t treat the areas of the ear, there are lots of things a physio can do to help the overall positioning and movement of your head and body to hopefully reduce, or end, your BPPV episodes.

Things a physiotherapist can do to help BPPV include:

• Manual treatment: mobilising certain muscles in the back and neck can ensure better movement of the head. This can also release any tension which is temporarily inhibiting you from moving your head normally.
• Exercise and stretching: you may benefit from strengthening certain areas of your neck and back, which can improve your posture, balance and movement.
• Targeted hand, eye and body movements: when you are stretching or exercising, there could be additional movements you should do to strengthen your overall movement.
• Regular treatment: treating BPPV with physio is different for everyone, but keeping in touch with a physio to monitor occurrence and strengthening options is important for long-term treatment outcomes.

Working with The Brisbane Spine Clinic

The Brisbane Spine Clinic team is made up of experienced and friendly physiotherapists who understand how disruptive ongoing BPPV can be to your life.

We can help you diagnose, treat and understand BPPV with precision and care, using our client-centred approach. From your first appointment onwards, we’ll work with you to:

• Assess and diagnose your BPPV
• Treat any areas of concern or potential causes
• Work with you to determine an ongoing course of treatment
• Provide you with stretches and exercises you can do at home

Book an appointment today to meet our experienced physios and get on top of your BPPV for good.

Disclaimer

All information is general and not intended as a substitute for professional advice. The Brisbane Spine Clinic can consult with you regarding your individual health needs.

References

• New South Wales Government, Benign paroxysmal positional vertigo, fact sheet, accessed online 22 January 2024, https://aci.health.nsw.gov.au/networks/eci/clinical/ed-factsheets/benign-paroxysmal-positional-vertigo.