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
If any of these is sudden or severe, call 911 or go to an emergency room. For the others, get examined before you start self-care.
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
The longer road
- 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
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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.