Up to 2.4% of the population will develop BPPV in their lifetime, and people over the age of 60 are seven times more likely to develop it. This is just one of many conditions that can cause vertigo, a feeling of movement when you are still or stop moving.

People can experience many feelings of vertigo. Still, BPPV is characterized by a sense of rotation in oneself or a room. The most reliable marker of BPPV is that the sensation of rotation occurs in bed and lasts less than one minute. You usually don’t get dizzy when you’re upright. People usually experience some instability when standing or walking but can usually do their normal activities without much trouble.

Your physical therapist can accurately assess and address the problem.

What causes BPPV?

BPPV is an inner ear disease caused by calcium carbonate crystals detaching from receptors in the central cavity and entering the semicircular canal. These tubes and central chambers are filled with fluid, and the movement of this fluid signals to the brain that a head movement has taken place.

Usually, the pipes on both sides of the head work in pairs to sense rotational motion in different planes. There are three semicircular canals in other planes, and the most frequently affected semicircular canals are those at the bottom or posterior.

If you lie down and either roll toward the affected side or tilt your head back, gravity will cause the heavy crystal fragments to fall, thus moving the fluid inside the tube. Only the movement of fluid on one side creates a reflex that causes your eye to bounce up and down, which is what we call nystagmus. The sensation of rotation and nystagmus can last for 30 seconds or less. When you sit up, the sensation of rotation will occur again as the crystals fall back to their original position in the tube.

How does physical therapy help?

The good news is that you don’t have to suffer from intermittent vertigo! The treatment is as simple as placing the crystal fragment back into the central chamber through a series of actions known as the “repositioning strategy.” The therapist’s specific strategies depend on which conduit is affected.

In 80% of the cases, only one strategy is needed to relocate the debris. Still, if multiple canals on either side are affected or have problems, relocation is required after several visits.

You can see online that you can do relocalization yourself, but if it’s not in the back tube, the technique doesn’t work, so it’s best to consult a trained physical therapist to assess your condition and diagnose you correctly.