Vertigo Spotlight: BPPV – the Most Common Vertigo Disorder

Vertigo Spotlight: BPPV – the Most Common Vertigo Disorder

BPPV, or benign paroxysmal positional vertigo, is the most common vestibular disorder.  Each year, it affects over 150,000 people. BPPV causes severe episodes of vertigo, especially with changes in head position.  The name of the condition can sound overwhelming, but when you understand the meaning of each word, it illuminates the nature of this common vertigo disorder.

  • Benign – benign means that the condition is not harmful in a life-threatening way.
  • Paroxysmal – paroxysmal refers to the timing of the episodes, which come in sudden, short-lived spells.
  • Positional – vertigo episodes associated with BPPV are triggered by certain head movements or positions.
  • Vertigo – the hallmark characteristic of BPPV, vertigo is defined as a false sensation of rotational movement.

What’s Causing my BPPV Episodes?

BPPV is caused by a problem in the inner ear.  Our vestibular system, the system that controls our body’s ability to balance, is made up of 3 fluid-filled semicircular canals.  Normally, there are calcium carbonate crystals embedded in another area of the inner ear called the utricle. These crystals aid in sensing motion, ultimately giving our brain the information it needs to maintain our sense of balance.  These crystals can break down over time and become dislodged, or they can be damaged by an inner ear infection or head injury. They then migrate into the fluid-filled canals where they don’t belong. This disturbs the normal fluid movement in the inner ear, causing severe bouts of vertigo.

How do I Know if it’s BPPV?

Some of the biggest telltale signs that BPPV is the cause of your vertigo are that it does not cause constant dizziness (BPPV episodes are relatively short but intense) and it is almost always brought on by changes in head position.  Here are some other ways you might be able to tell if you are experiencing benign paroxysmal positional vertigo:

  • BPPV is the likely cause of vertigo that comes on when you lie down.
  • BPPV can aggravate other conditions such as migraines.  Migraine sufferers who develop BPPV might notice an increase in the frequency or severity of their headaches.
  • If you woke up in the morning with vertigo, BPPV is the likely cause.
  • You will have very specific, abnormal eye movements called nystagmus that accompany your vertigo episodes.

The Most Common BPPV Treatment Options

In some cases, BPPV can be relieved by certain maneuvers that are designed to shift the particles away from the semicircular canals.  Canalith repositioning maneuvers such as Epley maneuver have been shown to be helpful for symptomatic relief. The Epley maneuver relies on moving the person’s body and head into different position with the idea that gravity will help the loose crystals to migrate into a different part of the inner ear where they can’t cause vertigo symptoms.

Rarely, BPPV suffered might be prescribed medications that are designed to suppress the vestibular system.  These are usually only given for short-term relief since long-term use can actually cause symptoms to worsen.

BPPV and Your Neck

Head position is inseparable from neck position.  It is because of how your neck is designed, particularly the upper part of it, that we have the wide range of movement of our heads that we do.  Because the strength and alignment of your neck determine how you are able to hold your head up, BPPV can be as much a neck problem as it is a problem having to do with head position.  This is especially relevant to vertigo sufferers with any history of head or neck injury. We know that vertigo is connected to the neck for several reasons, including the following:

  1. It can be aggravated by changes in head position – vertigo and dizziness can arise when rolling over or getting up out of bed, when you extend your neck back to look up (like when getting something out of a high cupboard), or when bending down to pick something up off the ground or tie your shoes.
  2. Communication of signals via the vestibular nerve and brainstem – the uppermost vertebrae in your spine protect the brainstem.  Abnormal positioning of these vertebrae can distort signals that tell your brain how your body is positioned in space. This can lead to vestibular dysfunction and vertigo.
  3. History of head or neck injury which can cause otoconia to dislodge – sometimes even a slip and fall or seemingly mild fender-bender can be the event that triggered the loosening of the calcium crystals in your inner ear.  An accident or injury can also cause the vertebrae that hold your head up to shift, resulting in abnormal nerve function and head position.

Upper Cervical Chiropractic Care Brings Hope to Vertigo Sufferers

Upper cervical chiropractic care is a subspecialty in the chiropractic profession that focuses on the vertebra at the upper part of the neck.  The positioning of these vertebrae – the atlas (C1) and the axis (C2) – have a significant influence on head movement, brainstem function, and how the rest of the spine beneath it works.  For vertigo sufferers, having your neck checked by an upper cervical chiropractor is one of the best things you can do if you are looking for lasting, natural relief. This becomes even more important with any history of head or neck trauma, no matter how mild it may have seemed at the time.

Because upper cervical chiropractic adjustments are so precise, they do not require a great deal of force.  We take the necessary time to do an in-depth analysis of your head and neck positioning so that we can customize adjustments that are designed to hold in place for as long as possible.  By correcting and maintaining normal atlas alignment, your body can begin to heal naturally and function normally again. Before resigning yourself to dealing with recurring bouts of BPPV, contact us for a free, no-obligation consultation to find out more about how upper cervical chiropractic care can help.


To schedule a consultation with Dr. Kuhn call 780-450-1041 or just click the button below.

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