How to Prevent BPPV from Recurring (Vertigo)
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- เผยแพร่เมื่อ 28 ก.ย. 2024
- If you've had BPPV before, you'll want to do everything you can to keep it from coming back!
BPPV, also known as Benign Paroxysmal Positional Vertigo, occurs when little crystals called "otoconia" float into the inner ear canals from an adjacent inner ear organ.
The result can be very uncomfortable and sudden vertigo.
For some people, effectively treating the BPPV once with the Epley Maneuver and/or the Gufoni Maneuver will be enough to keep the vertigo from coming back.
But for others, the vertigo can recur, sometimes frequently.
In this video, I'll answer some common questions I get from viewers about how to prevent BPPV from recurring, and I'll also share 3 tips to help minimize the vertigo from coming back in the first 24-48 hours.
If you've had success treating your vertigo or preventing it from coming back after treatment, please share your story below!
- Luke Gordon, DPT
Doctor of Physical Therapy/Owner of Gordon Physical Therapy
www.gordonphys...
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I've had two episodes of BPPV, 7 years apart. Came out of nowhere both times. First time had the Epley Maneuver by a PT and it resolved after one visit but it made me so, so sick! Second time (just recently back in May) went to my chiro and he was able to resolve it much more gently and effectively just by maneuvering my head, without all the sitting up, laying back down nonsense that got me sick the first time. The frustrating thing is it came out of nowhere. Now I'm trying to stay hydrated, sleep with my head elevated a bit, and taking a Vitamin D supplement. Praying it stays away! It's awful!
What ever works! One chiro session worked for me... hydrating is good but not relevant, for me at least...am well hydrated and will float away if do more ...these various maneuvers all are great
Yes it is. Mine is triggered by looking down. My daughter can’t drive with her learner permit because it triggers mine bad. I am triggering right now with it.
I dealt with vertigo for 6 weeks….it was horrible and I was working with my PT using the epily maneuver ……it helped but it didn’t go away…I started doing some extensive research….I’ve always been a huge Edgar Cayce fan…..he recommended water hydration…….within 2 days of drinking at least 72oz of filtered water daily it was gone. I’ve continued to stay hydrated and haven’t had another reoccurrence. For anyone suffering……what do you have to loose…..water is free and it helps to thin the viscosity of the fluid in the canals.
That's an excellent piece of advice! Thank you for sharing!
Ty for sharing
Ty!
You articulated my post acute vertigo sensations perfectly, i.e., after a vertigo event, medium to fast vertical head motions cause moderate dizziness/nausea. Continued vertical head motions bring back full blown vertigo attacks.
Thank you for sharing. I need to start drinking more water. 👍🏻 😊
Its been 1 year since my 1st vertigo experience..when it hit i thought i was dying..my head spun for 7 days as if someone threw me out of an aeroplane. started suffering from panic attacks for a few months. its now the 3rd time it hits me out of nowhere this time the spinning only lasted 2 days.. been 4 days now and still feel dizy when i move my head around but its getting better. dont have any great advice.. but i have moved from SA to Aus and i feel like im linking all of this to stress and maybe IBS which flared up a year ago as well. Its been the biggest life change to me ever. Didnt think me immigrating stressed me so much until this started happening. Haven't been active with training or stuff to reduce the everyday stress of our lives.. i have chronic neck and shoulder pains from .. i guess underlined stress. IbS and gastritis linked with every occurrence. Dont know if it affects my ears as well or can an inflamed stomach lining cause such bad vertigo?
My first episode was just over year ago. Horrible feeling that i obsessed over and fear everyday! I saw neurologist and diagnosed BPPV. He used Eppley maneuver and it did stop the dizzyness. I used maneuver with success. Several months later I had recurrence, went to Dr., labs done. My Vitamin D was Very LOW. I started supplements. I believe my symptoms and recurrence has diminished since taking Vitamin D.
nake sure it is enough do not take some massive initial dose and the D has to be with K in formula and taken with magnesium. good luck
@@donnasherwood283 Yes, I agree - I take all 3 - the K2 I take is the mk7 - I’ve heard that a large percentage of people are Vit D deficient - doctors should always test for that with normal bloodwork
@@Melody-285 in the latitudes where sun is potentially quite limited there is no choice. D3 is a pro hormone not a vitamin and it regulates close to 300 biochemical processes. in my youth parents used to force us to drink milk in fairly large quantities . Most i know dropped it from diet as soon as they could for issues of vertigo high doses of D3 + K and magnesium eat up the excess calcium in system. Yes americans are very deficient due to processed foods and being led down a road that dairy is bad for you. ergo need for supplements. I used Metagenics D3 + K a tiny gel easily swallowed at 10K a day but depending on blood serum levels you may not need that dose check it out on next blood draw they formulated at 5L as well.
I have BPPV and i have watched DR ERIC BERG MD im going to start taking Vitamin D3 with vit K2 and magnesium
It’s good for your bones too - the D helps calcium absorption & the K2 directs calcium to your bones instead of your arteries - don’t want calcified arteries !
I have BPPV caused by the gentamicin operation in 2000 where double the amount of gentamicin was used but now I have also developed cervicogenic vertigo which requires exercising head movements ….I feel between a rock and a hard place.
I had my granddaughter help to do the Epley after a few weeks of suffering. We watched TH-cam to see how to do it. Yes i threw up on 2 positions but felt slightly better afterwards. It took about another week to recover.
My longest bout was 9 weeks. Couldn't drive, couldn't do anything and kept my head in a certain position to be able to function, any other movement had me nauseas. Saw the neuro, ENT, had scans, but it was finally when the ENT said it could be coming from my neck and I saw a chiro who cracked my neck that i recovered. Chiro though, thought that the sudden movement he performed was similar to an Epley.
I now have a physio on speed dial when it hits. It's a horrible affliction.
I'm glad the chiro was able to help you! Thank you for sharing your story!
Retired physician here...your videos are excellent and your explanations very clear. I wonder if I could ask your opinion this: a patient has documented right post-canal BPPV,,,positive DH test and responded to Epley. Has had several subsequent episodes of transient vertigo with vertical head movements...DH intermittently positive; Epley repeated only when DH positive. But...now has reproducible vertigo (x15sec) after sleeping for an hour with right ear down WHEN moves head to neutral position (so looking straight up while still supine). Nystagmus appears to be up-beating (though difficult to be sure without the goggles etc). Question: Still posterior canal or now horizontal canal?? Tried the diagnostic test for horizontal BPPV and no vertigo or nystagmus... so, confusing... Appreciate your thoughts!
That sounds very confusing... I haven't seen this type of presentation before. With the head in neutral, I definitely wouldn't expect posterior canal involvement, as both canals are flared out at 45 degrees with the head in neutral (no gravitational effects). So I'm wondering if it's horizontal canal BPPV at this point. Have you tried the Supine Roll Test yet? Let me know how this turns out!
After suffering from years I discovered the solution. A Korean research project found that taking vitamin D will prevent it coming back. After taking vitamin D after finding out I had low levels, its worked.
I drink dmilk every day and I still get it 😭
I only have this problem as I'm waking up. Thankfully not very often. But it hit me hard this morning and scared me to death! All I did was start waking up and rolling over. My head was a spinning top and I freaked out screaming. It stopped when I laid on my back for a few seconds. I have a lot of migraines and ear ringing.
Same!! This is terrible
That sounds awful! Have you tried to diagnose it yet with the positional tests?
No but it hasn't happened since. I think I just woke up too fast and my body took longer to catch up with my brain. Another weird thing that's happened was me realizing when I was half asleep one time I'd left the heater on and running out to turn it off. As I got up to it suddenly I couldn't move and felt frozen when I got to it. Then my heart started pounding and I had to go back to bed or I would have had another episode. This happens Everytime I get up before my body is ready.
@@moonfire41im dealing with this right now. So scary. I got up to use the bathroom, came back to bed and it started. I screamed for my husband to call 911. It literally felt like I was in a washing machine ( even though I've never been in one). Ems called and it just kept happening. Im home now and scared to move my head.
I have it now it is horrible. Debilitating.
What did you do to make it go away
Me too...just awful
Mine was first diagnosed when I was in my early 30s, about 30 years ago, after I tried to learn jiu jitsu. Turns out doing rolling ukemis is a bad idea when you have BPPV. Heh. After that I have had occasional attacks, most often connected to that rolling over in bed move, but they haven't been particularly common, and I have learned to deal with them. They usually pass by themselves after something like half an hour, if they don't doing those head movements can help.
I have probably have had the tendency at least from a fairly young age, I have, for example, never learned how to ride a bike. I have sometimes wondered if falling off a horse head first may have had something to do with the whole thing. I had a helmet, but since the top of my skull was the first part of my anatomy to make first contact with ground, well... the critter made a sudden stop, yanked its head down and bucked a bit, and the saddle slid a bit forward, and I was trying to hang on to the reins but being just barely over 10 years old at that time that just kind of propelled me forward and over the horse's head. I don't remember being all that dizzy at that time, and I climbed back on after a few minutes, but still... 🤔
Thank you for sharing your story!
Should one continue to sleep elevated from this point on to prevent vertigo from happening again? Thank you.
How do I know which ear is causing the Vertigo?
Hey has your vertigo gone away?
By doing the two positional tests: Dix-Halpike and Supine Roll Test.
Which ear is the affected one? I get dizzy when turning from right to left side in bed
I get the same thing so not sure which ear myself.
Same here. I think left ear is affected
Hi,
Second bout of Vertigo over about a month's time. Both seemed to be triggered by a massage followed by brain fog, and feeling weird- then a yoga pose gives way to the vertigo. Once in down dog, and this last time on my back in happy baby. Epley seems to stop it. But have felt off all month in between events. Am i just not getting the crystals back into place? Why would massage seem to contribute?
HAD IT 9 TIMES A YEAR FOR OVER 49 YEARS, DO I NEED TUBES
Often, restrictions aren't prescribed post treatment due to research not showing it significant being helpful.
Why do you give restrictions? Just curious.
Can flying cause vertigo? Never had this before but the other day after a very early flight I came home and napped and woke up to dizziness and this terrible thing ! Dont want this to happen again! 🙏🏻
I am wondering the same thing. Mine occurred on a cruise ship after a flight. Flying has really bothered my ears since I had COVID a year ago.
Haah...I did vertical head movement..that was the culprit..
Also forgot to mention I was extremely dizzy everytime the Eppley was performed.
See my other comments... I'm glad it worked in the end!
My doctor suggested I do 3 maneuvers a day for a week until I no longer have symptoms. Are you saying that would be incorrect?
That's good advice as long as you're doing the correct maneuvers. Also, once you clear the symptoms, you should stop and let everything settle.
BPPV → Benign paroxysmal positional vertigo
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Is medicines worked like vertigo medicines?
Meclizine 25mg is prescribed for Vertigo..... Urgent Care Centers can write a prescription for this if you can't get to your Primary Doctor
Betahistine dihydrochloride definitely works, but it is unavailable in the USA.
So we can avoid epley by being careful and taking meds?
Does it have side effects? Can it be used for ppl like me who cant ttolerate epley@@stazym69
Thanks for this video. I was diagnosed with BPPV in 1998 and it has recurred at times ever since.
You're welcome!
dang so there's nothing you can do to stop it coming back.
You can avoid the 3 things I mention and make sure your vitamin D levels are normal. But otherwise, you're correct, there's not much you can do.
I have MS and not allowed to do epley. Will bppv eventually go with proper hydration vitamins rest and watching movements plus meds? I get seizures cant do any epley. Got an inner infection snce a month and was gven wrong antibiotics snce bppv never went but i do sleep upright but still get floating random attacks. I dont thnk its purely bppv.
My vertigo started immediately after I sat up from doing “plough pose” or Halasana in my yoga class. I have done the same pose many times before without causing vertigo. Coincidence or the probable cause? Will be scared to do it again now. The Epley manoeuvre stopped it though but not till a week later when I luckily discovered your video. Thankyou so much!
I would definitely test for BPPV and then continue treating with the Epley or Gufoni until it resolves. Good luck!
Thanks for the tips. I had BPPV 6 months back. My son is a doctor at Mayo Clinic. I was super nervous thinking I have some serious disease with my head spining. He mentioned to me “Mummy don’t worry it’s BPPV- I then looked for the answers myself thanks TH-cam and Google. I did Epley and got rid of spinning head.
Now I got the recurrence again. Not as pronounced but not good feeling. I am thankful to you for “what not to do” I was thinking that my neck may be the culprit- so rotated my neck. That’s going to stop. I have adjustable bed so will incline tonight.
Thank you long haired help sitting somewhere!!
Glad this helped! Good luck in the future!
I recently had a period of vertigo for 2 weeks, the first few days being the worst. The symptoms pointed to BPPV. I’ve seen a physio twice and he did the epley twice. The vertigo has now gone - it was gradually fading over days.
However I still have a ‘whooshing’ in my left ear, slight ringing and it does seem a bit muffled. I’ve had this on and off for a few years. Could it be anything else?
Also now have a cold including laryngitis so don’t know if that’s related!
If you're having auditory symptoms such as whooshing and ringing, you can have something else like Meniere's Disease. I'd recommend seeing an ENT if it keeps bothering you. Good luck!
@@GordonPhysicalTherapy thank you!
My bed has a vibration function. I was using this for pain relief from a back injury. Had 2 diagnosis of BPPV in 3-month period after that. Not sure it's related but wondering if anyone else experienced this? Is my bed shaking the rocks lose in my head?
I don’t have the answer to that, but I really think it could contribute to the problem - I had vertigo a while back & my electric toothbrush made me feel a little woozy - just thinking about my bed vibrating kind of gives me anxiety - lol
I believe it may … I have one of those beds and within a year having it (coincidence?) … my first vertigo attack occurred. It was bizarre and scary… I was ill for a week with nausea, spinning, and my gait affected … walking in diagonals since my balance was completely off. It went away somehow and did not reoccur until 11 years later… possibly prompted from excessive hours working at my computer … continuous hours at a time over many nights (volunteer work for the greater good)… plus working long hours during the day and long drives to/from office. Since then, it’s occurs intermittently - thankfully, I learned of the Epley maneuver - and it corrects the condition. Sometimes it requires repeating the exercise for it to work. I wait a day to repeat it if it doesn’t take the first time.
My question is.. is there something u can do like weekly or daily to prevent vertigo? Ive had it for 30yrs or more. Just all of a sudden bam yr dizzy as hell & sick for days. Vitamin D & water seems to be what most of the comments are saying. Thank God for the internet & being able to communicate with others for advice. The drs are only in it for the $$. Its shows by theur homes & cars. But the internet drs are giving advice for free. Maybe making $$ from their youtube chl instead of big pharma !
The internet certainly is helpful! And if people make a little money sharing good advice, good for them! Water and Vitamin D are important for prevention, as well as good nutrition and some other B vitamins. If you're having true BPPV, there isn't a lot of long-term prevention. The short-term prevention is to avoid certain positions for 2-3 days, but after that there isn't much to do except know how to treat it quickly if it comes back. I hope that helps!
@@GordonPhysicalTherapy thank u for the reply. I'm just living with it & dealing with it. Thanks for sharing & actually doing the job of a real dr. Helping people get healthy!
Is vertigo caused by Menieres disease treated with the epley maneuver? How to know the root cause?
Thank you for the suggestions on how to mitigate recurrence following an episode. I appreciate it!
I was exercising woke up next day with mild dizziness when I moved. Last Sunday I laid on my right side and had 2 vertigo attacks first one stopped after I got up and second lasted 6 hours with inability to walk and being sick. I ended up at the hospital was given fluids and zofran which helped the sickness and was diagnosed with bvvp. Fast forward this week I went to see my doctor which she said just keep doing the epley exercises and gave me a nasal spray and ear drops as my ear also pops. On Thursday I had a mini vertigo spell while trying to put the ear drops in and got scared I ended up finding a physical therapist. He performed the epley on me and I had vertigo for about a minute each time. He said that isn't common but to just hold the positions a bit longer. After Thursday I'm having extreme anxiety attacks, dizziness, migraine, brain fog and sickness feeling I also go from feeling like I'm tilting backwards to forwards randomly like at the moment feel like I'm tilting forward even laying down. I tried laying on the effected ear and no vertigo just anxiety so I'm not sure what else to do. I'm scared it won't go away and I'm gonna be stuck like this forever and the sickness makes it hard to eat like at all.
If you found a PT who knows how to treat vertigo, I would go back for a follow up and see what they can tell you. It should help!
How are you now bro?
Dont worry it will go away
Take that water !
Hope you will feel better soon…. 🤗
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Few months ago, positive ageotropic horizontal canal in left ear. Did Gufoni 2x and nystagmus stopped. Since then I test negative during supine and dh, but when laying down flat on left side, body and head, I have slow horizontal nystagmus that lasts less than a minute? How do you know what to do now? No nystagmus on right side.
I FALL ALL THE TIME, HIT MY CAR 8 take vitamin d 50,000 mil weekly no use
after 48 hours after epley im i safe to go back to work and do some head movements
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ROOM SPINS AND VOMIT 9 TIMES A YEAR FOR OVER YEARS
Hello,
While taking face massage, vibrator was used on ear by mistake, after that it was felt that liquid inside ear got disturbed.
After taking maneuver done from expert physician,
No spinning happen from last 6 months after sleeping on both ears.
1. Should i consider that issue got resolved?
2. Little imbalance what to do for that?
3. Can I again play cricket or football?
4. This was not agewise ear crystals loosening, it was accidental, will it recur?
It sounds like you just need to do some VOR/gaze stabilization exercises to get your inner ear to function at a higher level. After that, you should be good to return to normal activities, Just be on the watch out for the BPPV to recur, and then treat again as needed.
@@GordonPhysicalTherapy
Thank you so much for your reply.
You are really great
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Thanks for sharing!
can you fly in a plane ? I keep thinking what if that happens on a airplane.
Exactly...
Do you know why some BPPV episodes would clear on their own within a few days? I’ve had episodes on and off since 2014 and a couple of my attacks have disappeared on their own without treatment in 2-3 days
Good question! Two things can happen: sometimes the crystals probably float back to where they belong on their own, and other times it's possible that they dissolve. Those are the theories :-)
Are you diagnosed with BPPV
@@kathleenhowe8134 Yes I am since 2014
How do you know which ear canal is affected? I always sleep on my side
You diagnose the canal and the side with the Dix-Halpike test and the Supine Roll Test.
I thought I had BPPV. It took 6-8 Eppley Manuevers to allegedly get crystals in place. The manuevers were done over the course of three visits. My neurologist said it should never take that many manuevers to clear crystals and that one visit is usually all you need. Thoughts?
Great question! Once in a while, it can take multiple days and Epley treatments to clear the crystals. And other times, it works right away (like a miracle!). So your experience sounds normal to me.
When I first got vertigo, the initial room spinning only lasted about 20 seconds, but after that, for 4 months, I had this really weird swirling feeling in my head - I went & had brain scans, heart tests, etc & by the time I found a physiotherapist, he said the crystals can get stuck to the ear canal - so maybe that’s what happened with you - on my first appt., it induced the room spinning again, but gradually seeing him, I got better - it was really bad for 4 months, though - the dizzy, swirling feeling combined with killer migraines & really loud tinnitus - there was no position that I could get away from it some days - I really don’t know if I will ever feel completely normal again, but I can live with this - it’s a terrifying feeling, though -
you will get relief - I once had it for 6 mos. - before I learned of the Epley maneuver … 🙏🏻🙏🏻 which fixes it.
Thank you for this info!
My pleasure!
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I was told I have Vestibular Neutris. Now 4 months still sometimes feel very off
Hi! All this is very helpful. I see some mention of yoga postures and that some folks have had to quit. I've been doing yoga for five decades and don't want to give it up. What postures should I stay away from, or movements? Thank you so much!
You don't necessarily need to avoid any yoga poses, unless they're causing vertigo (such as Down Dog). If you're able to clear your BPPV and head movements no longer cause symptoms, you should be able to make a full return to yoga. And then just watch out for symptoms in the future and re-treat your BPPV as needed (as recurrence rates are somewhat high).
Hi. Thanks for ur video. I had horizontal BPPV. Basically it was in left posterior canel and i thought it was in right and did epely manuer for right and it made the spinning worse and threw up 2 times and didn't eat anything for the whole day.
After 5 days I went to ENT whlo then reffered to a vertigo center where they put up some VR kind of device and did multiple testss ans finally convoluted its left horizontal canel.
They did manuer and it was gone. Noe its been 15 days after the treatment but I still feel dizzy but no spinning.
My question is does BPPV occur because of continuous driving? Im still very nervous Bout turning while sleeping and bending forward.
Also I suggest ppl to just visit an expert to identify the correct canel and get the manuer done there itself instead of self doing as I m still struggling with dizziness even after 15 days
You ok now?
@@angelajangula47 I get occasional dizziness, I feel good while driving but when I stop driving I get dizziness. Usually it goes off when I go for a long walk and cover my ears.
I guess I have vestibular neurites which has triggered BPPV as a secondary symptom.
Doctors say it will take months or years to heal
I work bending up and down all day. What can I do then? I use a wedge pillow is that good
Is there much benefit in brandt daroff exercises? I have read mixed evidence!
I'm not a huge fan. I've seen them prescribed to treat BPPV, which doesn't seem to do much. After treating BPPV, I prefer VOR exercises, and other dynamic balance exercises.
I did the Brandt Daroff on the recommendation of my doc, with my first bout of BPPV, twenty years ago. He told me at the time that I will likely need to do them in the future at some point. It worked, and I had no issues until last year. Now I have occasional problems and use them.
@@pamlyon8176 oh that's interesting thank you, do you know which side / canal your crystals are dislodged? I find it so hard to get through the dizziness in any position that sets it off to be honest! So the brandt daroff fills me with dread as it is so time consuming!
@@pamlyon8176 Oh that's interesting to hear it worked for you! How did you manage that level of vertigo so regularly? I think the move is supposed to be done for 30 mins a day (10 mins x3 times a day for 2 weeks?). Which is nightmarish for me haha! Especially if it didn't work. I know it can also be used to desensitise. Did you ever know what side or canal yours was in?
@@cassiafriello5570 The first one was severe on both, i believe brought on by a fall. I did the exercises twice per day, three reps, I think. Took awhile. Don’t know why it took so long to come back. Now it comes and goes on one side or the other. If I sleep on my right side and it happens, I guess that it’s on the right. I can’t say that I keep it under control, except that I’m careful about how I move my head. No extreme tilt, like looking sideways under the bed. Don’t sleep on my right, if it’s there, etc. I am terrible about staying hydrated. I wonder if doing that would help, like someone else said. Good luck to you. It’s a miserable situation.