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Writer's pictureKim Cole

The Not So Merry-Go-Round: Understanding BPPV

Updated: Oct 29

As a child, I enjoyed riding on the merry-go-round. That is, until I got dizzy and would get off, waiting for my head to stop spinning so I could play again. Some people, however, can’t step off their personal merry-go-round.


Benign Paroxysmal Positional Vertigo, also known as BPPV, is one form of vertigo or spinning type dizziness that occurs in our inner ear. Treatment by a skilled medical practitioner can usually alleviate the symptoms in 1 to 3 visits.


What are symptoms of BPPV?

Symptoms include:

  • Dizziness

  • Feeling that surroundings are spinning or in motion (vertigo).

  • Loss of balance, even while standing still or laying in bed.

  • Nausea

  • Vomiting


While there are different factors that create a BPPV attack, the most common is head movement. Each attack can last from a few seconds to a few minutes or even longer. It typically is accompanied by involuntary, jumpy eye movement, called nystagmus. People prone to BPPV usually are over the age of fifty, have suffered a head injury, or have a disorder of the balance organs.


What causes BPPV?

Often we do not know what causes an episode of BPPV, hence the phrase idiopathic. However, some known causes of BPPV are:

  • A mild to severe blow to the head.

  • A concussion

  • A motor vehicle accident.

  • Not moving the head for a long time, such as in the dentist chair, salon, lying down during recovery, etc.

  • Rigorous activities, such as biking on rough trails and high intensity aerobics.

  • Other inner ear diseases, such as an inflammatory condition.


The vestibular system is designed to monitor and regulate body/head position. Any insult to this system can create balance problems. A brief anatomy lesson will help you understand BPPV more clearly. The inner ear contains the vestibular labyrinth made up of three, loop-like structures called the semicircular canals and the cochlea. Between each structure is a chamber called the vestibule.




Inner Ear


Situated in the vestibule are otoliths glands which contain calcium crystals that are sensitive to gravity. Sometimes these crystals dislodge and drop into one of the semicircular canals. Then, when you move your head, these crystals stimulate the sensitive hairs that line the semicircular canals and create a false sensation that the body is moving, resulting in your sensation of spinning or dizziness.




What is the treatment?


Treatment for BPPV (calcium crystals in the semicircular canal), the most common form of inner ear maladies, is easier than you might think. The goal is to return the dislodged crystals to the otoliths and out of the semicircular canals. It requires no special equipment, surgery, or medication. A medical professional skilled in vestibular disorders can evaluate you to determine the best form of treatment and often perform a simple procedure such as the Epley maneuver to return the crystals to their normal position. The practitioner will run a battery of tests to determine which side is affected and where the crystals are interfering. The practitioner will then perform the procedure to move the crystals out of the semicircular canal back into the otia. The treatment process usually takes less than 30 min and often resolves the problem within 1-3 treatments.


Your therapist may provide you with an option for home treatment or give you exercises to reduce your risk of recurrence. Let’s explore a few of the options available.

  • ½ Summer Adult Maneuver

    • This self administered maneuver shifts the dislodged particles by kneeling and lowering the head to the floor, followed by lifting the head up to be level with your back. This maneuver is similar to the Epley maneuver, but it requires more flexibility.

  • Brandt-Daroff Exercise

    • This simple exercise is used when the affected ear canal is unclear. It is a simple exercise, but requires consistent execution over one to two weeks to see results. This exercise sometimes stimulates vertigo symptoms. If this happens, stop the exercise and contact your medical provider.

  • Yoga and Tai Chi

    • Simple yoga moves can help train your brain how to compensate for the effects of vertigo. Take it slow, you don’t want to trigger another vertigo attack. Moves such as Child’s Pose and Corpse Pose is a good place to start.

  • Stress management

    • Stress can contribute to BPPV and vertigo, so learning how to manage stress is beneficial. Breathing exercises, meditation, and acknowledging your stress may help reduce BPPV symptoms.


There are other options that can help once we know what is causing the dizziness. Click here to learn more exercises and helpful tips. If your symptoms persist, additional treatments with the medical provider may be needed until the symptoms resolve for at least twenty four hours.


What can be done to avoid BPPV?


While we don’t always understand the cause of BPPV, we do know a few ways to reduce the odds of experiencing the vertigo after being diagnosed:

  • Don’t sleep on the affected ear.

  • Avoid the specific head movements which bring on vertigo, such as looking up.

  • When waking up, do so slowly and sit in bed for a few minutes.


If symptoms persist or intensify, call your primary care provider


Understanding the inner ear and the proper exercises to correct the situation brings you a step closer to achieving a healthy, balanced life. (Pun intended). If you are experiencing any symptoms of BPPV, consider contacting your medical provider or a skilled physical therapist for assistance.


CoreFit has skilled therapists to help you with your vertigo symptoms. You may contact us through Facebook or our website so that you too can get off your personal merry-go-round.


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