BPPV Benign Paroxysmal Positional Vertigo

BPPV Benign Paroxysmal Positional Vertigo

Physiotherapy’s Role in Managing Benign Paroxysmal Positional Vertigo (BPPV)

Benign Paroxysmal Positional Vertigo (BPPV) is a common vestibular disorder characterised by brief episodes of vertigo triggered by specific head movements. While BPPV is not life-threatening, it can significantly impact daily activities and quality of life. Physiotherapy offers effective techniques for diagnosing, treating, and managing BPPV, helping individuals find relief from vertigo and regain stability.

Understanding BPPV:

BPPV occurs when tiny calcium carbonate crystals (otoconia) become dislodged from their normal position within the inner ear and migrate into the semicircular canals, where they can disrupt the flow of fluid and trigger false signals of movement to the brain. This results in brief episodes of vertigo, typically lasting less than one minute, often accompanied by nausea, dizziness, and imbalance. BPPV is commonly associated with changes in head position, such as rolling over in bed, tilting the head back, or looking up.

The Role of Physiotherapy in BPPV Management:

Physiotherapy plays a crucial role in the diagnosis, treatment, and management of BPPV, offering specialised techniques to address the underlying vestibular dysfunction and alleviate symptoms.

Here’s how physiotherapy can help individuals with BPPV:

  • Canalith Repositioning Manoeuvres: Physiotherapists perform specific canalith repositioning manoeuvres, such as the Epley manoeuvre or the Semont manoeuvre, to reposition the displaced otoconia within the inner ear and alleviate vertigo symptoms. These manoeuvres involve a series of controlled head movements designed to guide the otoconia out of the affected semicircular canal and into a less symptomatic location.
  • Vestibular Rehabilitation: Physiotherapy includes vestibular rehabilitation exercises aimed at promoting central compensation and adaptation to the vestibular dysfunction associated with BPPV. These exercises may include gaze stabilisation exercises, balance training, habituation exercises, and adaptation exercises to improve vestibular function, reduce dizziness, and enhance overall stability.
  • Education and Home Exercises: Physiotherapists provide education on BPPV triggers, precautions, and self-management strategies to empower individuals to manage their symptoms effectively. Additionally, they prescribe specific home exercises and positional manoeuvres to complement in-clinic treatment and facilitate symptom relief between physiotherapy sessions.
  • Functional Assessment and Fall Prevention: Physiotherapists conduct comprehensive assessments to evaluate individuals’ functional abilities, balance, and risk of falls related to BPPV. Based on these assessments, they develop personalised treatment plans aimed at improving balance, reducing fall risk, and enhancing overall functional independence.
  • Long-Term Management: Physiotherapy offers long-term management strategies to help individuals with BPPV minimise symptom recurrence and optimise vestibular function. This may include periodic reassessment, maintenance exercises, lifestyle modifications, and ongoing support to address any new or persistent symptoms.


Benign Paroxysmal Positional Vertigo can be disruptive and distressing, but with the right approach to management, individuals can find relief and regain stability. Physiotherapy plays a vital role in diagnosing, treating, and managing BPPV, offering specialised techniques to address vestibular dysfunction, alleviate symptoms, and improve overall quality of life.

If you’re experiencing symptoms of BPPV, Contact our reception team at Physio Elements and we can organise an appointment for you with either our Physio Lachlan or Ramneet who can assess your condition, develop a personalised treatment plan, and guide you on the path to recovery and stability.

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