It’s Easy to Fix Positional Dizziness — The Most Common Cause of Vertigo

Positional Dizziness — The Most Common Type of Vertigo

Many peo­ple expe­ri­ence an occa­sion­al episode of dizzi­ness.  It’s only when the attacks of ver­ti­go keep recur­ring that you might seek the help of a doc­tor.

For­tu­nate­ly, the sin­gle most com­mon cause of dizzi­ness is easy to diag­nose, and you don’t even need fan­cy med­ical tests to do it.

The most com­mon cause of dizzi­ness is a con­di­tion known as Benign Parox­ys­mal Posi­tion­al Ver­ti­go, though we’ll call it BPPV for short.

It’s con­sid­ered to be Benign because it doesn’t involve an under­ly­ing dis­ease that will wors­en with time or cause oth­er symp­toms to emerge.

It’s called Parox­ys­mal because the attacks of ver­ti­go occur sud­den­ly and last only a brief time.

And it’s called Posi­tion­al because the dizzi­ness depends on the posi­tion or motion of your head.

BPPV occurs when cal­ci­um crys­tals (called otoliths), which nor­mal­ly float in cer­tain parts of your inner ear, get lodged in the wrong chan­nel.  Then, when you turn your head in a par­tic­u­lar direc­tion, the otoliths cre­ate abnor­mal stim­u­la­tion of the nerve recep­tors, and you get dizzy.

How to Diagnose BPPV

You might have BPPV if

  • you have episodes of spin­ning caused pri­mar­i­ly by turn­ing your head in a par­tic­u­lar direc­tion
  • the dizzi­ness lasts for about 30 sec­onds at most
  • you feel well in between attacks

You might have a dif­fer­ent diag­no­sis if

  • the dizzi­ness lasts for longer than 1–2 min­utes
  • you have symp­toms oth­er than dizzi­ness or nau­sea
  • you get dizzy spon­ta­neous­ly – with­out mov­ing your head
  • you feel faint-head­ed (not tru­ly dizzy)  main­ly when you sit up or stand up quick­ly

Two oth­er fair­ly com­mon caus­es of dizzi­ness that need to be exclud­ed are

  • Meniere’s dis­ease – in which the dizzy spells last far longer than in BPPV and also typ­i­cal­ly includes hear­ing loss and tin­ni­tus (ring­ing in the ears), and
  • Ortho­sta­t­ic hypoten­sion – caused by a sud­den drop in blood pres­sure when you quick­ly stand up, leav­ing you light-head­ed, not tru­ly dizzy.

For­tu­nate­ly, if you fit into the diag­nos­tic cri­te­ria for BPPV, it’s unlike­ly that you need fur­ther diag­nos­tic tests.

Simple BPPV Therapy

What’s even more for­tu­nate is that BPPV is eas­i­ly treat­ed in most cas­es with­out drugs or surgery.  Doc­tors have devel­oped a series of head and body posi­tions that, per­formed in sequence, allow for the offend­ing otolith to repo­si­tion itself prop­er­ly with­in the inner ear.  This treat­ment sequence is known as the Epley Maneu­ver or the CRP - canalith repo­si­tion­ing pro­ce­dure.

Need more infor­ma­tion?  E-mail Dr. Lavine at


About Ronald Lavine, D.C.

Dr. Lavine has more than thirty five years' experience helping patients alleviate pain and restore health using diverse, scientifically-based manual therapy and therapeutic exercise and alignment methods. His website,, provides more information about his approach. Please contact him at or at 212-400-9663.
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