Understanding BPPV and How Physical Therapy Can Help
- Dr. Lilly Koh
- Feb 26
- 2 min read
Benign Paroxysmal Positional Vertigo (BPPV) is a common cause of vertigo—the sensation that you or your surroundings are spinning. Although BPPV can be disorienting and unsettling, it is generally treatable through targeted physical therapy techniques. Understanding the condition and how therapy can help provides a pathway to relief and restored balance.
What Is BPPV?
BPPV occurs when tiny calcium carbonate crystals (otoconia) in the inner ear become dislodged and move into the semicircular canals. These canals help your brain detect rotational movements. When the crystals move into these canals, they disrupt the normal fluid movement and send false signals to the brain, causing dizziness.
Symptoms of BPPV:
Brief episodes of vertigo triggered by changes in head position (e.g., looking up, bending down, rolling over in bed).
Nausea or vomiting.
Loss of balance or unsteadiness.
Nystagmus (involuntary eye movements).
Causes of BPPV:
Age-related degeneration of the inner ear.
Head trauma.
Vestibular disorders.
Prolonged bed rest or inactivity.
How Physical Therapy Helps
Physical therapy plays a vital role in managing and resolving BPPV. The primary goal of therapy is to reposition the dislodged crystals back to their correct location in the inner ear to stop the vertigo.
Common Physical Therapy Techniques for BPPV:
1. Canalith Repositioning Maneuvers (CRM)
These maneuvers guide the misplaced crystals back to their proper chamber.
Epley Maneuver:
Most widely used for BPPV affecting the posterior semicircular canal.
Involves a series of head and body movements performed in a specific sequence.
Semont Maneuver:
An alternative approach involving rapid side-to-side movements.
Barbecue Roll (Log Roll) Maneuver:
Effective for horizontal canal BPPV.
2. Brandt-Daroff Exercises
These exercises involve repetitive head and body movements to help desensitize the inner ear and resolve symptoms. They are often prescribed as home exercises.
3. Balance Training
For patients experiencing lingering imbalance after vertigo subsides, physical therapists may provide balance exercises to improve stability and reduce fall risks.
Benefits of Physical Therapy for BPPV:
Rapid symptom relief.
Improved balance and reduced fall risk.
Increased confidence in daily activities.
Minimized need for medication.
What to Expect During Treatment
Initial Assessment: A thorough evaluation to confirm the diagnosis and determine which semicircular canal is affected.
Treatment Plan: Personalized exercises and maneuvers tailored to your condition.
Follow-Up: Monitoring progress and adjusting the therapy as needed to ensure optimal recovery.
Home Care Tips
While physical therapy is highly effective, there are additional steps to support recovery:
Avoid Sudden Movements: Move your head slowly to reduce symptom onset.
Sleep Position: Use extra pillows to elevate your head.
Home Exercises: Perform prescribed exercises regularly to maintain progress.
Hydration: Staying well-hydrated can help maintain vestibular function.
When to Seek Professional Help
If vertigo episodes persist, worsen, or significantly interfere with daily activities, consulting a physical therapist or healthcare provider is essential. Prompt treatment can prevent complications and expedite recovery.
Conclusion
BPPV can be a disruptive condition, but with effective physical therapy techniques, most individuals experience significant relief. If you're dealing with persistent vertigo, working with a physical therapist trained in vestibular rehabilitation can help you regain your balance and confidence.
-Dr.Lilly Koh, PT, DPT, OCS, CSCS
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