BPPV: Why you get sudden vertigo & how physio helps
Woke up dizzy? Feel like the room spins when you roll over in bed?
It could be BPPV (Benign Paroxysmal Positional Vertigo), one of the most common and treatable causes of vertigo in Adelaide.
Learn what causes BPPV, how long it lasts and how physiotherapy can help you feel balanced again.
TL;DR: BPPV| The key takeaways
- BPPV is a common, mechanical inner-ear problem causing bouts of vertigo
- It’s caused by tiny crystals moving in the canals of your inner-ear
- Physiotherapy manoeuvres (e.g. Epleys, Brandt Daroff) fix BPPV in 2-3 sessions for most people
- Symptoms are triggered by rolling in bed, looking up, sitting up from lying position or quick head turns
- BPPV is not dangerous but can be very uncomfortable and disruptive to your function
- Early physio intervention leads to faster resolution
- Recurrence may happen but is easily managed
What is BPPV?
BPPV stands for Benign Paroxysmal Position Vertigo.
The name sounds dramatic but the condition itself is very common and very treatable.
BPPV happens when tiny calcium crystals (called otoconia) inside the inner ear move into the wrong pot.
It’s like having a small pebble stuck in a wheel bearing and every time the wheel moves, things feel unstable.
When you change head position, these loose crystals roll affect the motion of the fluid in the inner ear and sends “confusing” signals to the brain, causing:
- Sudden spinning sensations (vertigo)
- Dizziness when lying down or rolling in bed
- Unsteadiness when turning your head
- Nausea (in moderate causes)
BPPV is mechanical in nature and not dangerous and is easily treated with hands-on physiotherapy.
How common is BPPV in Australia?
BPPV is one of the leading causes of vertigo, especially in adults over 40.
Australian data suggests:
- Around 30% of vertigo cases seen in primary care are BPPV related
- Women are affected slightly more than men
- It’s extremely common after mild head knocks, falls or even dental procedures
In Adelaide, we see BPPV often in everyday people from office workers to retirees to athletes.
What Causes BPPV?
Common triggers include:
- Recent viral illness / infections
- Minor head bumps
- Age-related changes in the inner ear
Sometimes BPPV occurs “out of the blue” with no clear cause.
Symptoms You should not ignore
Most BPPV symptoms are short-lasting (seconds to a minute).
Seek medical advice if you have:
- Persistent severe headache
- Double vision
- Hearing loss or ringing (tinnitus)
- Numbness, weakness or difficulty speaking
The above symptoms are not typical of BPPV and need urgent assessment.
How Physiotherapists diagnose BPPV
At Physio Physique, the physio will run through a clear and gentle assessment to confirm the diagnosis and address any contributing factors that may be responsible for your symptoms.
History Check
We look at your dizziness & vertigo triggers, patterns, duration and any red flags
Positional Testing
The physiotherapist will use the Dix-Hallpike test to identify which canal is affected.
A positive test can trigger a specific involuntary eye movement (nystagmus) and reproduce symptoms.
Balance Assessment
Some people will have lingering imbalance after BPPV resolves so we need to assess balance to ensure everything is resolved.
Contributing Factors
Assessment of the neck, shoulders and jaw is also necessary to ensure other potential factors are addressed as needed.
Evidence based physio treatment: Canal repositioning maneouvres
BPPV rarely settles quickly on its own and will require specific techniques to settle the vertigo quickly.
Epley Manoeuvre
The gold standard for posterior canal BPPV. Approximately 85-95% of people improve after 2-3 treatments.
Semont’s Manoeuvre
Also used to treat posterior canal BPPV however may trigger severe dizziness and be less tolerable by patients.
Lampert / Barbeque Roll
Used to treat horizontal canal BPPV.
How long does BPPV Take to recover?
Most people improve significantly within 2-3 physiotherapy sessions.
Recovery varies depending on:
- The canal involved (anterior, posterior, horizontal)
- How long you’ve had symptoms
- Your sensitivity to movement
Some people may feel fatigued or a bit “floaty” for a day or two and usually returns to full stability within a few days once symptoms resolve.
Can BPPV Come back?
Yes, approximately 30% of people will have another episode within a year.
The good news is that recurrences are usually milder and physio treatment works just as well the next time.
FAQs
Is BPPV dangerous?
No. BPPV is uncomfortable but not harmful or life threatening.
Can you drive with BPPV?
We recommend that you avoid driving as a precaution until the vertigo and spinning settles. Safety first.
Do I need scans?
No. BPPV is diagnosed clinically.
Can stress cause BPPV?
Stress does not cause BPPV however it may amplify your symptoms once present.
Will medication fix BPPV?
No. Motion sickness tablets may reduce nausea but does not fix the underlying cause which are the otoconia in the inner ear canals.
Stop the spinning and regain your equilibrium
If you’re waking up dizzy, feeling unsteady or noticing your vertigo gets triggered by simple head movements, get in for a treatment today.
Physiotherapy treatment for BPPV is fast and effective.
References
Silva, A.L.d.S., Marinho, M.R.C., Gouveia, F.M.d.V., Silva, J.G., Ferreira, A.d.S. & Cal, R. (2011) Benign Paroxysmal Positional Vertigo: comparison of two recent international guidelines, Brazilian Journal of Otorhinolaryngology, 77
(2), pp.191–200.
https://www.sciencedirect.com/science/article/pii/S1808869415308090
