You may get a sudden episode of vertigo, you may experience sudden dizziness or nausea, moving your head may cause you to get dizzy, or your eyes may go into a flickering, which is called a nystagmus.  Even rolling over in bed or just looking up can trigger dizziness or severe vertigo in some cases.

Because dizziness and vertigo are so common, it’s very important to have BPPV diagnosed correctly. At our clinic in Brisbane we have vertigo specialists who can do this, or your GP may use several tests to be able to diagnose the type of Vertigo you have and which side it’s occurring on.

We find that in our clinic a lot of BPPV symptoms have gone away after only two treatments. In the few days following a treatment it’s important that the patient takes good care of themselves to ensure the little ear rocks do not go back into the canal where they were stuck. Preventative methods include:

• sleeping propped up at a 45 degree angle
• Avoiding sudden movements of the head and neck
• No bending over
• No picking up heavy objects
• No looking up into the sky

Benign paroxysmal positional vertigo, or BPPV, is a condition that presents in the inner-ear, typically triggered by changes in position of the head or body. Often, these symptoms will only last for a moment or two but if left untreated will continue to return. Common positions or actions that can bring about these symptoms include rolling in bed, getting in or out of bed, or even simply getting up from a chair.

As well as dizziness or spinning sensations, patients may also experience nausea, vomiting, or be unsteady on their feet. Neck pain and stiffness, headaches, and jaw pain can also be related to either the onset or ongoing effects of BPPV. Unfortunately, the cause of BPPV is not fully understood however we do know that it usually occurs after a bout of sickness that creates swelling in the ear canals or due to an event that triggers motion sickness (e.g., being on a boat). Other factors that can increase your risk of getting BPPV include family history, hormonal changes, previous history, reduced hearing, increased ringing in the ears (i.e., tinnitus) or recent ear infection. 

BPPV is a condition that affects the otoconia, or “ear rocks”, in the semicircular canals in the inner ear. Normal function of the semicircular canals is where the ear rocks move through the semicircular canals to stimulate cells, which then send information to our brain and body to help detect where we are in space. In BPPV, the ear rocks do not move properly in the canals and we therefore get conflicting messages that get sent to the brain and body, hence triggering dizziness and spinning symptoms.

Our physiotherapists are well trained at assessing and treating BPPV. Assessment is crucial to ensure that the patient is indeed experiencing BPPV, or if their symptoms are due to something else (which may require medical attention). Assessment usually starts by checking neck and eye movements to ensure that the neck and visual system is not causing any symptoms. Provided they are clear, we then move to specific BPPV tests that position the semicircular canals (horizontal, anterior and posterior in each ear) in a way that can reproduce dizziness and spinning symptoms if that specific canal is the affected one. If one of these tests is positive, then treatment focuses on a manoeuvre that helps to get the ear rocks moving normally in that canal. Treatment concludes with some advice about positions to avoid whilst your symptoms are settling, as well as a few exercises to help further reduce your symptoms and to prevent neck pain (which can occur due to patients not wanting to move their neck when they feel dizzy).

Most patients with BPPV respond positively to the canal repositioning manoeuvres and only require 1-2 treatments. Some patients will require medication to help reduce their dizziness on top of physiotherapy treatment, which can be either be purchased over-the-counter at a pharmacist or for stronger doses can be prescribed by a GP if suitable.