vertigo Treatment in Adelaide

What Is BPPV?

Benign Paroxysmal Positional Vertigo — commonly known as BPPV — is the most common cause of vertigo in adults. It causes sudden, intense episodes of dizziness triggered by specific head movements, such as rolling over in bed, looking up, or bending forward.

Despite how alarming the symptoms can feel, BPPV is not dangerous. It occurs when tiny calcium crystals (called otoliths or "ear rocks") become dislodged from their normal position inside the inner ear and migrate into one of the semicircular canals. This disrupts the signals your inner ear sends to your brain about head position — causing the characteristic spinning sensation.

The good news is that BPPV responds very well to physiotherapy. With the right assessment and repositioning technique, many people experience significant relief within one to three sessions.

Key Clinical Assessment

The Dix-Hallpike test is a simple positional assessment your physiotherapist performs to confirm BPPV and identify which ear canal is affected. This guides the specific repositioning technique used in your treatment.

Who Does BPPV Affect?

• Most common in adults over 40, though it can affect any age
• More common in women than men
• Can follow a head knock, prolonged bed rest or inner ear infection
• Can recur — effective management reduces future episodes
• Associated with migraine, osteoporosis and vestibular conditions
• Often appears without a clear cause

Common Symptoms of BPPV & Vertigo

Symptoms typically come on suddenly and are linked to changes in head position. You or a family member may notice:

• A sudden spinning sensation lasting seconds to a minute
• Dizziness when rolling over, lying down or sitting up
• Nausea — and occasionally vomiting — during an episode
• Unsteadiness or feeling "off balance" between episodes
• Dizziness when looking up or bending forward
• Brief but intense episodes triggered by head movements
• Fatigue and difficulty concentrating from persistent dizziness
• Anxiety about movement or falling, especially in older adults
• Difficulty with tasks requiring head movement (driving, screen work)
• A sense of the room moving even when you are still
  

What Can Contribute to BPPV & Dizziness?

BPPV can arise spontaneously, but certain factors are associated with higher risk:

• Age-related changes in the inner ear
• Head trauma or concussion
• Prolonged bed rest or immobility
• Inner ear infections (labyrinthitis or vestibular neuritis)
• Migraine-associated vestibular dysfunction
• Low vitamin D levels (linked to otolith dysfunction)
• Osteoporosis — associated with crystal fragility
• History of prior BPPV episodes
• Certain medications affecting the inner ear
• No identifiable cause (idiopathic) — very common

A thorough physiotherapy assessment helps identify the specific type and canal involved, and any contributing factors that may need addressing alongside primary treatment.

How Physiotherapy Can Help BPPV & Vertigo

Our physiotherapists take a structured, evidence-based approach from your very first appointment. Treatment begins with a careful assessment to confirm the diagnosis, identify which ear canal is affected and rule out other causes of dizziness that may require further medical review.

Rather than simply providing a home exercise sheet, we use hands-on repositioning techniques as the core of treatment — guiding the displaced crystals back to where they belong and restoring normal inner ear function. The goal is fast, effective symptom relief combined with the right rehabilitation to restore balance, reduce recurrence risk and improve your confidence with movement.

Treatment is tailored to your specific diagnosis, symptom severity and activity levels. Where appropriate, it may include:

• Epley Manoeuvre & Repositioning The gold-standard hands-on procedure to return displaced crystals to their correct position. Highly effective when applied to the correct canal — often providing relief within one to two sessions.
• Vestibular Rehabilitation A progressive programme to retrain your brain's processing of balance signals and reduce residual dizziness, gaze instability and sensitivity to head movement.
• Balance & Fall Prevention Structured balance retraining and dynamic stability exercises — particularly important for older adults at increased fall risk from vestibular dysfunction.
• Neck Treatment for Dizziness Manual therapy, soft tissue release and sensorimotor retraining for cervicogenic (neck-related) dizziness — a frequently missed cause of unsteadiness that responds well to targeted neck treatment.
• Gaze Stabilisation Exercises Targeted exercises to improve visual steadiness and reduce dizziness with head movement — addressing visual-vestibular mismatch common in ongoing vestibular conditions.
• Education & Self-Management Clear guidance on what to expect during recovery, safe head positioning, activity modification and how to manage a recurrence quickly and independently.



Many people come to us after weeks or months of dizziness — sometimes following multiple practitioners without a clear diagnosis or effective treatment. A targeted physiotherapy assessment and repositioning procedure can make a remarkable difference, often from the very first session.

Can Dizziness Come From the Neck?

Yes — and it is more common than most people realise. Dizziness that originates from the neck is called cervicogenic dizziness, and it is one of the most frequently missed causes of ongoing balance problems and head unsteadiness.



The neck contains a dense network of sensory receptors — particularly in the joints and muscles of the upper cervical spine — that send constant signals to the brain about head position and movement. When these structures are irritated, stiff or injured, those signals can become distorted, leading to dizziness, unsteadiness and a vague feeling of being "off." This is distinct from the spinning vertigo of BPPV, and it does not respond to repositioning manoeuvres — it requires treatment directed at the neck itself.

How the Neck Causes Dizziness

Your brain cross-references signals from three sources to maintain balance: the inner ear, the eyes, and the sensory receptors in your neck joints and muscles. If the neck sends inaccurate signals — due to stiffness, joint dysfunction or muscle tension — the brain receives conflicting information. The result is dizziness, unsteadiness or a sensation of the environment feeling slightly unstable.