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Positional Vertigo: What It Is and What To Do About It

Downward view of a person's feet blurred with the leaves on the ground from Vertigo.

Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo – the sensation that the room is spinning or swaying around you. It’s triggered when tiny calcium carbonate crystals inside your inner ear become dislodged and fall into one of the balance canals – an area where they don’t belong. This leads to an intense sensation of vertigo when you move your head, especially when you look up at a high cabinet, roll over in bed or sit up. It may also cause nausea and a feeling of being unbalanced. BPPV can affect people of all ages but is most common in people over the age of 60.

The classic symptoms of BPPV are characterized by brief episodes of dizziness lasting less than a minute; however, they do recur over the span of days or even a month until completely resolving. A visit to your primary care provider is the first step to rule out other reasons for your dizziness. Diagnosing BPPV involves taking a detailed health history and performing a diagnostic text called the Dix-Hallpike maneuver to look for nystagmus. This is when your eyes exhibit rapid, involuntary eye movements that are caused by changing your head position in certain directions.

What else can cause dizziness? Learn more: I'm so dizzy! Should I Call My Doctor? 

If you are diagnosed with BBPV, your doctor can refer you to a vestibular therapist who specializes in treating vertigo with special repositioning exercises that will help move the tiny pieces of calcium back into their correct place, according to Kasey Mayer, DPT, a physical and vestibular therapist with Yale New Haven Health who treats patients in Guilford.

“We can treat BPPV with a procedure called canalith repositioning,” said Mayer. The most common repositing procedure is called the Epley maneuver, which involves a series of movements of the head, neck and body that are performed in a specific order to move the crystals that are trapped in your ear’s semicircular canal. The maneuver can be completed in office with your physical therapist and takes about five to 10 minutes. Nearly 80 percent of people experience report relief from BPPV symptoms immediately, said Mayer. 

Can you perform the Epley maneuver by yourself? While there are videos online that explain it, it’s best to talk to your healthcare provider before trying any do-it-yourself procedures. “If the Epley maneuver isn’t done correctly, it can make the vertigo symptoms worse and possibly make it more difficult to treat in the long run,” said Mayer.

Learn more about Rehabilitation Services at Yale New Haven Hospital.