Treatment for BPPV

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

What is 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 are 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’s around a 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 in the inner ear. Each canal is responsible for sensing movement in a particular direction. Each canal can cause BPPV. The most common is the posterior canal, 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 canal BPPV. Resulting in a poor treatment outcome and prolonged suffering.

BPPV is extremely common and yet many often go years without an accurate diagnosis because not all cases present in a textbook style. Your brain is powerful and has the ability to suppress symptoms like dizziness or vertigo. 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. They go through life thinking they have agoraphobia but in fact they just have BPPV


What is the Epley’s manoeuvre?

Treatment is through the Epley’s manoeuvre or canal repositioning manoeuvre. This involves rolling the affected canal through a specific motion to help drain the crystals out of the semi-circular canal. It’s quick and painless, although you may experience some vertigo during the treatment. Immediately afterwards you may also feel a bit floaty, different or spaced out for a short while. However, there is around a 79% chance of a full resolution of symptoms with one treatment. In some cases it may take up to 5 treatments.

In some cases people continue to experience some dizziness and anxiety after the BPPV has been successfully treated. This may be PPPD and requires some special exercises and training. Vestibular rehabilitation is very safe and requires no special equipment. You will need to perform exercises at home, starting with basic skills progressing through to move advanced skills. Your treatment plan needs to be specific you. 

If you have been diagnosed with BPPV but experience symptoms like hearing loss, tinnitus or you can hear your heart beat in your ear, then you probably need to ask for a second opinion. Conditions like Meniere’s disease, 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’s important to contact your GP or hospital.

Consult myself, or others trained in the diagnosis of BPPV, for an accurate diagnosis and improved treatment outcomes. Our chiropractic clinic in Woking has a special focus on BPPV. If you have any questions you are very welcome to contact me.


If you have any other questions or would like to make an appointment, click here to contact me.