5 Reasons to Work with a Vestibular Physical Therapist to Solve BPPV, Rather Than the DIY at Home Approach.

This is a question I hear a lot and it makes sense: “If BPPV is treated by a simple maneuver, why not save time, money, and hassle, and just do the maneuver by myself at home?”

BPPV stands for “Benign Paroxysmal Positional Vertigo” and describes a condition where someone experiences an intense sensation of spinning when changing the position of their head relative to gravity.  The most common movements that my clients report to bring on their symptoms are:

• getting into bed

• rolling over in bed

• getting out of bed

• bending over to get dressed

• looking up while washing hair

• bending over to blow-dry hair

• looking up while putting on contact lenses

• exercise movements on the ground such as sit ups or yoga

BPPV takes place when a person’s crystals (or technically “otoconia”) move into the wrong place in the inner ear, and give that person signals that they are moving when the person is actually still.  This it is treated with a simple maneuver (or maneuvers) that are referred to as “canalith repositioning”.

So the big question: Can someone treat their own BPPV at home successfully?  Absolutely.

Another question that should be asked: Should someone treat their own BPPV?  Probably not and here are 5 reasons why, in no particular order:

1. Being treated by a vestibular specialist is likely easier, quicker, and the most direct route from spinning back to stable.

2. When someone is experiencing BPPV, their “crystals” are likely to be in 1 (or more) of 4 different canals.  If someone is doing the maneuver for the wrong canal, it is likely to cause them discomfort and dizziness, with no benefit.

3. The maneuvers to fix BPPV are simple (the most common one is called the Epley Maneuver), however they are extremely difficult to do alone while actively experiencing BPPV.  While helping clients through the moves in the clinic, I am guiding them into the correct positions with my hands and verbally coaching them about what we are doing now and what the next move is going to be.  If my client is experiencing spinning, I’m there to provide tactile/ hands-on feedback that they are safe, and welcome them to hold onto me or the treatment table to increase their sense of security.

4. Remember the multiple canals mentioned above?  There is a small chance that, even when done perfectly, crystals can move from one canal to another during the maneuvers.  This is called “canal conversion” and on the plus side indicates that the crystals are being moved, but on the negative side, would then require a different maneuver to solve.  When this happens in the clinic (I believe it has happened 4 or 5 times in my career), we immediately transition to a different maneuver to treat the new canal that’s being affected (and often completely solve the problem that day).  If a canal conversion happens when someone is by themselves at home, they will likely be experiencing worse symptoms, and have no idea how to fix the new problem.

5. Ninety-nine times out of one hundred, in my experience, a sense of spinning as previously described is simply BPPV.  That said, I never just “do the maneuver” but instead provide a short but meaningful vestibular evaluation first.  This helps to ensure that we are treating the right thing, and not skipping past other symptoms that would require a referral to another medical professional.

At the end of the day, people should do what works best for them, but should have as much information as possible before making their choice.

Do you live in Central Florida and suspect you are experiencing BPPV? Feel free to give us a call at 863-216-8611!  We offer free phone consultations and would love to help.