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Information

Benign Paroxysmal Positional Vertigo (BPPV)

Short spells of spinning dizziness when you move your head, caused by loose crystals in the inner ear, and how it is treated.

Illustration of a man holding his head with stars circling around it, showing dizziness.

What is it?

BPPV is a problem in the inner ear that can make you feel dizzy for a short time when you move your head in certain ways. It often happens when you lie down, roll over in bed or look up. Even if you are staying still, it might feel like you or the room is spinning. You might also feel sick to your stomach, throw up, sweat or have strange eye movements.

What causes BPPV?

BPPV happens when tiny crystals in your inner ear, sometimes called “ear rocks,” come loose and move into different parts of the inner ear. This area helps with balance. These crystals can come loose for different reasons, like after an ear infection, a fever, a head injury or whiplash. We do not know all of the causes. BPPV can also happen with other inner ear conditions or migraines. Some doctors think it can also just be a normal part of getting older.

What makes BPPV more likely to happen?

  • Being above 50 years old
  • Osteoporosis or osteopenia
  • Being female
  • Low vitamin D
  • Concussion or hitting your head
  • Other ear problems

How is BPPV treated?

Most people (about 85%) get better with special head and neck movements done by a doctor or therapist. These movements help move the crystals back to where they belong in the ear. Research shows that this treatment works the first time in 80-90% of cases.

What can I expect after treatment?

You might feel funny after treatment or feel sick to your stomach, dizzy or off balance. This might last the rest of the day and into the next day, but you should feel better after that.

Your therapist might have you limit fast head turns and looking up for a few hours after treatment. Most times, you are able to sleep normally after treatment.

Does BPPV come back?

Because we don’t know exactly what causes BPPV, we don’t know how to stop it from happening. Medicine does not help and can sometimes make things worse. If your BPPV comes back, you should call your physical therapist. The crystals in your ear might be in a different spot, so your treatment could be different than last time. Never try to fix it yourself unless your doctor or therapist tells you how.

The good news is that BPPV can be treated, and the special movements can help make the dizziness and other symptoms much better.

When should I worry about dizziness?

Go to the hospital right away if you have any of these with your dizziness:

  • Weakness in your arms, legs or face
  • You cannot talk or have trouble talking
  • Double vision
  • You cannot walk
  • One half of your face is drooping