Positional Vertigo

Feeling dizzy? What should you do?

Imagine it. You’re lying comfortably in bed when suddenly the phone rings. You struggle to sit up in bed and suddenly, disaster strikes! The room begins to spin, faster and faster. You completely lose your bearings. You feel like you’ve spent the night in a revolving door.

Nausea tightens your throat, and cold sweat runs all the way down your neck. Only a few seconds have passed, but it feels like an eternity.

You decide to try and stand up, but to no avail. You just can’t find your balance, and you nearly fall down on the bedroom rug.

After twenty interminable seconds, the merry-go-round finally slows down and you start feeling normal again.

You drive to work, thinking the whole uncomfortable episode is over. But every time you check your blind spot, you can feel the dizziness starting up again. At the office, every time you bend over to pick up a fallen sheet of paper or a pencil, the dizziness begins again.

You decide to take a sick day. You’re not sure what is happening to you, and you’re worried that it might be serious.

Sounds scary, doesn’t it?

But this scenario is more common than you might think. An average of one in three people over 60 develop what is called positional vertigo, or BPPV (Benign Paroxysmal Positional Vertigo), a condition that makes any kind of activity impossible.

This condition affects more women than men, and the risk of developing it increases with age. It’s caused by a biomechanical problem in the inner ear.

The inner ear is the location of the organs that sense the way the head is moving through space. For example, if you’re going forward in a car, or turning your head, or riding an elevator.

In a case of positional vertigo, these organs are over-stimulated by crystal debris that should not be there. In 35% of cases the cause of this is unknown. It may occur following a head injury (15%), an inner ear infection (15%) or certain illnesses.


Unfortunately, only half of those affected recover without treatment, and there is a 40% chance that the dizziness will reoccur.

That’s why a precise physiotherapeutic diagnosis must be made in order to treat the condition effectively. To do this, it is most useful to consult a physical therapist certified in vestibular rehabilitation.

Luckily, the treatment of choice for positional vertigo is both simple and very effective. It is based on the repositioning and liberatory maneuvers. These consist of moving the head rapidly in several precise directions in a specific sequence in order to shift the crystals into the right area, where they will then be eliminated. Normally this only requires a few treatments, and there are no aftereffects.

If you or someone you know suffers from dizzy spells or intense vertigo, consult a physical therapist with training in vestibular rehabilitation at Physio Atlas.