BPPV (benign paroxysmal positional vertigo) causes brief spinning spells when you move your head in a certain way, for example when you roll over in bed. A trained physiotherapist can check for it and, where appropriate, treat it by guiding your head through repositioning manoeuvres. At Physio 1 Airdrie, that starts with an assessment of your symptoms, safety and health history.
Key facts
- A BPPV spell usually lasts less than a minute, and MyHealth Alberta says BPPV isn’t a sign of a serious health problem.
- It happens when tiny calcium particles in the inner ear move into one of its semicircular canals.
- The Dix-Hallpike test checks for it, and the Epley or Semont manoeuvre is done with the help of a doctor or physiotherapist.
- These manoeuvres should not be done on people with back or spine injuries or problems.
- BPPV can come back, sometimes after months or years, and the vertigo can put you at risk of falls.
- You do not need a doctor’s referral to see a physiotherapist in Alberta, although some benefit plans ask for one.
What is BPPV and what does it feel like?
BPPV causes short spells of spinning that start when your head changes position, such as rolling over in bed, tilting your head back or looking down. A spell usually lasts less than a minute. If the vertigo is bad enough, you may also feel sick or vomit.
Tiny calcium particles in your inner ear normally help you keep your balance. With BPPV, some of them move into a semicircular canal, where they trigger the sensors that make you feel you are spinning. The spinning can put you at risk of falls, so get up slowly and sit on the edge of the bed for a moment before standing.
MyHealth Alberta says BPPV isn’t a sign of a serious health problem and that it can come back, sometimes after months or years. Dizziness has many other causes, though, so a new or different spell should be checked rather than assumed to be BPPV. MyHealth Alberta’s guide to BPPV explains the condition in more detail.
How does a physiotherapist check for BPPV?
The physiotherapist asks about your symptoms, then may check your eye movements, balance and how you respond to certain positions. In the Dix-Hallpike test, your head is turned and you are helped to lie back while your eyes are watched.
Some of these positions can briefly bring on your symptoms. At Physio 1 Airdrie, your physiotherapist explains each step and goes at your pace.
What to tell the physiotherapist
- Which movement brings on the spinning.
- How long each spell lasts.
- Whether you have fallen or feel unsafe walking.
- Any back, neck or spine injury, problem or movement restriction.
- Any previous assessment or medical advice about the dizziness.
The assessment is also a safety check. It helps decide whether repositioning suits you, whether balance or gaze exercises fit better, or whether you should see a doctor first.
How does repositioning treatment work?
Repositioning treatment uses set head and body movements, such as the Epley or Semont manoeuvre, to help move the particles out of the canal. MyHealth Alberta’s page on the Epley and Semont manoeuvres says they are done with the help of a doctor or physiotherapist and that some people need more than one treatment.
These manoeuvres should not be done on people with back or spine injuries or problems, which is one reason to have an assessment first. Mention any neck problem as well, because it can make the movements hard to tolerate.
Repositioning is only one part of what the clinic’s vertigo and balance therapy may include:
| Possible part of care | When it may be considered | What the assessment adds |
|---|---|---|
| Repositioning manoeuvre | Your positional test points to BPPV | Checks whether the technique is appropriate and safe for you |
| Balance exercises | Unsteadiness affects walking or daily activities | Sets a safe starting level |
| Gaze stability exercises | It is hard to keep your vision steady when you move | Guides the exercise level and progression |
| Home exercise program | Practice between appointments is appropriate | Gives clear instructions and safety limits |
| Fall-risk education | Dizziness or imbalance affects your safety | Links advice to your home and activities |
What does the research say about the Epley manoeuvre?
A 2014 Cochrane review of 11 trials found the Epley manoeuvre safe and effective in the short term for BPPV in the posterior canal of the inner ear. The trials were mostly small and their follow-up was short. Nausea during the manoeuvre was common, and some people could not tolerate it because of neck problems.
The review does not tell you how many visits you will need, and BPPV can come back. Your physiotherapist reassesses how you respond and adjusts the plan. No set number of visits applies to everyone.
When is dizziness an emergency?
Call 911 if you pass out, have sudden dizziness that doesn’t get better, or have dizziness with signs of a heart attack or a stroke. MyHealth Alberta lists these signs, among others:
- chest pain or pressure, sweating or shortness of breath;
- sudden numbness, tingling, weakness or loss of movement in your face, arm or leg;
- sudden trouble speaking, sudden vision changes or sudden confusion;
- sudden problems with walking or balance;
- a sudden, severe headache that is different from past headaches.
If your dizziness is new, severe or comes with other concerning signs, seek medical attention before booking physiotherapy.
Before your appointment in Airdrie
Plan the practical details before you book, because a positional test can briefly bring on your symptoms.
- Arrange a ride. If dizziness affects your ability to drive, arrange a ride to and from your appointment.
- Know your triggers. Note which movements bring on the spinning, how long it lasts and whether you have fallen.
- Mention back, neck or spine problems. They affect whether a manoeuvre is suitable for you.
- Check your plan. You do not need a doctor’s referral to see a physiotherapist in Alberta, but some extended benefit plans need one before they pay.
- Complete your intake form. The clinic’s before your visit guide explains the intake form and what to have ready, such as your medications and health history.
At Physio 1 Airdrie, care for vertigo may include repositioning techniques where appropriate, balance and gaze stability exercises, a home exercise program and fall-risk education. Two of the clinic’s physiotherapists list vestibular rehabilitation training. If your dizziness or unsteadiness is not positional, read what to expect from vestibular therapy in Airdrie.
Frequently asked questions
Can BPPV come back?
Yes. MyHealth Alberta says BPPV can come back, and that it sometimes stops for months or years and then returns. If the spinning returns, note what brings it on and how long it lasts, and have it checked rather than assuming it is BPPV again. Dizziness that is new, severe or different from before needs medical attention first.
Do I need a referral to see a physiotherapist for BPPV?
No. The College of Physiotherapists of Alberta says you do not need a doctor’s referral to see a physiotherapist. Some extended benefit plans require a physician’s referral before they pay, so check your plan before your first visit. If your dizziness is new, severe or comes with other concerning signs, seek medical attention before booking physiotherapy.
Should I drive to my appointment?
If dizziness affects your ability to drive, arrange a ride to and from your appointment. Some assessment positions can briefly bring on symptoms, so plan your trip home before you arrive. Tell the clinic in advance if you are worried about walking, getting on and off the treatment table, lying down or becoming dizzy during the visit.
Can I do the Epley manoeuvre at home?
Only if a clinician has shown you how and you feel confident, as MyHealth Alberta advises. The manoeuvre should not be done on people with back or spine injuries or problems, and dizziness can have other causes. An online video is not a substitute for an assessment that checks whether the manoeuvre suits you.
Is BPPV serious?
MyHealth Alberta says BPPV isn’t a sign of a serious health problem, but the spinning can cause nausea and put you at risk of falls. Other conditions can also cause dizziness. Call 911 if you pass out, have sudden dizziness that doesn’t get better, or have dizziness with signs of a heart attack or a stroke.
If you think you have BPPV and your symptoms are not an emergency, read about vertigo and balance therapy at Physio 1 Airdrie, then book an assessment online or call the clinic.
This article is educational and does not replace an assessment, diagnosis or advice from a qualified healthcare professional.
