You're dizzy, now what? Understanding BPPV and how physio can help

Have you ever rolled over in bed and suddenly felt like the room was spinning? Or maybe you looked up quickly and felt dizzy or off-balance?

If so, you might be experiencing something called BPPV—a common and treatable inner ear condition.

Let’s break it down in simple terms and talk about what’s going on, what you can do, and how a physiotherapist can help you feel steady again.

What is BPPV?

BPPV stands for benign paroxysmal positional vertigo.

That’s a mouthful, but here’s what it means:

• Benign: It’s not dangerous
• Paroxysmal: It comes on suddenly
• Positional: It’s triggered by certain head movements
• Vertigo: It makes you feel like you or the room is spinning

BPPV happens when tiny crystals in your inner ear—called otoconia—get loose and float into the wrong part of your ear, specifically the semi-circular canals.

These canals help you keep your balance.

When the crystals are in the wrong place, they send mixed signals to your brain, making you feel dizzy.

Common symptoms of BPPV

• A spinning feeling (vertigo) when you move your head
• Dizziness when lying down, rolling over, or looking up
• Nausea or feeling sick to your stomach
• Feeling unsteady or off-balance
• Eye movements that flicker (called nystagmus)

These episodes usually last less than a minute but can be very unsettling.

You’re dizzy, now what?

If you suddenly feel dizzy, here’s what you can do:

1. Stay calm – it’s scary, but BPPV is not dangerous.
2. Sit or lie down – this helps prevent falls.
3. Avoid quick head movements – these can make it worse.
4. See a physiotherapist or doctor – they can check if it’s BPPV and help treat it.

How is BPPV diagnosed?

A health professional will usually do a simple test where they move your head in certain ways to see if it triggers dizziness or eye movements.

This helps them figure out which part of your inner ear is affected.

How can physiotherapy help?

Physiotherapists trained in vestibular rehab (that’s the balance system in your inner ear) can treat BPPV with special head movements called repositioning manoeuvres. These help move the crystals back where they belong.

Common treatments include:

• Epley manoeuvre – A series of head movements to guide the crystals out of the canal
• Barbecue roll – Used for a different part of the inner ear
• Brandt-Daroff exercises – Simple movements you can do at home to reduce symptoms

Most people feel better after just one or two sessions!

Why the vestibular canals matter

Your inner ear has three tiny loops called semi-circular canals. They help detect movement and keep you balanced.

When crystals get into these canals, they mess with your balance signals. That’s what causes the spinning feeling in BPPV.

Final thoughts

BPPV is common, especially as we get older, but it’s also very treatable.

If you’re feeling dizzy, don’t ignore it.

A physiotherapist can help you get back to feeling steady and confident again.