Self-Treatment of Vertigo (BPPV)

By Rachel Long, PT, DPT

Have you ever experienced dizziness or vertigo (the sensation of spinning) when changing positions? You may be experiencing Benign Paroxysmal Positional Vertigo (BPPV).  This condition is the most common cause of dizziness and has a high rate of resolution if correct positioning treatment is performed. 

Defining BPPV

Benign: non-life threatening (although symptoms can be intense)

Paroxsysmal: symptoms come and go in short spells

Positional: certain head positions or movements can trigger a spell

Vertigo: sensation of the room spinning

Cause of BPPV

There are crystals in the inner ear that are made of calcium carbonate. They sense change in position.  These crystals can dislodge from their normal position in the inner ear.  The crystals then float around and/or get stuck in one of the 3 three canals of the ear which cause an abnormal sense of movement (spinning) when changing positions.  They may break loose for many reasons including an inner ear infection, concussion, Meniere’s disease or migraines.  Most often, BPPV is a part of the “normal” aging process and there are no precipitating factors as previously described. 

Treatment

It is important to understand that there is no “one size fits all” treatment for BPPV.  The calcium carbonate crystals can float into one of three canals of the ear.  They can also get “stuck” in a part of the ear.  A physical therapist can assess which ear is affected and in which canal the crystals are located to choose the appropriate repositioning technique. 

The most common technique is called the Epley Manuever and involves a series of particular head and body positions with the goal of moving the crystals into the correct position.  If you are able to localize a side that is more symptomatic when turning the head or rolling, a home modification of the Epley Manuever can be performed.

The description and video below describes an Epley Maneuver for the RIGHT EAR.  If you are more symptomatic to the left, you can perform the exercise to the opposite side.  This maneuver should only be performed if you are experiencing dizziness.  It will not work to prevent future episodes of dizziness.

  1.  Sit on a bed with your legs extended and 2-3 pillows on the bed behind you.
  2. Turn your head to the right about 45 degrees and quickly lay back.  It is normal (and expected) to experience dizziness in this position.  Wait until the dizziness subsides and then stay in that position for another minute. 
  3. Keep your head extended and turn your head to the left.  If any dizziness is present, wait until it subsides and then wait another minute.
  4. Roll onto your left side.  As you are rolling, tuck your chin to your chest.  You may again experience dizziness (don’t panic, this is a normal response).  Hold this position for a minute after the dizziness subsides.
  5. Swing your legs off the bed and sit up (while keeping your head in the same position).

You can repeat this maneuver until you are asymptomatic. If you are not having success with home treatment, it is important to reach out to a vestibular specialist to perform a thorough evaluation.  Contact us today to schedule your evaluation.  80% of BPPV cases can be resolved with as little as one session!  Stop avoiding activities and/or head positions that bring on your dizziness…..IT CAN BE TREATED!!

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s