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Stop the Room From Spinning: Causes and Treatments of Vertigo

Unless you’re spinning around on an amusement park ride, sudden dizzy spells can be deeply unsettling. This sudden illusion of motion, known as vertigo, affects millions of Americans every year, and it is especially common among older adults. If you’re experiencing sudden bouts of dizziness while lying down or rolling over, you may have a condition called benign paroxysmal positional vertigo (BPPV).

Despite the intimidating name, BPPV is rarely serious and can be treated quickly without surgery or medication.

“When patients experience symptoms for the first time, it can be very alarming, making them wonder if they’ll ever be able to function normally again,” says Kristen Black-Bain, PT, DPT, a vestibular therapist at University of Utah Health. “This is not the case, and a vestibular specialist can take care of it rather quickly—sometimes after one session—so people can go on with their normal lives.”

Why Is the Room Spinning?

BPPV is the most common form of vertigo, an inner-ear condition that makes you feel like the world is spinning when it is not. As we age, calcium carbonate crystals within the inner ear can break down and become dislodged. While flowing freely within fluid-filled spaces of the ear canal, they send false signals to the brain. When the head moves, the brain’s equilibrium is thrown off-kilter, causing sudden yet brief (no more than a minute) sensations of spinning.

“When you move your head in certain ways—getting out of bed, rolling onto your side, looking up and down at the computer screen, for instance—you can cause these crystals to move and trigger sudden dizziness,” Black-Bain says.

Although age is the major risk factor for BPPV, this condition can also be caused by a head injury. Cases among children and young adults are extremely rare. 

Classic symptoms of BPPV include:

  • Sensations of spinning or rocking
  • Dizziness and lightheadedness
  • Nausea and vomiting
  • Trouble with balance 

Note: Get help immediately if you’re experiencing vertigo with other symptoms (hearing loss, trouble speaking, numbness or tingling, etc.), which may signal a medical emergency.

What Happens in Treatment?

BPPV can be treated quickly and efficiently in physical therapy. During an assessment, a vestibular therapist will turn the patient’s head in different positions to trigger the dizziness and track the eye movements. This helps them determine which of the three ear canals the free-range crystals are floating in. Then, the therapist performs a repositioning procedure, which involves turning the patient’s head in multiple positions to help reposition the problematic crystals and return them to where they belong.

Following treatment, patients are advised to avoid frequent head movements for 24 hours. Afterward, they can resume their daily activities without any symptoms. Black-Bain encourages anyone who’s experiencing BPPV symptoms to get help right away because there’s no reason to prolong the suffering.

“Symptoms brought on by BPPV can cause a lot of suffering and stress,” Black-Bain says. “Don’t wait and see if it goes away; book an appointment with a specialist who can help you feel better quickly.”