Benign Paroxysmal Positional Vertigo (BPPV) - Understanding the Most Common Cause of Vertigo

What is Benign Paroxysmal Vertigo

When you've just received a benign paroxysmal positional vertigo diagnosis, chances are you might feel overwhelmed.  BPPV is actually the most common cause of vertigo, despite its complex and intimidating-sounding name. About 107 out of every 100,000 people have it.  It is rare for children to develop BPPV, but it can occur in adults of any age, with seniors being particularly vulnerable. Most cases of BPPV seem to happen without an apparent reason.  To shed some light on BPPV, we are going to take a look at what its name really means, how the condition develops, and what you can do to find relief.

BPPV – What's in a Name?

Benign paroxysmal positional vertigo might sound scary and serious, but once you take a moment to break down each of those terms, the true nature of the condition comes to light:

  • Benign - the term benign indicates that it is not a life-threatening condition
  • Paroxysmal - paroxysmal means that episodes occur in sudden, brief spells
  • Positional - BPPV episodes are triggered by certain changes in head position or head movements
  • Vertigo - vertigo is characterized by the false sensation of movement or rotation

Taking each of these words together, you start to get the full picture of BPPV.  While it can be debilitating to experience vertigo attacks, the condition is thankfully non-life-threatening. It occurs due to changes within the inner ear.

The Inner Workings of a BPPV Episode

The way your body senses balance relies on input from several sources – your vision, sensors in the muscles and joints of your arms and legs (called proprioceptors), and your inner ear (vestibular system).  The central nervous system receives all of this sensory information, while the brainstem processes them. If everything is working properly, then your body is able to make the necessary corrections in posture so that you maintain your sense of balance.

Your inner ear contains calcium carbonate crystals called otoconia that normally stay embedded in place.  For people experiencing BPPV, these crystals can become dislodged and migrate into three fluid-filled semicircular canals. When these crystals end up where they don't belong, they can start to disturb the normal fluid movement within the inner ear. As a result, the brain receives false signals.  The brain then senses movement when there actually isn't any, which leads to the sensation of vertigo.

Symptoms of BPPV

Symptoms of BPPV can vary in frequency and severity from person to person, but often include a combination of the following:

  • Short but intense bouts of vertigo, or a spinning/rotating dizziness
  • Nausea or vomiting depending on the severity of vertigo
  • Feeling faint (syncope)
  • Nystagmus, which refers to abnormal movements of the eyes that occur during a BPPV attack

Between episodes of vertigo, BPPV sufferers might feel completely fine, or they might retain a mild sense of feeling off balance.  It is important to also know that BPPV does not affect your hearing, give you dizziness or vertigo that is constant, or cause other neurological symptoms such as numbness or tingling.

Relief Options for BPPV

  • Vestibular rehabilitation – a professional who is expert in vestibular rehabilitation therapy will recommend specific exercises to reduce your vertigo and dizziness. These exercises will retrain the eyes, and protect against the risk of falling due to loss of balance.
  • Treatment maneuvers – the most well-known maneuver to treat BPPV is the Epley maneuver.  This involves a particular series of head movements designed to try to reposition the displaced crystals to a place where they won't disturb balance signals.  Some providers may even give instructions on how to perform this maneuver at home. The Epley maneuver doesn't work for all presentations of BPPV, and your should be cautious before attempting to do this on your own.
  • Medications – many BPPV sufferers take medications to treat their symptoms of vertigo and nausea.
  • Surgical options – in rare and severe cases, surgical intervention to address BPPV is an option.

How Upper Cervical Chiropractic Can Help Naturally

Associations are evident between BPPV and head or neck trauma, as well as with migraines.   These are all very common conditions that can get better with upper cervical chiropractic care.  BPPV has a long-term recurrence rate of approximately 50%, especially in those who have experienced a trauma or injury.  This makes it especially important for people who have BPPV or vertigo to consult an upper cervical chiropractor.

The Connection Between the Neck and BPPV

Your neck and vertigo can be connected in more ways than you might think.  Your brainstem is responsible for the processing of balance signals from the components we discussed above.  In order for your brainstem to function properly, it needs to be free from irritation or pressure. The vertebra that provides protection for the brainstem, the atlas (C1), also happens to be the most freely movable.  Because it moves so much, it can be especially vulnerable to misaligning following even a mild head or neck injury. When the atlas shifts out of its normal position, rather than protecting the brainstem, it can actually cause irritation that results in abnormal signal processing.  This can be a contributing factor for vertigo sufferers that is often overlooked.

Thankfully, upper cervical chiropractic provides a simple, safe, and effective solution for this underlying problem.  Because of the precise nature of upper cervical adjustments they are, by nature, extremely gentle. The goal of upper cervical chiropractic care is to restore normal atlas alignment so that your central nervous system can operate at its highest possible capacity.  When this interference is removed, your body can begin to heal naturally, resulting in a reduction or resolution of your vertigo.



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The content and materials provided in this web site are for informational and educational purposes only and are not intended to supplement or comprise a medical diagnosis or other professional opinion, or to be used in lieu of a consultation with a physician or competent health care professional for medical diagnosis and/or treatment. All content and materials including research papers, case studies and testimonials summarizing patients' responses to care are intended for educational purposes only and do not imply a guarantee of benefit. Individual results may vary, depending upon several factors including age of the patient, severity of the condition, severity of the spinal injury, and duration of time the condition has been present.