Fixing Vertigo With a Turn of the Head

One minute you’re fine, the next minute everything is spinning. It happened recently to a coworker who woke up one morning and found that any little movement sent the room spinning and her stomach lurching. She couldn’t even get out of bed.

Her doctor told her she had benign paroxysmal positional vertigo (BPPV) — a type of dizziness common among older adults, and for which there is an amazingly easy fix.

BPPV was also the subject of a recent New York Times article by Paula Span, who wrote, “So many of the ailments that plague older adults can be managed but not cured. Benign paroxysmal positional vertigo is a different story.”

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BPPV is caused by a problem in the inner ear. It most often occurs in those age 50-plus, according to the Mayo Clinic, and more often in women than in men. It happens when a small piece of calcium crystal inside the ear becomes dislodged and enters the inner ear’s fluid-filled canals, where it disrupts the way your brain keeps you balanced.

The condition can often occur out of the blue, as my coworker discovered. One expert told the Times that the stickiness that keeps these crystals in place wears off with age, “like an old Post-it note.” It also can be triggered by a head injury, even a minor bump, or an ear infection, or sometimes just being tilted back in the dentist’s chair for too long.

While it’s uncomfortable, the biggest danger is an increased risk of falling because you feel so dizzy. The effect can wear off in a few days to weeks, but there is an easy fix. Unfortunately, many patients with BPPV see numerous doctors and go through many unnecessary tests before finding relief, Susan Herdman, a physical therapist and professor of rehabilitation medicine with Emory University’s Dizziness and Balance Center, told AARP.

Partly that’s because “dizziness is actually a complex problem and may be from a number of different causes — medications, low blood pressure, as well as a large number of inner ear disorders,” she said. Doctors who don’t recognize the condition — or who write it off to just part of aging — may prescribe medication, like meclizine (brand name Antivert), which is “ineffective as a treatment for BPPV,” Herdman said.

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The most effective treatment is the Epley maneuver (in medical terms, canalith repositioning), named for the doctor who developed it. As shown in this slideshow, the patient’s head is turned while he or she sits and then lies in different positions. It generally takes five minutes or less to get the crystal to float back in place, and it immediately cures vertigo in about 90 percent of people.

The Epley maneuver is usually done by a health care expert, “but if patients can do it correctly, we may suggest they try it at home if they have a recurrence,” Herdman says. But, she emphasizes, “they must be sure that what they are feeling is exactly the same as what they had before. If it is not the same, they should be seen by a qualified clinician.”

WebMD also offers descriptions for trying this maneuver at home.

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