Vertigo and dizziness (BPPV)
Does the room spin when you roll over in bed or look up? BPPV is the most common cause of vertigo, and a simple repositioning manoeuvre often helps.
About vertigo and BPPV
Vertigo is the feeling that you or the room is spinning. Healthdirect notes that the most common cause is benign paroxysmal positional vertigo, or BPPV. It happens when tiny calcium crystals in your inner ear move out of place and drift into one of the balance canals. When you move your head, the loose crystals send the wrong message to your brain.
BPPV causes short bursts of spinning, usually lasting less than a minute, set off by rolling over in bed, lying down, sitting up, looking up at a shelf or bending forward. You may feel sick and unsteady afterwards. It can follow a knock to the head or an inner ear virus, but often there is no clear cause, and it becomes more common as we get older.
Not all dizziness is BPPV. Inner ear inflammation, Meniere's disease, migraine, neck problems, blood pressure changes and some medicines can all make you dizzy, so a careful assessment matters. Some of our physiotherapists have a special interest in vestibular problems.
Move carefully, not fearfully
Get up slowly: sit on the edge of the bed for a moment before you stand. Keep a light on at night and take care on stairs. Don't drive, climb ladders or swim alone while you are having spinning attacks.
It is tempting to keep your head very still, but avoiding movement can slow your brain's recovery. Once BPPV is treated, gentle head and balance exercises help you feel steady again.
How we treat it
We take a careful history of your dizziness: what it feels like, how long it lasts and what sets it off. We check your eye movements, balance and neck, and use positional tests such as the Dix-Hallpike test to see whether BPPV is the cause and which ear and canal are involved. We also screen for signs that you need to see a doctor.
Treatment may include:
- repositioning manoeuvres, such as the Epley manoeuvre, to guide the crystals back to where they belong
- home exercises if your symptoms return
- vestibular rehabilitation exercises to help your brain adjust and reduce dizziness when you move
- balance training to lower your risk of falls
- advice on getting back to driving, work and exercise
If you feel unsteady on your feet, our All About Balance class is a good next step.
Read more on our blog: Feeling dizzy? It could be your vestibular system and Balance and falls.
your dizziness comes on suddenly with a severe headache, double vision, slurred speech, a drooping face, weakness or numbness in your face, arm or leg, new trouble walking, or sudden hearing loss. These can be signs of a stroke: call 000. Also see a doctor promptly if dizziness follows a head injury, is constant for hours or days, or comes with fainting, chest pain or a racing heart.
Getting started
Who you'll see
One of our physiotherapists, one to one in a private room. You can choose your physiotherapist when you book. Meet the team.
Your first appointment
60 minutes. We listen to your story, check how you move, explain what we find and start treatment, then give you a short plan to follow at home. Follow-up appointments are 30 minutes.
Cost and rebates
First appointment $225. Follow-up $150, or $135 on a pass. No referral needed. We claim private health rebates on the spot with Tyro (works like HICAPS) where available. We are not a bulk billing clinic: with a GP care plan (GPCCMP), you pay in full and Medicare pays $63.40 back for up to five allied health visits a year. If you can't make an appointment, please give us 24 hours notice. Funding and referrals.
Where and when
Suite 2, 69 Eyre Street, North Ward, Townsville. Free parking on both sides of Eyre Street, plus an accessible bay right outside. Open Monday to Thursday 7 am to 7 pm, Friday 7 am to 3:30 pm and Saturday 7 am to 1:30 pm. Book online or call 07 4724 0768.
Common questions
How many sessions will I need?
It varies. Some people feel much better after one or two treatments, while others need more, especially if more than one canal is involved. We check your progress at each visit.
Can BPPV come back?
Yes, it can. If it does, the same treatment can usually be repeated, and we can teach you what to do at home.
Do I have to sleep upright after treatment?
Usually not. Current guidelines don't recommend strict movement limits after a repositioning manoeuvre for most people. Your physio will tell you if anything specific applies to you.
Can I do the Epley manoeuvre at home?
Some people can, once they know which ear and canal are involved. Doing the wrong manoeuvre may not help, so get a proper diagnosis first.
Do I need a referral?
No. Private patients can book straight in. If your dizziness is new and you are not sure of the cause, it's also worth seeing your GP.