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  • Emily McGuire

Relieving the Spin: How Physical Therapy For Vertigo Alleviates BPPV Symptoms

Benign Paroxysmal Positional Vertigo (BPPV) can be an incredibly disorienting and unsettling condition. Characterized by brief but intense episodes of vertigo triggered by specific head movements, BPPV can significantly impact one's daily life and overall well-being. The good news is that BPPV can be effectively treated with physical therapy, specifically vestibular therapy, helping individuals regain their sense of balance and conquer the dizziness.

Woman experiencing BPPV symptoms

What is BPPV?

BPPV is a common inner ear disorder that causes brief episodes of intense spinning or vertigo. These episodes occur suddenly and are typically triggered by specific head movements. BPPV occurs when tiny calcium carbonate crystals, known as otoconia, become detached from their usual position within the inner ear and travel through the semicircular canal.

Diagram of a normal inner ear vs one with vertigo

Signs and Symptoms

Recognizing the signs and symptoms of BPPV is crucial for seeking timely treatment. Common indicators include:

  1. Vertigo: The hallmark symptom of BPPV is a strong sensation of spinning or whirling, often brought on by changes in head position. This sensation can last for just a few seconds to a minute.

  2. Nausea and Vomiting: Vertigo in BPPV episodes can be severe, leading to nausea and sometimes vomiting.

  3. Unsteadiness: Individuals with BPPV often feel unsteady, as if they might fall, especially when getting out of bed or looking up.

  4. Nystagmus: During a BPPV episode, abnormal rapid eye movements, known as nystagmus, may occur. A healthcare professional can detect this through an examination.

Diagnosis of BPPV

Diagnosing BPPV typically involves a combination of patient history, physical examination, and specific tests. The diagnostic process includes:

  1. Patient History: The healthcare provider will inquire about the patient's symptoms, their onset, duration, and any specific triggers.

  2. Physical Examination: The provider will perform a physical examination that may include evaluating the patient's eye movements and coordination.

  3. Dix-Hallpike Test: This is a common diagnostic maneuver used to provoke BPPV symptoms. During the test, the patient's head is moved into specific positions while the provider observes for nystagmus and reports of vertigo from the patient.

Treatment Through Physical Therapy

Vestibular therapy is a specialized form of physical therapy used to treat and improve the symptoms caused by vestibular disorders. This form of therapy is a highly effective and non-invasive treatment for BPPV. Here's how it works:

  1. Assessment: The physical therapist conducts a thorough assessment to determine the type and location of the BPPV (which ear canal is affected).

  2. Epley Maneuver: The Epley maneuver is a well-established technique used to treat BPPV. It involves a series of guided head positions to transfer the loose otoconia back into their correct position within the inner ear.

  3. Education: Physical therapists educate patients on how to avoid triggering head positions and movements that can exacerbate BPPV symptoms.

BPPV Treatment Demonstration

Benefits of Physical Therapy for BPPV

Physical therapy offers numerous advantages for BPPV patients:

  1. Quick Relief: Many patients experience a significant reduction in vertigo and other BPPV symptoms after just one or two sessions of physical therapy.

  2. Non-Invasive: Physical therapy is a non-surgical and drug-free approach, minimizing potential side effects and complications.

  3. Improved Quality of Life: By addressing the root cause of BPPV, physical therapy significantly improves a patient's overall quality of life, restoring their sense of balance and reducing the fear of vertigo.

Rehab United Can Help

Benign Paroxysmal Positional Vertigo can be unsettling, but it is treatable, and physical therapy is an effective tool for managing this condition. If you or someone you know is grappling with BPPV, consider seeking the expertise of a physical therapist. With their guidance and the appropriate maneuvers and exercises, you can regain your equilibrium and enjoy a life free from the disruptive symptoms of BPPV. Don't let vertigo spin you out of control; physical therapy can help you find stability once more.


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Emily McGuire is a Marketing Associate and staff writer for Rehab United. With a Bachelor's degree in International Business from UC San Diego, she is a California native with a passion for writing, digital marketing, health, and wellness.

Medically Reviewed By: Brittany Hollenbeck, PT, DPT, FAFS, CERP, BFRC,a physical therapist, certified vestibular physical therapist, and Clinic Director of Rehab United in La Mesa. She received her Doctorate in Physical Therapy in 2015 from San Diego State University and has stayed at the forefront of evidence-based treatment techniques through various continuing education courses. She has treated numerous injuries and disorders involving musculoskeletal, nervous system, and vestibular pathologies with great success.

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