Vertigo & BPPV:

Causes, Symptoms, Risk Factors, and How Physiotherapy Can Help

Have you ever turned over in bed, looked up, bent down, or moved your head and suddenly felt like the room was spinning?

If so, you may have experienced vertigo.

Vertigo can be unsettling and, for many people, frightening. It can make you feel unsteady when walking, hesitant to move your head, nauseated, or worried about falling. One of the most common causes of vertigo is Benign Paroxysmal Positional Vertigo (BPPV).

At CareWell Health Group in Guelph, we see patients with vertigo and BPPV every week. Our goal is not simply to reduce the spinning sensation. We assess the underlying vestibular, visual, balance, and musculoskeletal factors that may be contributing to your symptoms and develop an individualized treatment plan to help you safely return to your normal activities.

 

What Is Vertigo?

Vertigo is the sensation that you or your surroundings are spinning, moving, tilting, or shifting when there is no actual movement.

It is important to understand that vertigo is a symptom rather than a single diagnosis. Several different conditions can cause dizziness or vertigo, and the appropriate treatment depends on identifying the underlying cause.

One of the most common causes is Benign Paroxysmal Positional Vertigo (BPPV).

 

What Is BPPV?

BPPV stands for Benign Paroxysmal Positional Vertigo. It is a condition involving the inner ear’s balance system.

Inside the inner ear are tiny calcium carbonate crystals, often called ear crystals or otoconia, which normally help your body detect movement and position relative to gravity. Sometimes these crystals become displaced and move into one of the semicircular canals.

When the head changes position, the displaced crystals can stimulate the balance sensors abnormally, sending confusing signals to the brain. This can produce the sudden spinning sensation associated with BPPV.

BPPV is typically triggered by specific changes in head position, such as:

• Rolling over in bed
• Getting in or out of bed
• Looking up
• Looking down
• Bending over
• Turning your head quickly
• Sitting up from a lying position

Episodes are often brief, although people may continue to feel off-balance or cautious with movement afterward.

 

Common Symptoms of BPPV and Vertigo

Everyone experiences vertigo differently, but common symptoms include:

• A sudden spinning sensation
• Feeling like the room is moving
• Dizziness when changing head position
• Nausea or vomiting
• Feeling off balance
• Difficulty walking confidently
• Feeling unsteady when turning
• Hesitation to move the head
• Fear of falling
• Visual disturbances or difficulty focusing
• Feeling “off” even after the spinning has stopped

At CareWell Health Group, we commonly see patients who become very guarded with their movements because they are worried that turning their head or changing position will trigger another episode.

This can create a cycle: vertigo leads to fear of movement, fear of movement leads to less activity, and reduced activity can contribute to deconditioning and ongoing balance difficulties.

 

What Causes BPPV?

In many cases, the exact cause of BPPV is unknown. This is known as idiopathic BPPV.

However, BPPV can sometimes be associated with factors such as:

• A previous head injury
• Changes or disorders affecting the inner ear
• Prolonged periods of lying down or bed rest
• Previous ear surgery
• Age-related changes in the vestibular system

Research also identifies increasing age, head injury, and certain conditions affecting bone health as potential risk factors. BPPV can occur at any age, although it becomes more common as people get older.

 

BPPV Risk Factors

Some factors may increase the likelihood of developing BPPV, including:

1. Age

BPPV can affect anyone, but it is more common in adults over 50.

2. Previous Head Injury

A concussion or other head injury may increase the risk of BPPV.

3. Inner Ear or Vestibular Problems

Conditions affecting the balance organs of the inner ear may increase the risk.

4. Prolonged Bed Rest

Spending an extended period lying down, including after surgery or illness, may contribute to BPPV in some people.

5. Bone Health

Osteoporosis and other factors affecting bone health have also been associated with an increased risk of BPPV.

 

How Is BPPV Diagnosed?

A proper assessment is an important part of BPPV treatment in Guelph.

At CareWell Health Group, our physiotherapists take a comprehensive approach rather than assuming every case of dizziness is BPPV.

Depending on your presentation, an assessment may include:

Positional Testing

Tests such as the Dix-Hallpike test and supine roll test can help determine whether certain head positions reproduce symptoms and can help identify the affected semicircular canal.

Clinical guidelines specifically recommend the Dix-Hallpike manoeuvre when posterior canal BPPV is suspected and the supine roll test when lateral canal BPPV is suspected.

Balance Assessment

We assess how well you maintain your balance and how your symptoms affect standing and walking.

Eye Movement Assessment

The vestibular and visual systems work closely together to maintain balance and orientation. Depending on the presentation, we may assess eye movements, visual tracking, saccades, and how your eyes respond to head movement.

Cervical Range of Motion

Neck movement can be relevant when assessing someone with dizziness, particularly when neck stiffness, muscle guarding, or restricted movement is present.

Vision and Visual Symptoms

We may also ask about visual symptoms such as blurriness or difficulty focusing.

The purpose of this broader assessment is to help determine whether BPPV is the likely cause of your symptoms and whether other factors may also be contributing.

 

How Can Physiotherapy Help With Vertigo and BPPV?

Vestibular physiotherapy can play an important role in the assessment and management of BPPV and other vestibular conditions.

Treatment is individualized because not every person with dizziness needs the same intervention.

1. Canalith Repositioning Manoeuvres

When BPPV is confirmed, specific canalith repositioning manoeuvres can be used to help move displaced particles out of the semicircular canal and back toward an area where they are less likely to trigger symptoms.

The Epley manoeuvre, for example, is commonly used for posterior canal BPPV.

Clinical guidelines strongly recommend appropriate canalith repositioning procedures for patients with posterior canal BPPV.

2. Vestibular Rehabilitation Exercises

Depending on your assessment findings, vestibular exercises may be incorporated into your treatment plan.

These can include exercises designed to improve:

• Gaze stability
• Balance
• Coordination
• Head movement tolerance
• Walking stability
• Confidence with movement

Vestibular rehabilitation has strong evidence for improving symptoms and functional limitations associated with vestibular disorders.

3. Balance Training

If you have been avoiding movement because you are afraid of triggering dizziness, your balance and confidence may also be affected.

Balance exercises can help you gradually and safely challenge your balance system and improve confidence with everyday activities.

4. Head and Eye Coordination

Your eyes, inner ears, brain, and musculoskeletal system work together to help you understand where your body is in space.

Depending on your individual findings, your physiotherapist may incorporate appropriate eye and head movement activities into your rehabilitation program.

5. Addressing Neck and Upper-Back Muscle Tension

At CareWell Health Group, we also look beyond the vestibular symptoms.

When someone experiences sudden vertigo, it is common for them to become very guarded. They may stop turning their head normally, hold their neck stiffly, or tense their upper back because they are worried about triggering another episode.

For appropriate patients, we may incorporate manual therapy and soft-tissue techniques around the neck and upper back, as well as techniques around the external ear region, to address muscular tension and guarding.

This is part of our broader approach: we don’t want to focus only on the spinning sensation. We also want to address the physical tension, movement restrictions, balance problems, and fear of movement that may accompany the condition.

 

Can Medication Cure BPPV?

People experiencing sudden vertigo can understandably become frightened and may rely on medication to suppress their symptoms.

Vestibular suppressant medications may sometimes be used under medical guidance for certain situations, but clinical guidelines recommend against routinely treating BPPV with vestibular suppressant medications as the primary approach. For confirmed BPPV, appropriate repositioning manoeuvres are an important part of treatment.

If you are taking medication for dizziness or vertigo, speak with your physician or prescribing healthcare professional before making any changes to your medication.

 

Why Choose Vestibular Physiotherapy at CareWell Health Group in Guelph?

At CareWell, we understand that vertigo is about more than simply feeling dizzy.

When you suddenly experience the room spinning, everyday activities can become intimidating. Walking, getting out of bed, turning your head, driving, working, or even looking up can feel uncertain.

Our approach to vestibular physiotherapy in Guelph combines assessment and treatment of the vestibular system with attention to balance, movement, vision, and musculoskeletal factors.

We provide one-on-one physiotherapy care, allowing your treatment to be tailored to your specific symptoms and assessment findings.

Rather than focusing only on temporarily relieving symptoms, we look at the bigger picture—including muscle tension and guarding around the neck and upper back—to help you regain confidence in movement and return to your usual activities.

 

A Patient’s Experience

One of our patients came to CareWell on the same day they experienced vertigo. After assessment and treatment, they experienced significant improvement and were able to return to their usual routine after two sessions.

Every patient is different, and the number of physiotherapy sessions required depends on the underlying cause, severity, and individual response to treatment. However, this experience highlights why early assessment can be valuable when sudden positional dizziness occurs.

 

When Should You Seek Help for Vertigo?

If you experience sudden, recurring, or unexplained dizziness or vertigo, it is important to have the symptoms appropriately assessed rather than assuming they are BPPV.

Seek urgent medical attention if dizziness or vertigo occurs along with symptoms such as:

• New or severe headache
• Double vision or significant changes in vision
• Difficulty speaking
• Weakness or numbness
• Fainting
• Significant difficulty walking
• New hearing loss
• Other sudden neurological symptoms

These symptoms may indicate a condition requiring urgent medical evaluation and should not simply be assumed to be BPPV.

 

Don’t Let Vertigo Put Your Life on Hold

Vertigo and BPPV can make you feel like you need to move carefully or avoid normal activities altogether. But the right assessment can help determine what is causing your symptoms and what treatment approach is appropriate.

If you’re experiencing BPPV, dizziness, balance problems, or vertigo in Guelph, vestibular physiotherapy may be an important part of your recovery.

At CareWell Health Group, our physiotherapists can assess your symptoms, identify factors contributing to your dizziness and imbalance, and create an individualized treatment plan to help you move with greater confidence.

Don’t let vertigo keep you from doing the things you enjoy. Contact CareWell Health Group in Guelph to learn more about vestibular physiotherapy and BPPV treatment.

Book Your Vertigo-spinning Assessment Today

 

Don’t let your spinning-vertigo limit your work, workouts, or daily life.

 

At CareWell Health Group, we help you recover faster with expert physiotherapy and personalized care.

 

 Book your appointment today and start your recovery journey.