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Vertigo is the symptom of a particular type of balance disorder in which you experience the sensation of dizziness, spinning or being giddy or unsteady. The cause of vertigo varies but it generally involves the inner ear. It affects a large percentage of the population on a daily basis ( one in three people will experience at least one episode in their life )

One of the most common causes of vertigo is Benign Paroxysmal Positional Vertigo ( BPPV ). BPPV affects the semicircular canals (balance mechanism) of the inner ear.

The condition is caused by the dislodgement of minute calcium carbonate crystals through degeneration or trauma. These crystals then gravitate from their usual place in the ear to the region of the inner ear which contains sensory organs. Once they reach this region, they trigger vertigo. The condition occurs in one or sometimes both ears.


A test called the Hallpike Manoeuvre is used to diagnose BPPV. This is a  simple test to determine which ear and semicircular canal is affected.


The treatment of dizziness/BPPV is called “vestibular rehabilitation”. The vertigo can be dramatically relieved by specialist techniques performed by our physiotherapists skilled in this area. These techniques ( Epley or Canalith repositioning manoeuvres ) are quick and effective. The goal is to move the crystals out of that part of the inner ear where they are causing the problem. The techniques are almost always effective with 80% of cases resolving after one treatment. If left untreated the condition may resolve spontaneously in weeks to months. However, in about 30% of people it may persist for years. In those where it is left untreated, relapses may occur in 20-30% of patients.

If a recurrence occurs or there is not complete relief of symptoms after the first treatment, a second treatment may be required. Some people may need to progress to particular exercises which are performed regularly at home.

There are other causes of dizziness, such as Menieres disease and acoustic neuroma, which require different treatment approaches. Therefore, it is important to consult your general practitioner before beginning a program of vestibular rehabilitation. In some cases you may be referred to an Ear Nose and Throat specialist or a neurologist for an expert review of your symptoms.

At Macquarie Street Physiotherapy, vestibular rehabilitation is performed by physiotherapists who have undergone postgraduate training in this area. They can assess and treat your BPPV, or will direct you to a specialist doctor as necessary.


Macquarie Street Physio