Vertigo and BPPV: How Physical Therapy Can Help You Stop the Spinning

The name sounds complicated, but the condition is common—and very treatable! Up to 57% of patients with traumatic brain injury (TBI) develop BPPV, particularly in cases of mild TBI or concussion (Zalewski et al.).

What Is BPPV?

Inside your inner ear, there are tiny balance sensors that help your brain understand where your head is in space. Sometimes, little crystals (called otoconia) break loose and end up where they don’t belong. When this happens, your balance sensors send the wrong signals, and you feel dizzy or like the world is spinning.

Common symptoms include:

● Brief spinning dizziness when you change positions

● Trouble rolling in bed, looking up, or bending over

● Feeling unsteady or nauseous

How Physical Therapy Treats BPPV

The good news: BPPV is not dangerous, and physical therapy can often fix it in just one or two visits!

The Epley Maneuver

A physical therapist can guide you through a series of gentle head and body movements, called the Epley maneuver. This helps move the loose crystals out of the balance canals and back where they belong. Many people feel better almost right away.

Balance and Eye Exercises

Sometimes, even after the crystals are moved, people still feel a little off balance. In that case, your therapist may give you special exercises to:

● Improve your balance

● Help your eyes and brain adjust

● Build confidence moving again

What to Expect at Physical Therapy

At your first visit, your therapist will:

1. Ask about your symptoms.

2. Do a quick test (like the Dix-Hallpike test) to see

which ear is affected.

3. Perform the right repositioning maneuver.

4. Teach you what to do at home if dizziness comes

back.

Most people improve very quickly and can return to daily activities without the fear of spinning dizziness.

The Takeaway

BPPV may feel scary, but it’s one of the easiest causes of dizziness to treat. Physical therapy

offers safe, drug-free relief that often works right away. If you’ve been struggling with sudden

dizziness, talk to a vestibular-trained physical therapist—you don’t have to live with the spin!