Benign Paroxysmal Positional Vertigo (BPPV)

BPPV is one of the most common causes of vertigo. It produces brief but intense spinning sensations triggered by changes in head position - such as rolling over in bed, lying down, looking up, or bending forward. It happens when tiny calcium-carbonate crystals (otoconia) that normally sit in one part of the inner ear become dislodged and move into the balance canals, sending false signals about movement. BPPV is mechanical, generally not dangerous, and often responds well to specific physiotherapy repositioning techniques offered at Goji Physio in Lentor, Singapore.

What are the signs of BPPV?

BPPV has a characteristic pattern. People typically notice:

• Short episodes of spinning (usually seconds to under a minute) triggered by head movement
• Symptoms brought on by lying down, rolling in bed, looking up, or bending down
• A sense that the room is spinning rather than a constant lightheadedness
• Sometimes nausea, and a lingering unsteadiness between episodes

BPPV does not cause hearing loss, ringing in the ears, headache, or neurological symptoms. If you have any of those, it points toward a different cause that needs further medical assessment.

What does a session at Goji involve?

Your physiotherapist will take a history of your symptoms and triggers, then carry out tests to confirm BPPV and identify which ear and canal are involved. This typically includes:

• Screening: ruling out features that suggest a cause other than BPPV
• Positional tests: guided head-and-body movements (such as the Dix-Hallpike test) that briefly reproduce your vertigo while your physiotherapist observes your eye movements
• Identifying the affected canal: determining which inner-ear canal the crystals are in, so treatment can be targeted

Because testing deliberately provokes brief vertigo, your physiotherapist will explain what to expect and support you throughout.

How is BPPV treated?

BPPV is usually treated with canalith repositioning manoeuvres - a specific sequence of head and body movements (such as the Epley manoeuvre) that guide the displaced crystals back to where they belong. Some people need only one treatment and others need several. Your physiotherapist will re-test to check the response and may give you follow-up advice or exercises.

Frequently asked questions

Is BPPV dangerous?

BPPV itself is not dangerous - “benign” reflects this. It can be distressing and increase the risk of losing balance during an episode, but it is a mechanical inner-ear problem rather than a sign of something serious. Assessment confirms the diagnosis and rules out other causes.

How quickly does treatment work?

This varies from person to person. Some people need one repositioning treatment and others need several, and your physiotherapist will re-test to check the response. Some experience residual unsteadiness for a short period afterward, which usually settles.

Can BPPV come back?

Yes, BPPV can recur in some people. If it returns, the same repositioning approach can usually be repeated, and your physiotherapist can show you what to look out for.

Can I treat BPPV myself at home?

Home manoeuvres exist, but doing them without first confirming the affected ear and canal can be ineffective or worsen symptoms. It is safer to be assessed first; your physiotherapist may then teach you appropriate follow-up techniques.

Why do I still feel unsteady after the spinning stops?

A period of mild unsteadiness after successful treatment is common as the balance system settles. Simple balance and gaze exercises can help, and your physiotherapist will advise if any are needed.

How should I prepare for my vestibular physiotherapy session?

We recommend having a light meal at least 1 hour before your session. If you have prescribed medication to manage dizziness or nausea, take it as directed by your healthcare provider, especially if you are experiencing symptoms. Some assessment and treatment techniques may temporarily trigger dizziness or nausea, so these precautions can help you feel more comfortable and reduce the risk of vomiting during your session.