What is vertigo, and what is BPPV?
Vertigo is the false feeling that you or the room is spinning. It is a symptom, not a disease, and it has more than one possible cause.
The most common cause is benign paroxysmal positional vertigo (BPPV). Tiny crystals in the inner ear get loose and move into a canal that senses head movement. When you tilt your head, the brain gets a wrong signal and the world spins.
What does BPPV feel like?
It comes in short spells, each lasting seconds to about a minute, triggered by a change of head position. Typical triggers are rolling over in bed, sitting up, looking up at a shelf or bending down to tie a shoe.
Between spells you may feel normal, or slightly unsteady and queasy. Because it can strike in bed or in the bathroom, some people become afraid to move, which makes them stiff and worried. Our guide on fear of falling may help.
Is it a doctor-first problem?
Most short spins triggered by position are BPPV, but some dizziness needs a doctor first. It is wise to have a doctor see your first episode, especially if you are older or have other health problems.
Go to the emergency department right away if dizziness comes with sudden weakness or numbness on one side, drooping face, slurred speech, double vision, severe headache, chest pain, fainting or trouble walking. These can be signs of stroke or another emergency. See when to seek medical care.
How does a physiotherapist check for BPPV?
We start with your story: what sets off the spin, how long it lasts, any ear symptoms, medicines and past falls. Then we test your balance, eye movements and neck.
For the position test, you lie back on your own bed with the head turned, while we watch your eyes for a typical flicker. This shows which ear and canal are involved. If the test suggests a different cause, we stop and recommend a doctor.
What is the treatment?
When BPPV is confirmed, the treatment is a repositioning manoeuvre, a set of slow head and body movements guided by the physiotherapist to move the crystals out of the canal. It usually takes a few minutes.
You may feel spinning during the manoeuvre, and we stay with you. Afterwards we give simple advice for the next day or two. If the spin remains, a repeat manoeuvre may be needed. Our glossary explains vestibular rehabilitation.
What should you do at home in the first days?
Keep safe while the spinning settles. These steps help.
- Get out of bed slowly: sit on the edge for a minute before standing.
- Use a stool and the wall in the shower, or sit to shower, and keep a night light on.
- Avoid ladders, driving and cycling until you feel steady.
- Take the stairs with a rail, and ask someone to stay close.
- Drink enough water in Ipoh’s heat, because dehydration can add to dizziness.
After the spinning stops, balance exercises rebuild confidence. The World Health Organization (WHO) recommends tailored exercise that challenges balance and improves strength, with regular progression, for older people in the community to prevent falls [1].
What does a home visit look like?
The check works well at home because the problem starts in your own bed. The physiotherapist tests you where you lie, and a family member can learn what to do if it returns.
We also look at the bedroom and bathroom for fall risks. See home physiotherapy in Ipoh for how a visit runs, and the guide on neck pain and dizziness if your neck is also sore.
Questions people ask
Send any other question on WhatsApp. Home visits are available now, and our Canning Garden centre is opening soon.