BPPV is one of the most common causes of vertigo.  Vertigo, which can be a scary and intense experience, is described as the false sensation that you yourself are spinning or that your surroundings are spinning around you.  Because BPPV is so prevalent, answering some of the most frequently asked questions about the condition can help you gain a better understanding of your options for finding some relief.

Question #1: What does BPPV stand for?

BPPV is an abbreviation for benign paroxysmal positional vertigo.  While this might seem like a mouthful, it’s actually quite easy to understand once you know what each word is describing:

Question #2: What causes BPPV?

As part of the normal makeup of the inner ear, crystals of calcium carbonate called otoconia play a role in helping your body sense motion and balance.  Otoconia normally remain embedded in a part of the inner ear called the utricle. However, in BPPV, these crystals become dislodged and then migrate into one of the fluid-filled canals where they don’t belong.  The normal movement of this fluid, called endolymph, is what gives the brain information about how your body is positioned in space. When crystals interrupt the normal movement of endolymph it can send false signals to the brain, which can cause vertigo.  In BPPV, this can happen doing something as common as rolling over in bed.

Question #3: How common is BPPV?

It is estimated that about 2.4 percent of people will experience BPPV at some point in their life.  It most commonly occurs in adults, particularly in seniors. Children very rarely experience BPPV. Most cases of BPPV have no apparent cause, however, some connections have been made with migraines, trauma, and inner ear infections.

Question #4: What are the most common symptoms of BPPV

By far, the most common and severe symptom of BPPV is spells of vertigo that can be very severe.  Vertigo episodes can come on so suddenly that they are sometimes referred to as “drop attacks”. Because of the whirling or spinning sensation, many BPPV sufferers will experience nausea or vomiting as well.  You might also lose your balance or feel unsteady on your feet. The symptoms of BPPV can be very intense and can last from just a few seconds to several minutes or more. Once the worst of the episode has passed, residual dizziness and instability may persist.  Oftentimes, the first vertigo attack of BPPV is the worst and subsequent ones are milder.

Question #5: What is the Epley maneuver?

The Epley maneuver is one of several treatments that take the head through specific ranges of motion in an attempt to guide the loose calcium crystals back to where they should be.  Depending on where the calcium crystals are located, these maneuvers can be effective in relieving BPPV symptoms. It is important to seek out healthcare providers that are well trained in helping people with this condition to ensure that there aren’t other underlying health factors and to be sure that the treatment is properly rendered.

Question #6: What is Upper Cervical Chiropractic care and how can it help me?

Many people suffering from vertigo are finding relief with a special niche within the chiropractic profession.  Upper cervical care focuses exclusively on the uppermost vertebrae in the spine to ensure their proper positioning.  An upper cervical misalignment can have far-reaching implications when it comes to your body’s ability to function normally.  In the case of vertigo, this area of the spine plays an important role for two reasons:

  1. The upper cervical spine lies in very close proximity to the inner ear.  A misalignment of the atlas can affect how the inner ear functions and communicates with the brain about how your body is positioned in space.
  2. The atlas (C1) and axis (C2) vertebrae that make up the upper cervical spine protect the brainstem.  The brainstem is responsible for sorting and integrating the information received regarding how your body is positioned and must send the appropriate signals in response so your body can maintain its sense of balance.

When the atlas misaligns, it can change the way the inner ear functions and it can also irritate the brainstem, causing abnormalities in the way signals are interpreted and sent.  The focus in our practice is identifying whether or not the atlas is misaligned, and if it is, gently adjusting it back to its normal position.

Just as it might seem, once the atlas is aligned, your body’s normal functions are allowed to return naturally over time.  The longer you are able to hold your alignment, the more optimally your body can function. With upper cervical care, adjustments are given only when needed, making it a natural, non-invasive, non-painful way to achieve lasting relief from vertigo and its associated symptoms.




The medical condition vertigo causes you to feel as if you or the things in the environment around you are moving when they are actually standing still. It is known to have a rotational component of spinning or swaying. You may also experience nausea, vomiting, problems walking, or sweating. It often becomes more severe when the head is moved in a particular position. Vertigo is the most common form of dizziness.

Vertigo is put into two different classifications:

The Vestibular System’s Role in Vertigo

The vestibular system is a key component in helping the body keep in balance. It is a sensory system that keeps track of your spatial orientation and sense of balance so as to coordinate movement. It contains the cochlea, the labyrinth of the inner ear, including the semicircular canals (indicating rotational movements) and the otoliths (indicating linear accelerations). The vestibular system mainly sends signals to the neural structures that control eye movement and to the muscles keeping you upright.

Since the world is three-dimensional, the vestibular system has three semicircular canals in each labyrinth. They are at right angles to each other and are called the horizontal, the anterior, and the posterior semicircular canals. When the fluid contained in these canals moves, it corresponds to the rotation of the head. Depending on what kind of movement the head is making, the proper canal responds. If something occurs to cause a problem in this system, vertigo is often the end result.

Three Conditions That Have Vertigo as the Main Symptom

There are three main conditions known to have vertigo as a symptom. Let’s look at each one closely so as to understand the process involved.

BPPV (benign paroxysmal positional vertigo): One of the most common causes of vertigoBPPV causes brief episodes of mild to severe sensations of spinning. It is usually triggered by changes to the way your head is positioned. For example, when tipping your head up or down, when lying down, or when rolling over in bed. Symptoms include:

BPPV can come and go and is usually due to the crystals of the inner ear breaking off and moving to the wrong area of the ear. When the fluid in the ear moves with the head, it continues to move after the head has stopped. This is the reason why this type of vertigo happens.

Labyrinthitis and vestibular neuritis: These two problems have the same symptoms and are cared for in the same way. It is a problem inside the ear causing the labyrinth to become inflamed or swollen. The inflammation brings about sudden vertigo and makes you feel like you are spinning or whirling. You may experience temporary hearing loss or ringing in your ears. Symptoms are:

No one really knows why this occurs, but it is often connected to a viral or bacterial infection (a cold, the flu, upper respiratory infection, or a middle ear infection). When the vestibular nerve becomes inflamed, improper signals are sent to the brain about the body’s movement.

Meniere’s disease: A disorder of the inner ear that brings about vertigo, fluctuating hearing loss, and tinnitus. You may also experience a feeling of congestion in the ear, with only one ear being affected. It is considered a chronic condition and generally affects those in the age range of 20 to 50. Meniere’s disease is thought to occur due to an abnormal amount of fluid buildup in the inner ear. This has not been proven, however.

Vertigo Treatment Novato CA

Finding Help for Vertigo

No matter the reason for the spinning sensation you are experiencing, one thing that has been shown to help is upper cervical chiropractic care. This is because a misalignment in the bones of the upper cervical spine can be an underlying reason for vertigo. If the top bones of the neck, the C1 and C2 vertebrae, are misaligned, they can be putting the brainstem under stress. This causes it to mix up the signals being sent to the brain about the body’s location in its environment. When the signals from the brainstem do not match those of the eyes, ears, and nerves, the brain doesn’t know how to react and vertigo ensues.

As upper cervical chiropractors, we use a method that is both gentle and precise to help correct the problem. We do not have to resort to popping or cracking the spine. Once the bones are back into place, many patients report a great improvement in their vertigo. This often only takes a few adjustments.

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