Dizziness and Vertigo: How Physiotherapy Treats BPPV

Few sensations are as unsettling as the room suddenly spinning when you roll over in bed, tip your head back or bend to pick something up. For many people in Kochi this brief, intense whirl of dizziness is caused by a very common and highly treatable condition called benign paroxysmal positional vertigo, or BPPV. The good news is that a simple, drug-free physiotherapy technique often clears it in a single visit.

BPPV happens when tiny crystals in the inner ear move into the wrong canal. Normally these crystals sit in one part of the balance organ, but when they drift out of place they send confusing signals to the brain during head movement, and you feel a short but powerful spinning sensation.

What BPPV Feels Like

BPPV is one of the most common causes of dizziness. The hallmark is that spinning is triggered by a change in head position rather than appearing out of nowhere. Typical moments include rolling over in bed, lying down or sitting up, looking upwards to a high shelf, or bending forwards. The spinning is usually brief, lasting seconds, but it can feel violent and may bring on nausea and a loss of balance.

Because the crystals sit in the inner ear, no scan or medication fixes the underlying problem. What resolves it is guiding those crystals back to where they belong, and that is exactly what physiotherapy does.

BPPV is not dangerous, but it is deeply disorienting. The relief when a single, well-judged manoeuvre settles it can feel remarkable.

The Epley Manoeuvre

For the common posterior canal type of BPPV, the Epley manoeuvre, also called canalith repositioning, is a safe and effective treatment. It is a slow, guided sequence of head and body positions that uses gravity to move the stray crystals out of the canal and back to where they cause no trouble.

The evidence is reassuring. A Cochrane review found that a single Epley manoeuvre resolves symptoms in just under 80% of people, and it can be repeated if needed. It is superior to Brandt-Daroff exercises and has no serious side effects, though brief nausea during the repositioning is common. Recurrence happens in roughly a third of people, and if symptoms return the manoeuvre can simply be done again.

Vestibular Rehabilitation for Balance

Some people continue to feel unsteady or off-balance even after the crystals are repositioned, and others have dizziness from causes beyond BPPV. For these situations, vestibular rehabilitation exercises help improve balance and reduce dizziness by gently retraining how the brain, eyes and inner ear work together.

This kind of structured retraining is part of our neurological rehabilitation service, and it is especially valuable for older adults, for whom unsteadiness raises the risk of a fall.

When to Seek Help

If positional spinning has been disrupting your sleep or daily routine, there is rarely any need to simply put up with it. A proper assessment can identify the cause quickly and, in most BPPV cases, treat it the same day.

Frequently Asked Questions