If you’ve been told you have BPPV — or you just rolled over in bed and the room started spinning — this guide explains what’s happening, what vestibular physiotherapy can do about it, and what to expect at your appointment. Written by the vestibular team at Daisy Hill Physio, Logan QLD.

What is BPPV?

Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo in adults. It happens when tiny calcium-carbonate crystals (otoconia) inside your inner ear become dislodged from their normal position and float into one of the semicircular canals. When you change head position — rolling over in bed, looking up, bending down — those misplaced crystals stimulate the canal abnormally and your brain receives a brief but intense false signal that you are spinning.

Episodes typically last 10–60 seconds and are triggered by specific head movements. Between episodes you usually feel completely normal, although many sufferers describe a lingering sense of unsteadiness or “fog” for hours afterwards.

How do I know it’s BPPV and not something else?

The classic BPPV pattern is:

• Vertigo brought on by changing head position (lying down, sitting up, looking up, rolling over)
• Short, intense episodes — seconds, not minutes or hours
• No hearing loss, no ringing in the ears, no neurological symptoms
• Often a feeling of nausea or visual blurring during episodes

If your symptoms include hearing loss, persistent dizziness lasting hours, severe headaches, double vision, weakness, or trouble speaking — these are not BPPV and need urgent medical assessment. See your GP or go to an emergency department.

What causes BPPV?

In about half of cases BPPV appears with no identifiable cause. Known triggers include:

• Head trauma (falls, motor vehicle accidents, sports injuries)
• Prolonged bed rest
• Migraines
• Inner ear infections (vestibular neuritis, labyrinthitis)
• Reduced blood flow with age (BPPV is more common after 50)

How vestibular physiotherapy treats BPPV

The good news: BPPV is one of the most treatable causes of vertigo. Treatment is not medication — it’s a series of specific head movements (called repositioning manoeuvres) that physically guide the displaced crystals back to where they belong.

The most common manoeuvres a vestibular physiotherapist will use:

• Epley manoeuvre — for posterior canal BPPV (the most common variant, about 80% of cases)
• Semont manoeuvre — alternative for posterior canal BPPV when the Epley isn’t tolerated
• Lempert / barbeque roll — for horizontal canal BPPV
• Yacovino manoeuvre — for the rarer anterior canal BPPV

Studies consistently show that a single Epley manoeuvre resolves around 80% of posterior canal BPPV cases, and 90%+ resolve within 1–3 visits. This is one of the few areas in medicine where a 15-minute treatment can completely fix what felt like a serious problem.

What to expect at your first vestibular physio appointment

Your first session at Daisy Hill Physio for suspected BPPV will run about 45–60 minutes:

1. History. When did symptoms start, what triggers them, how long do they last, any associated symptoms? This narrows the diagnosis significantly.
2. Diagnostic positioning tests. The Dix-Hallpike test (for posterior canal) or the supine roll test (for horizontal canal) will reproduce a brief vertigo episode while we observe your eye movements (nystagmus). The pattern of nystagmus tells us exactly which ear and which canal is affected.
3. Treatment manoeuvre. Once we identify the affected canal, we perform the appropriate repositioning manoeuvre — typically the Epley.
4. Post-treatment instructions. Some clinicians ask you to keep your head upright for the rest of the day; current evidence suggests this isn’t strictly necessary but we’ll discuss what works for you.
5. Review. A follow-up 3–7 days later confirms resolution. About 20% of patients need a second manoeuvre.

Will it come back?

BPPV recurs in about 30% of patients within 5 years. The good news is that the same treatment works again. We teach our patients the warning signs of recurrence and, where appropriate, a self-applied home Epley they can perform if symptoms return.

Booking and access

Daisy Hill Physio offers vestibular physiotherapy assessments to clients across Logan City, south Brisbane, and surrounding suburbs. Same-week appointments are usually available because we know how distressing untreated vertigo is. We accept private, NDIS, DVA, and Medicare CDM-funded appointments. See our vestibular physiotherapy service page for full details.

To book, call 07 3209 2000, email info@daisyhillphysio.com.au, or use the Book Online button.

Frequently asked questions about BPPV

Can I drive with BPPV?

If your vertigo is triggered only by specific head movements and you can avoid those movements while driving, short trips are usually safe. We strongly recommend not driving in the days before treatment if your episodes are severe, frequent, or unpredictable.

Is BPPV serious?

BPPV is uncomfortable and can be scary, but it is not dangerous in itself. The biggest associated risk is falls — particularly in older adults. That’s why early treatment matters.

Can BPPV resolve on its own?

Yes, in some cases the crystals reabsorb naturally over weeks to months. But a vestibular physio appointment can resolve it in 15 minutes versus weeks of episodes — there’s little reason to wait it out.

Do I need a GP referral?

No. You can book a private appointment directly. A GP referral is only needed for Medicare CDM, DVA, or specific NDIS funding arrangements.

Does Medicare cover vestibular physiotherapy?

Yes, under a Chronic Disease Management (CDM) plan from your GP, you can access up to 5 subsidised allied-health visits per calendar year. We bill the CDM rebate directly.

What if it’s not BPPV?

Vertigo and dizziness have many causes — vestibular migraine, vestibular neuritis, Meniere’s disease, cervicogenic dizziness, and central neurological causes among them. A vestibular physio assessment will help differentiate; if we suspect a non-BPPV cause we’ll refer you appropriately, often back to your GP for ENT specialist referral.

This guide is general information and is not a substitute for individual medical assessment. If your dizziness is severe, persistent, or accompanied by any neurological symptoms, seek urgent medical care.