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Positional Vertigo (BPPV)

Positional Vertigo

  • Have you experienced dizziness, brought on by movement of your head or certain positions? 
  • Did you know that with specialised assessments, specific repositioning techniques can resolve your symptoms quickly?  
  • Has your GP told you that you have BPPV? 

What is Positional Vertigo (BPPV)?

BPPV is a common and debilitating condition that can affect people of all ages. Symptoms often come on without warning and can be frightening, especially if it is your first episode of the condition. 

BPPV stands for Benign Paroxysmal Positional: 

  • Benign – non-life threatening 
  • Paroxysmal – comes and goes, symptoms are transient 
  • Positional – brought on by moving your head and changing your position; typically getting in or out of bed, rolling in bed, looking up and bending down to the floor 
  • Vertigo – a false sense of motion such as room-spinning or a feeling of falling. 
     

BPPV is often called ‘positional vertigo’ due to the fact that it is movement of your head that provokes the symptoms. 

BPPV is caused by the dislodgement of ‘otoconia’ or small crystals that form in your inner ear (vestibular system), causing your symptoms. Although the symptoms can sometimes go away on their own, unmanaged BPPV most often persists for long periods of time, impacting significantly on your ability to participate in your usual activities.  

Many people do not realise that treatment is available. Fortunately BPPV is very treatable, with most symptoms resolving in one session for many people. There can be complex presentations as well and in this case, specialised assessment and supportive treatment is important for recovery and in learning to manage the condition.  

Common Symptoms

  • A sense that you or your surroundings are spinning or moving (vertigo) 
  • A loss of balance or unsteadiness when standing or walking 
  • Nausea 
  • Vomiting  
  • Abnormal rhythmic eye movements called nystagmus (usually present) 


Symptoms can come and go and can last anywhere from seconds to minutes. 
Some people experience less intense symptoms in between the acute symptoms, often described as a constant vague dizziness or as “not feeling quite right”. 

Common Associations for BPPV

Although there is often not one particular incident that results in BPPV, there are certain risk factors and situations that may make you more likely to experience episodes:

  • Head injury or trauma 
  • Prolonged time spent lying down e.g. in a dentist chair or surgery 
  • Female 
  • Low vitamin D levels 
  • Older age 
  • Other inner ear or vestibular disorders 
  • Migraine history – even in the past 
  • Stress 

How can we Help?

Our advanced trained physiotherapists (Vestibular Physiotherapists) use highly specific ‘repositioning techniques’ to shift the ‘otoconia’ or ‘crystals’ from the problematic area of your inner ear. There are a number of techniques that might be prescribed, the choice of which depends on careful assessment. Our Vestibular physiotherapists use cutting-edge technologies such as infrared video goggles and specific diagnostic tests to identify exactly where the problem is to ensure they administer the correct technique to treat your specific problem.  

As episodes of BPPV can recur, it’s really important to gain a good understanding of the condition, so you can recognise it and manage it quickly, before it impacts on your life or worse, results in a fall.  Our physiotherapists can teach you what you need to know, and how to mange the signs of BPPV early, preventing further injury. 

What Should I Expect From my Appointment?

  • Detailed Interview: This helps us to gain a full understanding of your symptoms, medical history and what you hope to achieve from our intervention. 
  • Support: We understand how frightening it is to experience vertigo, dizziness and imbalance so we will take care to address all of your needs to help you feel safe to participate in the assessment and treatments. 
  • Physical Assessment: We take a considered approach to assessing your body, head and eye movements and vestibular reflexes, using the latest technology. This enables us to accurately assess your function and develop a customised treatment plan for you. 
  • Education: We believe that your understanding of the findings, condition and aims of treatment is important to your outcome, so we will spend time explaining key points. 
  • Targeted Treatments: We use specialised treatment methods, such as repositioning techniques, to manage your symptoms.  In some cases, this can lead to immediate improvement in your symptoms and movement.  
  • Progressive Exercise Program: We teach you specially designed exercises and movements to retrain your brain, to enable independence and safely build confidence, capacity, coordination and balance, in line with your lifestyle goals. 
  • Communication and Collaboration with your General Practitioner and/or Specialist doctors to keep them informed of your progress and to support your care.  

Where can I see my Physiotherapist?

On this page

In Clinic

Online Video Appointments

Web & Mobile App

Private Gymnasium