Have you ever rolled over in bed and felt the room suddenly spin — so intensely that you had to grab the mattress or close your eyes?
If that’s happened to you, here’s an important question worth sitting with:
What if the dizziness isn’t coming from your blood pressure, your neck, or your brain — but from something much smaller?
Benign Paroxysmal Positional Vertigo, or BPPV, is the most common cause of positional dizziness. It often presents as brief but intense spinning sensations triggered by specific head movements. At LV Physiotherapy in St. Catharines, we see BPPV regularly — and the reassuring news is that it is highly treatable once the underlying cause is properly identified.
What Is BPPV?
BPPV is a vestibular condition that occurs when tiny calcium carbonate crystals inside the inner ear move into areas where they do not belong.
Inside the inner ear are:
- Fluid-filled semicircular canals that detect rotational head movement
- Otoconia (small calcium carbonate crystals) that help detect gravity and linear motion
Under normal conditions, these crystals remain in a specific chamber designed for sensing position. In BPPV, they become displaced and migrate into one of the semicircular canals. Because these canals are designed to detect rotation rather than gravity, the misplaced crystals disrupt normal balance signals.
The result is vertigo — a sensation of spinning — triggered by changes in head position
Why BPPV Causes Dizziness With Simple Movements
When you move your head with displaced crystals present:
- The crystals shift within the canal
- Inner-ear fluid moves abnormally
- Conflicting signals are sent to the brain
Your eyes and inner ear no longer agree about where your body is in space. This sensory mismatch creates the sudden spinning, tilting, or falling sensation typical of BPPV. Although the symptoms can feel dramatic and alarming, the condition itself is mechanical and not dangerous.
Common Signs and Symptoms of BPPV
BPPV commonly causes:
- Vertigo when rolling over in bed
- Dizziness when looking up or bending forward
- Brief spinning episodes lasting seconds to minutes
- Nausea associated with head movement
Symptoms are positional and typically stop once the head is kept still.
Why Does BPPV Happen?
In some cases, BPPV follows a clear trigger. In others, it appears without warning.
Common contributing factors include:
- Minor head trauma or falls
- Whiplash or sudden neck movement
- Prolonged positioning, such as during illness, dental procedures, or surgery
- Age-related changes affecting inner-ear structures
In many individuals, BPPV occurs without an identifiable cause. This is common and does not affect how well it responds to treatment.
How Repositioning Maneuvers Treat BPPV
One of the most surprising aspects of BPPV is how effectively it can be treated.
Vestibular physiotherapy uses specific repositioning maneuvers — guided sequences of head and body movements — to relocate the displaced crystals back to their proper chamber.
Commonly used maneuvers include:
- The Epley maneuver
- The Semont maneuver
- Other canal-specific techniques based on assessment findings
These maneuvers use gravity and precise positioning to:
- Move crystals out of the affected canal
- Restore normal inner-ear signaling
- Reduce or eliminate vertigo episodes
Many people experience significant improvement within one or two treatment sessions.
How Physiotherapy for BPPV Works at LV Physiotherapy
At LV Physiotherapy in St. Catharines, care begins with a thorough vestibular assessment to determine:
- Which ear is affected
- Which semicircular canal is involved
- Which movements trigger symptoms
Accurate identification is essential, as treatment depends on matching the correct maneuver to the correct canal.
Treatment also includes:
- Clear explanation of what is causing symptoms
- Guidance on what to expect after treatment
- Advice to reduce recurrence and manage symptoms safely
Repositioning maneuvers are highly effective, but precision and proper assessment matter.
What BPPV Is Not
Because BPPV symptoms can feel intense, many people worry about more serious conditions.
BPPV is not:
- A stroke
- A brain tumor
- A sign of permanent balance damage
While medical evaluation is important when symptoms are unclear, BPPV itself is a benign and manageable condition.
Can BPPV Come Back?
BPPV can recur, and recurrence does not mean treatment failed. It simply means the crystals have shifted again.
Strategies that may help reduce recurrence include:
- Staying physically active with regular head movement
- Managing neck stiffness and posture
- Seeking early treatment if symptoms return
- Avoiding prolonged bed rest when possible
When BPPV is addressed early, recovery is often quicker and less disruptive.
When to Seek Help for Positional Vertigo
You should consider scheduling a physiotherapy assessment if:
- Dizziness is triggered by head movement
- Spinning lasts seconds to minutes
- Symptoms disrupt sleep or daily activities
- You feel unsteady or anxious about falling
- Your symptoms are progressively getting worse.
Waiting it out is not necessary. Effective, evidence-based treatment is available.
If dizziness with head movement is affecting your comfort or confidence, proper assessment and treatment can make a meaningful difference.
At LV Physiotherapy in St. Catharines, vestibular physiotherapy focuses on clear diagnosis, precise treatment, and helping you feel steady and in control again. Book an assessment and get relief right away.
