Have you ever rolled over in bed and suddenly felt the room spinning? Your heart races as you hold onto your mattress, wondering if something serious is happening. Then, just as quickly, the spinning stops. If this sounds familiar, you might have BPPV — a common cause of vertigo that many people don't fully understand.
BPPV affects about 400,000 Australians each year and is the main cause of vertigo. 1Source: National Library of Medicine The good news is that BPPV responds very well to treatment when properly diagnosed and treated. This guide will help you understand what's happening in your ear, recognise the symptoms, and find effective treatments to stop your dizziness quickly and safely.
What Is BPPV?
BPPV stands for Benign Paroxysmal Positional Vertigo. This name might sound complicated but it actually tells you useful information about your condition.
- Benign means it's not harmful, even if it feels scary.
- Paroxysmal means symptoms come suddenly and then go away.
- Positional means certain head movements trigger your symptoms.
- Vertigo is the spinning feeling you experience.
BPPV is a disorder of the vestibular system, which maintains balance and spatial orientation. Your inner ear contains tiny calcium carbonate crystals (otoconia) that normally help with balance. In BPPV, these crystals become displaced to the wrong part of your ear. When you move your head, these loose crystals shift, sending incorrect signals to your brain. Your brain misinterprets these signals as movement, resulting in the spinning sensation of vertigo.
Many people think they're having a stroke when BPPV first occurs. But BPPV is different — it happens when you change position, lasts only briefly, and doesn't cause other symptoms like weakness or speech problems.
BPPV mainly affects people aged 50-70, with women approximately twice as likely to get it as men. 2Source: National Library of Medicine While it can happen at any age, it's rare in people under 35 unless they've had a head injury. About 10% of people will experience BPPV by age 80. 3Source: Wiley Online Library
How BPPV Feels and When It Happens
When BPPV occurs, you feel an intense spinning sensation that can be quite overwhelming. People often describe it as feeling like "the room is spinning like a washing machine" or they're "flying off the bed." The spinning typically lasts 20-30 seconds, though it often feels much longer.
You might also feel nauseous and sometimes vomit. Between episodes, you might feel a bit unsteady, but this usually improves as the main symptoms fade.
BPPV has specific triggers. The most common situations that bring on symptoms include:
- Rolling over in bed or getting up in the morning
- Looking up at a high shelf
- Bending down to pick something up
- Getting on and off a table for a chiropractic adjustment
- Tilting your head back at the hairdresser or dentist
- Lying down flat
There's usually a brief delay: you move into a certain position, then a few seconds later, the spinning begins. This delay is typical of BPPV and helps doctors distinguish it from other balance problems.
Between episodes, you might feel completely normal. Some people worry their symptoms aren't "real" because they come and go, but this on-and-off pattern is actually normal with BPPV.
Getting Diagnosed
Chiropractors along with General Practitoners diagnose BPPV using a simple test called the Dix-Hallpike manoeuvre that can be done in any clinic. This test recreates the movements that trigger your symptoms in a controlled way.
During the test, you'll sit on an exam table while your doctor turns your head to one side. They'll then help you lie back with your head slightly below the table. If you have BPPV, this movement will trigger your spinning feeling and make your eyes move in a specific pattern.
The way your eyes move helps show which part of your inner ear has the loose crystals. This guides the right treatment approach. Most BPPV cases affect the posterior semicircular canal in your ear, though other canals can be involved too.
While the test might briefly make you uncomfortable, it's needed for the right diagnosis and treatment plan. The short discomfort is worth it when it leads to effective treatment.
However, some symptoms require immediate medical attention and shouldn't be attributed to BPPV. Get emergency care if your dizziness comes with severe headache, vision changes, hearing loss, tinnitus, speech problems, weakness, numbness, or fainting. These symptoms might point to more serious conditions.
Our team of experienced chiropractors have helped thousands of patients find relief from BPPV and other vertigo conditions. They use gentle, precise techniques (including the Dix-Hallpike and Epley manoeuvres) to address both BPPV and any underlying spinal issues that may contribute to your balance problems.
Simple and Effective Treatments
BPPV treatment is quite simple. Instead of using medications, treatment involves moving your head and body in specific ways to reposition the loose ear crystals back to their correct place. These treatments are called canalith repositioning.
Epley Manoeuvre
The Epley manoeuvre is the main treatment for the most common type of BPPV. Research shows this procedure is successful for about 80% of patients after just one treatment, with most people achieving complete relief after 1-3 sessions. 4Source: Cleveland Clinic During this procedure, your doctor guides you through a series of head and body positions, each held for 30-60 seconds.
The manoeuvre starts like the diagnostic test, then continues with more position changes that help the crystals move back to their correct place. You might feel dizzy during treatment, but this actually shows the crystals are moving as they should.
Other Treatments
Other good treatments include the Semont manoeuvre and the barbecue roll technique for different types of BPPV. Your doctor will choose the best approach for your specific case.
Most people feel better right after treatment, though some have mild unsteadiness for a few days as their brain adjusts. This usually goes away within a week without more treatment.
Unlike many conditions, BPPV doesn't respond well to medicines. In fact, some dizziness medicines might slow your recovery by stopping your brain from adapting. Since BPPV is a physical problem where crystals are in the wrong place, it needs a physical solution — moving the crystals back where they belong.
Prevention and Lifestyle Tips
While you can't prevent all cases of BPPV, some simple lifestyle changes can lower your risk of getting it or having it come back.
- First, regular exercise helps prevent BPPV. 5Source: National Library of Medicine This is because physical activity improves blood flow to your inner ear and keeps it healthier.
- How you sleep matters too. Try not to sleep on the side that triggers your symptoms, and keep your head slightly raised. When getting out of bed, move slowly and sit on the edge for a moment before standing up.
- Vitamin D supplements can help prevent BPPV from returning, especially in winter when vitamin D levels are typically lower. 6Source: National Library of Medicine
- Managing stress helps too, as high stress can make BPPV worse. Good sleep, regular exercise, and relaxation techniques all support your balance system.
- Stay hydrated and cut down on alcohol, as dehydration affects your inner ear. If you have diabetes, keeping your blood sugar under control may also help reduce your risk.
When to See a Doctor
While BPPV usually gets better with treatment, sometimes you need professional help. Contact your doctor if your symptoms don't improve, keep coming back, or seem different from typical BPPV.
Treatment is usually successful when done properly. If you're not getting better, you might have a different type of BPPV, multiple affected canals, or another condition. Don't suffer in silence, other options are available.
Get immediate medical care if you have new symptoms like hearing loss, bad headache, vision problems, weakness, speech difficulties, or vertigo lasting more than 1-2 days.
Think about seeing a specialist if you feel anxious or low because of your balance problems. The unpredictable nature of BPPV can be scary and affect your quality of life. Taking care of these emotional aspects is important too.
If you want to learn self-treatment techniques, first work with a qualified professional. While some treatments can be done at home, expert instruction ensures you're using the right technique for your specific case.
Moving Forward
BPPV is one of the most treatable causes of dizziness, even though it can feel quite upsetting. With great success rates, getting professional help gives you an excellent chance of recovery.
The most important thing is getting the right diagnosis from an expert. BPPV needs specific head movements — not medicine — to guide the loose ear crystals back where they belong. With the right treatment, most people get back to their normal activities within days to weeks.
Don't suffer needlessly or waste time with treatments that don't work. Our chiropractors are experts in balance problems and have helped thousands of people with BPPV.
You can get your quality of life back completely. Book an appointment today and take the first step toward feeling steady and confident again.
