The treatment of BPPV

August 7th, 2018 | by Jake Cooke | Posted in Dizziness

An overview of BPPV.

BPPV is an extremely common condition causing vertigo. The dizziness can be very severe, causing fear, anxiety, nausea and even vomiting. Luckily the bouts of dizziness usually last less than 30 seconds. The attacks our brought on with rotation of the head in a specific direction, often when rolling over in bed. Fortunately the treatment is quick, surgery free and extremely effective. There is about an 79% chance of removing the majority of symptoms with one treatment. However, it does rely on an accurate diagnosis and precise technique.

There are three types of semi-circular canals (SCC) in the inner ear. Each canal is responsible for sensing movement in a particular direction. Each canal can cause BPPV. The most common by far is the posterior SCC, and this is the type which most clinicians are familiar with. However, many aren’t aware of, or know how to diagnose, the horizontal or anterior SCC BPPV. Resulting in a poor treatment outcome and prolonged suffering.

BPPV is so common and yet people often go years without an accurate diagnosis. This is because not all cases present in a textbook style. Your brain is very powerful and it has the ability to suppress symptoms like dizziness or vertigo. For this reason some people will suffer more but some may be able to suppress their symptoms to a certain extent. Instead of experiencing severe vertigo lasting 30 seconds. You may only experience a feeling like swaying on a boat, perhaps a feeling that floor is moving beneath your feet, or maybe just anxiety for no clear reason. Many people tell me that their chief complaint is anxiety when in crowded areas. You can learn more about anxiety here. They go through life thinking they haveĀ agoraphobia but in fact they just have BPPV.


Treatment of BPPV.

Treatment is through ‘canal repositioning maneuver’. This involves rolling the affected canal through a specific motion to help train the crystals out of the semi-circular canal. However, the brain changes every second of every day. If you have BPPV for more than a few days, there is a chance that your brain will start to adapt to life with BPPV. When BPPV is treated the brain re-learns what normal is and the symptoms subside. In some cases, however, the brain struggles to recalibrate the inner ear and symptoms may persist.

If you have been diagnosed with BPPV but experience symptoms like hearing loss, tinnitus, hearing you heart beat in your ear or dizziness experienced when changing altitude then you probably need to ask for a second opinion. Conditions like Meniere’s disease and perilymphatic fistula and superior canal dehiscence should be considered. Likewise, if you suffer from BPPV but start to experience symptoms like headache, weakness in the face or body, numbness in the face or body, trouble speaking, trouble swallowing then it is very important to contact your GP or hospital.

Vestibular rehabilitation is a very safe. It requires no special equipment. You will need to perform exercises at home daily, starting with basic skills progressing through to move advanced skills. Your treatment plan needs to be specific to the you and being given a generic list of exercises on a A4 print out isn’t good enough. Being told to follow instructions on a piece of paper without repeatedly being shown good technique isn’t good enough. Being told you don’t have options isn’t good enough.

Consult myself, or others trained in the diagnosis of BPPV, for an accurate diagnosis and improved treatment outcomes. I work in a chiropractic clinic in Woking.


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