Physical Therapy
BPPV (Benign Paroxysmal Positional Vertigo)
One of the most common — and most treatable — causes of vertigo.
Understanding This Condition
BPPV occurs when tiny calcium crystals inside the inner ear become dislodged from where they normally sit and drift into one of the ear's balance canals. When you move your head into certain positions, these displaced crystals send false signals to the brain about motion, producing a brief but intense spinning sensation.
BPPV is one of the most common causes of vertigo, and also one of the most reliably treatable — often resolving in just one or two visits once properly diagnosed.
What Causes It
- Head trauma or a recent concussion
- Age-related degeneration of inner ear structures
- Prolonged bed rest or inactivity
- Prior inner ear infection or vestibular neuritis
- In many cases, no identifiable cause at all
Signs & Symptoms
- Brief, intense episodes of spinning vertigo, typically lasting under a minute
- Vertigo triggered by specific head positions — rolling over in bed, looking up, bending over
- Nausea during vertigo episodes
- A sense of imbalance between episodes
How We Evaluate It
We use specific positional testing — most commonly the Dix-Hallpike maneuver — to identify which ear and which canal is affected, since accurate diagnosis is essential to selecting the correct treatment maneuver.
Our Treatment Approach
BPPV is treated with canalith repositioning maneuvers — specific sequences of head and body positioning designed to move the displaced crystals out of the affected canal and back to where they belong.
- Canalith repositioning maneuvers matched to the specific canal involved
- Follow-up positional testing to confirm resolution
- Balance retraining if any residual unsteadiness remains after the vertigo resolves
- Guidance on home exercises if symptoms return
What to Expect
Many patients experience significant or complete relief after just one or two treatment sessions, making BPPV one of the fastest-resolving conditions we treat.
BPPV can recur, particularly after head trauma or in older adults, but it responds just as well to repeat treatment when it does.
Frequently Asked Questions
How is BPPV different from other causes of dizziness?
BPPV is specifically triggered by head position changes and produces brief, intense episodes, whereas other vestibular conditions often produce more constant or gradual-onset dizziness — accurate diagnosis is what determines the right treatment.
Will the repositioning maneuver make me dizzy?
Briefly, yes — the maneuver is designed to move the crystals, which does provoke short vertigo during the procedure itself, but this confirms the diagnosis and is part of the treatment working.
Can BPPV come back after treatment?
It can, particularly after head trauma, but it responds to repeat treatment just as effectively the second time.
BPPV is genuinely one of the most satisfying conditions to treat, because the right maneuver, correctly applied, often resolves symptoms that have been disrupting a patient's life for weeks.
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1010 E McDowell Rd, Suite 410, Phoenix, AZ 85006 · Open until 7 PM Wednesdays