BPPV Explained: The Most Treatable Cause of Vertigo

If you’ve ever felt like the room was spinning when you rolled over in bed, bent down to pick something up, or even looked up at the ceiling, you’re not alone. These sudden dizzy spells are often caused by something called Benign Paroxysmal Positional Vertigo (BPPV)—the most common and also the most treatable cause of vertigo.

BPPV Treatments in Vestibular Rehabilitation

At SparqPT, many patients come in feeling scared or frustrated by their dizziness symptoms. The good news? BPPV is highly treatable, often with just a few simple maneuvers performed by a physical therapist trained in vestibular rehabilitation.

Let’s break it down: what BPPV is, what the signs look like, and how physical therapy can get you back on steady ground.

What is BPPV?

BPPV happens when tiny calcium crystals (called otoconia) inside your inner ear move out of place. Normally, these crystals help your body sense gravity and motion. But when they slip into the wrong part of your inner ear, they confuse your brain and create the spinning sensation we call vertigo.

The term may sound complicated, but the name actually tells you a lot about the condition:

• Benign – not life-threatening.

• Paroxysmal – comes in sudden bursts.

• Positional – triggered by changes in head position.

• Vertigo – the spinning or whirling sensation.

So, in simple terms: BPPV = brief spinning episodes that happen when you move your head a certain way.

Common Symptoms of BPPV

BPPV is one of the most common signs of a vestibular disorder. If you’re wondering whether your dizziness might be BPPV, here are some key clues:

• Vertigo triggered by movement – rolling in bed, lying down, looking up, or bending over.

• Spinning lasts seconds to a minute – usually brief but very intense.

• Loss of balance – feeling unsteady or veering when walking.

• Nausea – the spinning can be unsettling and sometimes make you feel sick.

It’s important to note that BPPV doesn’t usually cause hearing changes, headaches, or constant dizziness. If you have those symptoms, your provider may want to rule out other vestibular or neurological conditions.

Why Does BPPV Happen?

Sometimes BPPV just shows up out of the blue. But a few things can make it more likely:

• Head injuries or concussions

• Age-related changes in the inner ear

• Inner ear infections or vestibular neuritis

• Long periods of lying down (like after surgery or illness)

BPPV is most common in adults over 50, but we see it in younger patients too—especially after head trauma.

How Physical Therapy Helps with BPPV

Here’s the best part: BPPV is one of the most treatable causes of dizziness.

Physical therapists trained in vestibular rehabilitation use gentle repositioning maneuvers, such as the Epley maneuver, to guide the crystals back where they belong.

At SparqPT, your therapist will:

1. Perform a positional test (like the Dix-Hallpike) to confirm BPPV and identify which ear is affected.

2. Guide you through repositioning maneuvers that move the crystals back into place.

3. Teach you strategies to reduce dizziness symptoms in the short term.

4. Address balance problems with targeted vestibular exercises if needed.

Most patients feel significant improvement after just 1–2 visits. Sometimes symptoms linger or BPPV comes back (which is common), but physical therapy remains the gold standard for treatment.

Why Not Just Wait it Out?

Some people are told BPPV will resolve on its own. And yes, sometimes it does. But here’s the catch: while you’re waiting, you’re still at risk for falls, injury, or just feeling miserable from dizziness.

Even more importantly, leaving BPPV untreated for too long can put extra strain on the rest of your vestibular system. Your brain and body may start compensating in less efficient ways, which can make other vestibular issues harder to treat later on. Unlike BPPV, many other vestibular conditions don’t respond as quickly to treatment—so getting help early can prevent bigger, more stubborn problems down the road.

When to Seek Help

Not all dizziness is BPPV, so it’s important to be evaluated by a professional. You should seek help if you have:

• Sudden dizziness that doesn’t improve

• Repeated episodes of vertigo triggered by head movements

• Trouble walking straight or maintaining balance

• Dizziness combined with hearing loss, double vision, or neurological changes (these need urgent medical attention)

It’s also worth noting that in today’s healthcare system—where time is often limited—patients who complain of dizziness are sometimes told they “probably have BPPV” simply because it’s statistically the most common cause. But dizziness can stem from many different vestibular or neurological issues. That’s why it’s so important to see a vestibular specialist who can do the proper testing and give you the right diagnosis.

Life After BPPV

The good news is that once treated, many people go right back to their normal activities without restrictions. For those who do experience recurrences, knowing that physical therapy can quickly resolve symptoms is incredibly reassuring.

At SparqPT, we help patients every week who thought they’d just have to “live with” dizziness. Seeing someone walk out of the clinic feeling steady again after one or two visits is one of the most rewarding parts of our job.

Takeaway

BPPV may feel overwhelming in the moment, but it’s actually one of the easiest vestibular disorders to treat. If you’ve been struggling with dizziness symptoms or balance problems, don’t wait it out—physical therapy can help you feel steady and confident again.

If you’re in Castle Rock or the surrounding Colorado area and think you might have BPPV, we’d love to help. Reach out to SparqPT and let’s get you back to living without the spin.