BPPV clearly explained

BPPV is very common type of vertigo

bppvBenign paroxysmal positional vertigo, for the sake of everyone’s convenience, is thankfully referred to as BPPV or positional vertigo.

As well as feeling as though inanimate structures and objects are spinning around them, BPPV causes people to feel unbalanced, dizzy and nauseous.


It is a non-life-threatening disorder of the inner ear that causes vertigo.

By in large, it affects those over 60 and can, in most cases, be cured with a simple physical therapy maneuver. BBPV typically occurs in either the right or left ear but can sometimes be bilateral, meaning both ears are affected. To understand how it happens requires a bit of ‘sciencey’ terminology but I’ll do the best I can to simplify it.

You can also read more scientific BPPV overview here

Why is it happening?

You see, there is a small organ inside your ear called the vestibular labyrinth. Inside that, there are semicircular canals that contain fluid and fine, hair-like sensors that monitor the rotation of your head. Other structures monitor the head’s direction and are known as otolith organs- the utricle and saccule.

They contain tiny calcium crystals. When these crystals get dislodged, which can happen for a number of reasons, they are free to float around and can find themselves in one of the semicircle canals.

When you move your head, they move as well, which causes an unwanted flow of fluid in the semicircle canal, even after the head has stopped moving. This leads to a false sense that your head and body, or the world around you is spinning.


Subtypes of BPPV are distinguished by the particular semicircular canal involved and whether the detached crystals (known as octoconia) are free floating within the affected canal (canalithiasis) or attached to the cupula (cupulothiasis.)

The most common form, accounting for over 80% of all cases, is canalithiasis. This occurs in the prosterior canal which makes head movements like looking up, or rolling over and getting out of bed problematic.
BPPV may be experienced for a short period of time but can last a lifetime with symptoms re-occurring intermittently in a pattern that varies by duration, frequency, and intensity.

Although not considered life-threatening, BPPV can have a severely debilitating effect on a person’s work and social life. Routine tasks like getting groceries, cleaning driving, etc become almost impossible. BPPV also poses a health risk due to an increased risk of falls associated with dizziness and imbalance.

What to do about it?

The most common and effective treatment for BPPV is known as the canalith repositioning procedure. The procedure consists of several simple and slow maneuvers for positioning your head. The aim is to move the particles from the semicircular canal to the utricle where they don’t pose a problem. Each position is held for around 30 seconds after any symptoms or abnormal eye movements stop.

The procedure is usually effective after one or two treatments, and your healthcare practitioner will show you how to perform it yourself. Following the procedure, you should avoid lying flat or placing the treated ear below shoulder level for the rest of the day. It is advised to go to sleep on a few pillows, which gives time for the crystals to move from the affected area to a place where they no longer impact upon your balance.

If the therapy is ineffective, which is very rare, surgery might be recommended. A bone plug is used to block the portion of your inner ear that’s causing dizziness. The plug prevents the semicircular canal in your ear from being able to respond to particle movements or head movements in general. It’s been proven very successful with a success rate of over 90%.

If BPPV recurs, there is a host of support and tips out there to manage your symptoms. Sitting down as soon as you start to feel dizzy, a walking stick or cane, suitable lighting and doctor consultations can all contribute to the effective management of positional vertigo.

One of the best sources of advice can come in the form of support groups, either in your local community or online. The internet gets a lot of slack for alienating us from real social interaction, but online support groups do the opposite. They offer sufferers real human conversations with people who share their burden, people they would never meet in real life.

This is especially valuable for people who live alone, or live remotely. As a long-term sufferer, it can give you the opportunity to help those who have just been recently diagnosed, a positive change from the helplessness you’re used to feeling when your body slacks on the job it was designed to perform. I would recommend the following websites to connect with people who are there to offer their support.

The best I’ve found is:


If you prefer face to face interaction, you can ask your doctor about the nearest support group for sufferers of BPPV and related disorders.

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