Benign paroxysmal positional vertigo is a frustrating balance problem, but we can help


Throughout each day, when performing just about any given activity, we have our vestibular system to thank for keeping us balanced. Most of us don’t think about how much we use this system when we walk down a staircase, stand up from a chair, or cross the street, but for anyone with a balance disorder, some of these otherwise-basic tasks can become extremely difficult.

The vestibular system is the sensory system that provides the brain with the most important information regarding the body’s sense of balance and spatial orientation to coordinate our movements smoothly. The system detects motion of the head—mainly through the inner ear, as well as the eyes, muscles, and joints—and from this information generates reflexes that are crucial for our daily activities. Some of these essential tasks include stabilizing our visual gaze and maintaining the posture of our head and body.

When the vestibular system functions normally, most people are unaware of its existence and likely don’t think twice when they walk on uneven surfaces or arise from bed in the middle of the night. Certain disorders, however, can negatively affect the functioning of the vestibular system, leading to symptoms like dizziness, vertigo, and balance problems. Vestibular disorders can also lead to nausea, anxiety, fatigue, hearing changes, and difficulty concentrating.

One of the most common vestibular conditions is benign paroxysmal vertigo disorder (BPPV). BPPV can affect people of all ages, but it’s most common in adults over 60, with a prevalence of about 9% in that age group. BPPV is a disorder of the inner ear that causes brief periods of dizziness that usually occur when lying down, turning over, or looking up.

The inner ear contains tiny calcium crystals, or rocks, which normally help to regulate balance. In BPPV, a traumatic incident like an infection or inflammation causes these rocks to detach from their normal location, leaving them free to travel to other parts of the ear. Eventually the calcium crystals move to a part of the inner ear called to the semicircular canal and cause an unwanted flow of fluid, which tricks the brain into perceiving motion when no motion is occurring.

What our physical therapists recommend for BPPV

The good news is that BPPV can be easily treated, and most people can recover from it with some basic lifestyle modifications and treatment. Dynamic Sports Physical Therapy can treat your BPPV with several balance exercises and neck maneuvers that are all intended to remove these rocks from the semicircular canals. We also recommend gaze stabilization exercises, which help the eye, inner ear, and brain recalibrate after damage to the inner ear. Visual fixation of a target is a key gaze stabilization exercise that can be performed as follows:

  • Keep your eyes fixed on a single stationary target held in hand or placed on a wall 3-10 feet away
  • Move your head from side to side for 30 seconds, and repeat three times
  • Repeat three more times while you’re moving head up and down for 30 seconds
  • Do three sessions per day

The following lifestyle changes can also help to reduce the symptoms of BPPV:

  • Use two or more pillows in bed at night
  • Avoid sleeping on the side of your head with the ear that’s causing problems
  • Get up slowly in morning, sit on the edge of the bed, and take a moment before standing
  • Try to avoid leaning over to pick things up or tipping your head too far back to look up
  • Be cautious when playing sports that require you to turn your head, lean over, or lie on your back

If you’re experiencing BPPV and would like to get started on a treatment program to reduce or eliminate episodes of vertigo, or if you’re dealing with any other musculoskeletal aches or pains, we can help. Contact Dynamic Sports Physical Therapy in New York City at 212-317-8303 for more information or to schedule an appointment today.