Neck & Head
BPPV (Benign Paroxysmal Positional Vertigo)
Also called: Crystal-related vertigo
Brief, intense spinning triggered by position changes — rolling in bed, looking up, bending forward — caused by calcium crystals displaced into the inner ear's canals. The most common cause of vertigo, and one of the most satisfying to treat: repositioning maneuvers resolve most cases in one to a few sessions.
Common signs
- Spinning lasting seconds to a minute with position change
- Triggered by rolling over, lying down, looking up
- Nausea with episodes; unsteadiness between them
- No hearing loss or ear ringing (if present, think differently)
Seek help now if
- Vertigo with double vision, slurred speech, weakness, or severe imbalance — stroke must be excluded
- New severe headache or neck pain with vertigo
- Hearing loss accompanying vertigo
- Vertigo lasting hours continuously rather than brief positional bursts
Any of these: call 911 or get to an emergency room first. Everything else can wait.
What to do first
- Get assessed — a positional test (Dix-Hallpike) identifies which canal is involved
- Treatment is a specific repositioning maneuver (e.g., Epley) matched to that canal — often immediately effective
- Don't just 'wait it out' — untreated BPPV causes falls and lingering unsteadiness
If it's become chronic
- Recurrent BPPV happens; learn your maneuver and triggers
- Persistent unsteadiness after successful repositioning responds to vestibular rehabilitation exercises
- Check vitamin D status — deficiency is associated with recurrence
Natural healing options we use
- Canalith repositioning maneuvers performed and taught in-office
- Vestibular rehabilitation for residual imbalance
- Cervical care when neck dysfunction coexists (common)
- Vitamin D optimization
About imaging
Not needed for classic BPPV. Imaging enters when red flags or atypical features appear.
Daily self-care
- Sleep slightly propped for a night or two after repositioning if advised
- Move deliberately with position changes during recovery
- Fall-safety awareness until steady
More in Neck & Head
WhiplashCervical Sprain/StrainCervical Disc HerniationCervical RadiculopathyCervical Facet SyndromeCervical Degenerative Disc Disease & SpondylosisCervical Spinal StenosisCervicogenic Headache
Please read: this page is education, not a diagnosis. A proper examination is how a condition gets confirmed and a plan gets built. See our medical disclaimer.