Benign Paroxysmal Positional Vertigo: Is Your Dizziness Caused By BPPV?






















What is BPPV?

If you’ve ever experienced brief episodes of vertigo when lying down, sitting up, or rolling in bed, BPPV may be to blame. BPPV, or benign paroxysmal positional vertigo, is a common condition that affects the vestibular system (the inner ear). In people with BPPV, it is thought that calcium carbonate particles become dislodged from a structure inside the inner ear. Movement of these particles, which are often referred to as “crystals,” can cause brief episodes of dizziness.

What are the symptoms of BPPV?

The classic symptom of BPPV is vertigo, a sense of spinning, that is brought on by changes in head position with respect to gravity. However, some people that have BPPV do not experience true vertigo and may instead complain of lightheadedness or imbalance when a change in head position has occurred. Symptoms typically last seconds to minutes before resolving. It is also common for people with BPPV to experience nausea and/or vomiting.

What kind of movements can provoke BPPV symptoms?

Movements that involve pitching the head forward or backward, especially when combined with head rotation, can provoke symptoms. Commonly, BPPV symptoms are provoked with lying down, sitting up, and rolling in bed, bending forward, and pitching the head back in the shower.

What causes BPPV?

BPPV occurs frequently in older adults due to the degeneration of structures within the inner ear that occurs over time. The most common causes of BPPV in people under 50 is head trauma, which can be direct or indirect (such as a whiplash-type injury). Additional risk factors for BPPV include female gender, osteoporosis, Vitamin D deficiency, family history of BPPV, a history of migraines, and a history of other vestibular disorders, such as vestibular neuritis or Meniere’s disease.

How is BPPV treated?

Because BPPV is benign, you will not cause any additional harm to your inner ear or your body if you choose not to seek treatment. It is possible for symptoms to resolve spontaneously within several months. However, because the disorder can last longer than this and may increase your risk of falling, it is often best to actively seek treatment. BPPV treatment may be performed by a physical therapist, an audiologist, or a physician.

To treat your BPPV, your health care provider will perform an assessment to determine which ear is affected and where the crystals are located within the ear. A maneuver can then be performed to remove the crystals from the affected part of the inner ear (a canal). Maneuvers typically take several minutes to perform and have been shown to be very effective in alleviating symptoms.

I think I may have BPPV, what should I do?

Come see us at FYZICAL Therapy and Balance Center in Rockville, MD! We treat this condition all the time and would love to help you or your loved ones. You can request an appointment by emailing us at or calling us at 301-948-4395.

To reduce symptoms temporarily in the meantime, you can sleep with your head elevated on several pillows and try to avoid bending forward and pitching your head backward. After sitting up in bed, try to remain seated on the edge of the bed for several minutes before you try to stand up.