Understanding and Managing BPPV: A Guide to Relief
At Neurohealth Wellness, located on the Northern Beaches of Sydney, we are dedicated to helping our patients live pain-free, mobile, and balanced lives. One of the common yet disruptive conditions we frequently address is Benign Paroxysmal Positional Vertigo (BPPV). This highly treatable inner ear disorder can significantly impair quality of life, but with accurate diagnosis and targeted therapy, relief is within reach.
What is BPPV?
BPPV is the most prevalent vestibular disorder, characterised by brief episodes of vertigo triggered by specific head movements. This condition occurs when tiny calcium carbonate crystals, called otoconia, become dislodged from their normal location in the utricle and migrate into one of the semicircular canals. These canals are responsible for detecting rotational movements, and the misplaced otoconia make them abnormally sensitive to gravity.
Common triggers include:
- Lying down or turning in bed: Often experienced as a spinning sensation when waking up or preparing to sleep.
- Looking up: Activities like reaching for objects on a high shelf can provoke vertigo.
- Bending forward: Tying shoelaces or picking items off the ground may lead to dizziness.
Although BPPV can affect people of all ages, it is most common in older adults. Women are twice as likely as men to develop idiopathic BPPV, potentially linked to osteoporosis and vitamin D deficiency. Other risk factors include head trauma, prolonged immobility, inner ear infections, and a history of vestibular disorders like Menière’s disease.
Recognising the Symptoms
Patients with BPPV often report the following symptoms:
- Sudden episodes of intense dizziness, lasting less than a minute.
- Nausea or vomiting accompanying vertigo.
- Feeling unsteady or "off-balance" when walking.
- Anxiety about movements that might trigger an episode.
These symptoms can significantly impact daily activities and, in severe cases, increase the risk of falls, particularly in older adults.
Accurate Diagnosis
BPPV is diagnosed through clinical history and specific diagnostic manoeuvres, such as the Dix-Hallpike test or supine roll test, which identify the affected semicircular canal. During these tests, practitioners look for characteristic nystagmus—involuntary eye movements that indicate abnormal inner ear function.
At Neurohealth Wellness, our chiropractors are skilled in performing these tests and ensuring a comfortable and accurate diagnostic experience.
Evidence-Based Treatment Options
The treatment of BPPV focuses on repositioning the dislodged otoconia back into their proper location, where they no longer cause symptoms. This is achieved through safe and effective physical manoeuvres, including:
- Epley Manoeuvre:
This widely recognised technique involves a series of head and body movements designed to guide the otoconia out of the semicircular canal and into the utricle. Each position is held until vertigo subsides, ensuring the otoconia settle properly. - Semont Manoeuvre:
Known as a liberatory manoeuvre, this approach involves rapid positional changes to dislodge the otoconia. It is particularly effective for patients who may not tolerate the slower movements of the Epley manoeuvre.
Research shows that these manoeuvres have a success rate of over 90% after multiple applications, with many patients experiencing immediate relief.
Preventing Recurrence
Although treatment is highly effective, up to 50% of patients may experience a recurrence within the first year. At Neurohealth Wellness, we adopt a proactive approach to minimise this risk, including:
- Addressing Vitamin D Deficiency: Studies have linked low vitamin D levels to a higher risk of BPPV recurrence. Regular supplementation may help reduce this risk.
- Balance and Vestibular Training: Exercises designed to strengthen the vestibular system can improve stability and prevent falls.
- Encouraging Active Lifestyles: Prolonged inactivity is a known risk factor for BPPV, so maintaining regular movement and avoiding long periods of bed rest is essential.
Comprehensive Care at Neurohealth Wellness
At Neurohealth Wellness, we combine advanced techniques with a compassionate approach to address BPPV and its impacts holistically. Our team, including experienced practitioners like Steve, Lucinda, and Lucia, offers a range of therapies from chiropractic care to acupuncture, ensuring personalised and effective treatment plans.
If you’re experiencing vertigo or dizziness that disrupts your daily life, don’t wait to seek help. Early intervention can prevent complications and provide lasting relief.
Take the Next Step Towards Wellness
Contact us today at (02) 9905 9099 or book online at www.neurohealthwellness.com.au/booking. Let us help you regain your balance, confidence, and quality of life.
References
- Kim, J.S., & Zee, D.S. (2014). Clinical practice: Benign paroxysmal positional vertigo. New England Journal of Medicine, 370, 1138-1147.
- von Brevern, M., et al. (2015). Benign paroxysmal positional vertigo: Diagnostic criteria. Journal of Vestibular Research, 25, 105–117.
- Jeong, S.H., et al. (2013). Decreased serum vitamin D in idiopathic benign paroxysmal positional vertigo. Journal of Neurology, 260, 832–838.
- Strupp, M., & Brandt, T. (2013). Treatment of benign paroxysmal positioning vertigo, vestibular neuritis, and Menière’s disease. Evidence-Based Neurology.
- Mandalà, M., et al. (2017). How to diagnose and treat BPPV. European Academy of Neurology Congress Proceedings, Amsterdam.
