Benign Paroxysmal Positional Vertigo (BPPV) Treatment

Tired of being dizzy when you are changing positions?

​If you are suffering from BPPV and prefer to treat them with non-invasive, non-medication based treatment, Montreal's Active Solution Physiotherapy, will develop a treatment plan specific to your BPPV.


BPPV occurs when otolith crystals, located in the utricle, move through one of the semicircular canals. These channels are responsible for giving information to the brain regarding the location of the head in space according to its movement. For example, looking up or lying on a bed will strongly stimulate the left and / or right posterior SC channels, while the horizontal SC channels will be stimulated when we look left and right, especially if we are lying on our back.

When these crystals dislodge and migrate through a channel, they give the brain false information. They essentially tell the brain that the head is moving when it actually isn't, causing intense dizziness as well as involuntary eye movements (nystagmus). Postural changes such as rolling over, lying down and getting up from bed are typically the aggravating factors, as they cause large head movements in relation to gravity. These movements / position changes cause the crystals to move and thus cause dizziness. When you stop moving, the crystals gradually stop moving on their own, which is why this dizziness does not last long: between 30-60 seconds.

BPPV is therefore characterized by intense dizziness (ie: spinning room) for a short time (30 to 60 seconds) caused by changes in positions or head movements.


  • In 60-80% of cases, there is no known cause. The risks increase with age (especially after 55 years of age) and women are affected twice as often when compared to men. In addition, some links are present between BPPV and osteoporosis, atherosclerosis, arterial vasculitis, autoimmune diseases, diabetes, anxiety, hormonal changes and the position of the head during sleep.
  • 10 to 30% of cases occur as a result of trauma, such as a car accident or a severe blow to the head.
  • 5 to 25% of cases are the secondary consequence of another medical condition, such as labyrinthitis, neuronitis, Ménière's disease and migraines.


Firstly, the physiotherapist will conduct a full vestibular assessment in order to confirm the diagnosis of BPPV. Then, with this data, the physiotherapist can use different maneuvers of "repositioning" so that the crystals return to their usual location. These therapeutic maneuvers exist in several variations, but are all effective with a resolution rate fluctuating between 85 and 95% in 1 to 3 treatment sessions. The practitioner can also teach you the exercises you need to do yourself at home in order to speed up the recovery process.


Unfortunately, BPPV is a condition that can reoccur. In the long term, one in two people will get it again. The risk of recurrence increases for women, as well as people over 60 years of age, in addition to those who have experienced more than 3 episodes of dizziness, people with vitamin D deficiency, and people with osteoporosis.

Treatment Options

Vestibular Rehabilitation In clinic in Montreal


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