Vertigo is a sensation of feeling off-balance, dizzy, nauseous, motion sick, & the surroundings moving around. Vertigo can be a one-off feeling, appearing only once. Or it can be a chronic condition, with you feeling dizzy or nauseous in the middle of the day quite frequently. Vertigo isn’t a disorder on its own, rather a symptom of some underlying condition. In most cases, vertigo is caused by an inner ear issue.

Most common causes of vertigo include:

• BPPV, Benign Paroxysmal Positional Vertigo
• Vestibular Neuritis
• Labyrinthitis
• Head injuries
• Inner ear infections
• Meniere’s Disease
• Issues with the brain or the central nervous system

BPPV is by far the most common vertigo cause among people, with about 80% of vertigo patients suffering from it. BPPV is caused by the tiny calcium crystals in the middle ear, also known as otoconia, getting accidentally deposited in the semicircular canal of the inner ear. There they cause problems with the body’s balance as they are motion-sensitive. They trigger the tiny silica like hair on the surface of the semicircular canal into detecting motion when they move, even when there is none.

This mismatch of signals from the perceived motion by the hair inside the semicircular canal, & a lack of actual motion stimulus is what causes dizziness, sensations of the surroundings moving or spinning, & motion sickness. Some people also experience sweating, migraine headaches, & vomiting as a result of vertigo. Even if vertigo isn’t a sign of something seriously wrong with the body(which it may be in some rare cases), the symptoms are enough to drive a person into anxiety & fear of falling & getting dizzy in the most unexpected places.

Vertigo symptoms:

Vertigo patients often describe a range of symptoms that go along with their vertigo attacks. Not everybody experiences the same symptoms, but almost all vertigo patients experience one or more of the following symptoms:

• Dizziness that comes on suddenly & lasts anywhere between a few minutes to a few hours
• A sensation of the surroundings moving around or spinning
• Nausea
• Vomiting
• Migraine headaches
• Motion sickness
• Ringing in the ears, also known as tinnitus
• A feeling of pressure inside the ears
• Excessive sweating
• Heart palpitations

In some cases, when an inner ear infection like labyrinthitis or vestibular neuritis is the cause of vertigo symptoms, you might also experience earache & ear muscle stiffness. Some degree of hearing loss is also common among Meniere’s Disease patients & those with inner ear infections.

In this article, we will focus on vertigo caused by BPPV and its treatment. Specifically, we will focus on BPPV exercises, dizziness medications, & other BPPV treatments.

BPPV treatment:

Doctors often recommend certain BPPV exercises to help alleviate the symptoms of BPPV patients. These exercises are also known as canalith repositioning maneuvers, & are useful in moving the dislodged calcium crystals from the inner ear back into their original position in the middle ear.

These exercises also help give relief to the BPPV patient from their dizziness & other immediate BPPV symptoms like nausea, headaches, etc.

Some of the most popular BPPV exercises include:

Brandt-Daroff exercises:

• This BPPV exercise helps reduce the symptoms of vertigo. Doctors often recommend it for those suffering from BPPV and labyrinthitis.
• To perform the Brandt-Daroff exercises at home, follow the steps below.
• Sit at the edge of your bed, & turn your head 45 degrees to the right.
• Lie down on your left side and lie still for about 30 seconds until the dizziness passes.
• Sit up & wait for another 30 seconds.
• Turn your head 45 degrees to the left.
• Lie down on your right & hold the position for about 30 seconds until the dizziness goes away.
• Sit up & wait another 30 seconds.
• For best results, repeat the BPPV exercises about five times in a set, & around twice a day every day.

March-In-Place exercises:

Marching in place helps you maintain your balance while standing, & also helps train your body for more advanced movements. They are also quite easy to perform. To perform these exercises, follow the steps below:

• Stand near a wall or a corner & place your arms by your side. Alternatively, you can also place a chair nearby.
• Lift your right knee, & follow it up with your left knee while you march. Raise your knees as high as you can, comfortably.
• March is in a place like this for 20 times.
• You can repeat these exercises twice a day everyday, gradually increasing the marching frequency to 30 times.

Turning In Place exercises:

Turning in place is a slightly more advanced exercise than marching-in-place exercises. For this reason, it is advisable to have a chair or a walker nearby in case you feel dizzy. To perform the turning-in-place exercises, follow the steps below.

• Stand straight with your arms by your side.
• Now slowly turn towards your left in a half-circle, in a movement of about 180 degrees.
• Now stop moving & stand in place for about 10 to 15 seconds.
• Now slowly turn towards the right in a half-circle, & stand still for about 10-15 seconds.
• Repeat these exercises five times in a set. As you complete each set, start the next set in the direction that makes you feel dizzy.

Epley Maneuver:

The Epley Maneuver is a well-known BPPV exercise. It is also known as the canalith repositioning maneuver, & is often recommended to patients as the first line of BPPV treatment. To perform the Epley Maneuver by yourself at home for right-ear BPPV, follow the steps below.

• Sit at the edge of your bed & turn your head 45 degrees to the right.
• While keeping your head in this positio, lie back with your head reclined & your shoulders resting on a pillow. Hold this position for about 30 seconds.
• Now turn your head 90 degrees to the left, & hold this position for about 30 seconds.
• Now turn your entire body 90 degrees to the left in such a way that you’re lying facedown on your bed. Hold this position for about 30 seconds.
• Sit up on your left side & wait for any dizziness to pass.

Perform these exercises for BPPV in a set of 5 thrice a day every day until your symptoms completely resolve for a full 24 hours. For left-ear BPPV, just perform the steps in the opposite direction as mentioned above.

Semont Maneuver:

The Semont Maneuver, also known as the liberatory maneuver, is another popular exercise for BPPV exercise. Doctors recommend this exercise to provide quick relief from BPPV symptoms. To perform the Semont Maneuver at home, follow the steps below.

• Sit at the end of your bed & turn your 45 degrees to the right.
• Lie down on your left side while keeping your head in an upright position. Hold this position for 60 seconds.
• In a single movement, move from your right side to the left side while ensuring that your face is facing the bed. Hold this position for 60 seconds.
• Return to the original sitting position & sit still for 5 minutes.

Repeat this BPPV exercise about three times a day, or as many times as you are comfortable with. It’s important to remember that all of these exercises for BPPV have the potential to make you feel dizzy & trigger a vertigo attack. For this reason, it’s important to not engage in any activities that require your complete focus & attention immediately after performing these BPPV exercises.

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