Physical Therapy Treatments For Benign Paroxysmal Positional Vertigo (BPPV)

Physical Therapy Treatments For Benign Paroxysmal Positional Vertigo (BPPV) | Washington DC Physical Therapists

Benign paroxysmal positional vertigo, or BPPV, is a non-life threatening form of vertigo.

While BPPV may be considered non-life threatening, it can affect your life in many unpleasant ways.

It’s a condition that involves the inner ear, which is a part of your vestibular system, and can cause issues with your balance.

From dizziness and unsteadiness to nausea, if this type of vertigo is bothering you, you’ll want to feel better as soon as possible.

Though it’s not a dangerous condition, having to experience vertigo constantly can make you feel like you can’t participate fully in your own life.

However, you shouldn’t worry.

There are many things that can help you live your life with vertigo.

Physical therapy is among the most effective treatments for benign paroxysmal positional vertigo.

From figuring out how you can get accommodations at work to learning how to prevent your risk of falling due to vertigo, especially for seniors, we can help.

When asking yourself where to find vestibular physical therapy for balance issues, look to Capitol Physical Therapy to start your path to improvement.

Let’s take a closer look at benign paroxysmal positional vertigo.

What Is Benign Paroxysmal Positional Vertigo?

Taking a look at the name of this disorder, it’s a bit of an alphabet soup, which is why we’ll be referring to it as BPPV or simply vertigo in this article as well.

Here is a quick breakdown of what it all means:

  • Benign – means that this condition is not life threatening
  • Paroxysmal – means that the sensations you experience happen suddenly
  • Positional – means that the condition is triggered by certain movements and changes in position
  • Vertigo – refers to the feeling that the world around you is spinning or swaying

Benign paroxysmal positional vertigo, an inner ear problem that affects about ten percent of adults, is the most common cause of vertigo.

BPPV affects the vestibular system, which is the system in your body that works to maintain your balance.

BPPV occurs when calcium crystals shift within your ear.

These crystals are normally in the utricle part of the ear, but can shift to another part of the inner ear and cause balance issues.

This can lead them to send incorrect messages to your brain and eyes regarding the position of your head movements.

When your head moves into certain positions you may experience brief periods of dizziness.

Your brain may receive signals that there’s a large amount of movement even when you’re only moving slightly.

Sometimes tilting your head, lying down, turning over, changing your bed position, or standing up can also trigger episodes of this type of vertigo.

It can feel like the world around you is spinning when you move your head.

Experiencing severe vertigo can increase your risk of falling, which can lead to physical injury and concussions.

Symptoms Of Benign Paroxysmal Positional Vertigo

Usually, a benign paroxysmal positional vertigo episode will last less than one minute.

The hallmark type of dizziness associated with this type of vertigo is dizziness that feels like the room is spinning around you.

BPPV can be triggered by many activities that you do in your day to day life.

Even though they’re beneficial to your health in a number of ways, physical activities, such as yoga and pilates, can also trigger vertigo and feelings of dizziness.

The types of activities that trigger an episode of vertigo vary from person to person.

Aside from dizziness, the following are symptoms of BPPV:

  • Feeling lightheaded
  • Vomiting
  • Nausea
  • Blurred vision
  • Unsteadiness
  • Loss of balance
  • Headaches

Abnormal eye movements, referred to as nystagmus, often accompanies an episode of vertigo as well.

Episodes of BPPV are considered intermittent, meaning that symptoms will typically stop for weeks or months before coming back again.

If you experience vertigo regularly, consider consulting with a physical therapist to help determine what triggers your episodes and how to manage your symptoms.

What Causes Benign Paroxysmal Positional Vertigo?

Benign paroxysmal positional vertigo is caused by a disturbance in your inner ear.

The tubes inside your ears, called semicircular canals, contain fluid.

There is a layer of a substance called calcium carbonate, or otoconia, in your inner ear.

This stuff is also the main component of both eggshells and pearls, strangely enough.

Sometimes, crystals of calcium carbonate may break off and enter your semicircular canals.

This can stimulate nerve endings in your inner ear and cause the dizziness you may associate with vertigo.

Often, the cause of vertigo is not known, but there are some risk factors.

Head trauma, or any other condition that damages your body’s organs, such as arthritis, can cause vertigo.

Aging and infection can also cause the crystals in your inner ear to loosen, making you more susceptible to BPPV.

Of course, seniors are more prone to falling for a number of other reasons as well.

They can be affected by conditions like Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, and other disorders.

As a result, physical therapy for seniors often focuses on vertigo as well as these other conditions, in order to reduce fall risk.

You’re also more at risk of falling if you experience chronic fatigue or are inactive and do not perform regular physical activity.

These same risk factors associated with falling also apply to your risk of experiencing vertigo.

Your risk of BPPV is also higher if you experience certain conditions, such as Meniere disease, diabetes, heart issues, allergies, and osteoporosis.

There is also some evidence that BPPV is hereditary, and it’s more common in women.

Diagnosing Benign Paroxysmal Positional Vertigo

There are different ways to diagnose BPPV.

The technique used may depend on the symptoms you’re displaying, as well as your comfort level.

A test called the Dix-Hallpike test can be used to diagnose BPPV.

This test is done by holding your head in a certain position while you rapidly lie down.

A Washington DC physical therapist can use positional tests to see if you have reactions consistent with BPPV.

You may also get a thorough physical and neurological exam for diagnosis.

This may be helpful in determining if a neurological condition or physical disorder may be the cause of your BPPV.

Caloric stimulation, a technique in which a doctor uses warming and cooling of water in your inner ear while observing your eye movements, is another common test for BPPV.

How A Physical Therapist Can Treat Benign Paroxysmal Positional Vertigo

When looking for a physical therapist you’ll want to find one who can help you evaluate and treat the dizziness and imbalance you experience from your benign paroxysmal positional vertigo.

They can also help you understand what movements may trigger your vertigo and how to work on reducing these triggers.

Ideally, your physical therapist will have experience treating people with neurological conditions and with vestibular rehabilitation.

When meeting with your physical therapist, try to practice describing your symptoms in detail so they can best assist you.

The more detailed you are about your symptoms, the better they’ll be able to provide a treatment plan that benefits you.

Next we’ll discuss some of the treatments that may be used in physical therapy to help you with your BPPV.

How A Physical Therapist Can Diagnose and Treat BPPV | Washington DC Physical Therapists

1. The Epley Maneuver

The Epley Maneuver is considered one of the most effective treatments for benign paroxysmal positional vertigo.

The maneuver involves sitting on your bed and rotating your head at different angles for spans of thirty to sixty seconds.

The goal of this exercise is to move the calcium carbonate to the correct part of your ear, so it’s no longer causing your nervous system to react inappropriately.

You can do this exercise while at home, but you may want to consider having someone else present to monitor your progress.

2. The Liberatory Maneuver

The Liberatory Maneuver is used for a longer lasting BPPV of the anterior and posterior canals.

It involves your physical therapist placing a hand on your shoulder and neck while you do a similar movement as with the Epley Maneuver.

You would move to lie on your affected side and then, with your physical therapist still supporting you, you would move onto your opposite side.

You would hold this position between two and five minutes and repeat the exercise as needed.

This exercise is generally repeated until indicated by your physical therapist or until you no longer experience dizziness.

3. The Appiani Maneuver

The Appiani Maneuver is also for horizontal or lateral canal BPPV.

You would go from being in a sitting position to lying on your side.

Then your head would be quickly turned toward the ground and be held in that position for two minutes.

4. Vestibular Rehabilitation Physical Therapy

The vestibular system is the system in your body that contributes most to balance.

It consists of organs located within your inner ear, also known as your vestibular labyrinth.

These systems send information to your brain about your movement.

When your vestibular system is damaged, it can impact your balance and other bodily functions, which can be unpleasant.

Vestibular rehabilitation exercises train your brain to use different visual and other sensory cues to help maintain your balance.

These have helped people with their symptoms caused by benign paroxysmal positional vertigo.

It can help to reduce symptoms of vertigo, manage your gait better, and maintain proper posture.

Book Your Appointment With Capitol Physical Therapy Today

Are you struggling with benign paroxysmal positional vertigo and often experience dizziness and other related symptoms?

If you’re hoping to improve your balance or decrease your dizziness, you don’t have to be at the mercy of the vertigo caused by your BPPV.

At Capitol Physical Therapy we can help you reduce your symptoms and improve your daily function.

Book your appointment with Capitol Physical Therapy today.

Capitol Physical Therapy
1331 H St NW #200,
Washington, DC 20005


9560 Pennsylvania Ave. # 202,
Upper Marlboro, MD 20772


Capitol Physical Therapy offers orthopedic and other pain related solutions, with our versitile team of physical therapists in Washington, DC