What is vertigo, and what is BPPV?
Vertigo is not just dizziness; it is the specific illusion that you or the room is spinning. The most common cause is BPPV, benign paroxysmal positional vertigo. Inside your inner ear are tiny calcium crystals that help sense gravity. In BPPV, some of these crystals drift into the wrong canal of the balance organ. Every time your head changes position, rolling over in bed, bending to tie a shoe, looking up during pooja, the loose crystals swirl and send a false spinning signal to the brain.
The name tells the story: benign (not dangerous in itself), paroxysmal (comes in short bursts), positional (triggered by head position). Episodes typically last under a minute, but they are intense enough to make people afraid of their own bed.
Common symptoms
- Brief spinning episodes triggered by rolling in bed, lying down, sitting up, or tilting the head
- Nausea, sometimes vomiting, during or after an episode
- Unsteadiness or a floating feeling for hours after the spinning stops
- Anxiety about moving the head, leading to a stiff, guarded neck
- No hearing loss and no ringing in the ears in typical BPPV
What causes the crystals to dislodge?
Often there is no clear reason, and the risk rises with age. Known triggers include head injury, long periods lying flat (after surgery or dental work), inner ear infections, and migraine. BPPV also loves to recur; roughly one in three people gets another episode within a few years, which is why we teach patients what to do when it returns.
Red flags: when dizziness needs a doctor first
Not all dizziness is BPPV. Seek urgent medical care if vertigo comes with double vision, slurred speech, weakness or numbness in the face or limbs, severe imbalance where you cannot stand, a sudden severe headache, new hearing loss, or fainting. Continuous vertigo lasting hours to days, rather than brief positional bursts, also needs a medical review before physiotherapy. When in doubt, see a doctor first; we will happily take over once serious causes are ruled out.
How physiotherapy treats BPPV
BPPV is a mechanical problem, crystals in the wrong canal, so it needs a mechanical solution, not just tablets. Vestibular physiotherapy offers exactly that:
- Positional testing: we reproduce the vertigo briefly under controlled conditions to identify which ear and which canal the crystals are in. This step decides everything that follows.
- Repositioning manoeuvres: guided sequences of head and body positions, the Epley manoeuvre is the best known, that use gravity to steer the crystals back into the chamber where they belong. Many patients feel dramatic relief after one to three sessions.
- Vestibular rehabilitation exercises: for the residual unsteadiness that often lingers after the spinning stops, we prescribe gaze stabilisation and balance exercise therapy that retrains the brain to trust its balance signals again.
- Neck care: weeks of guarding the head stiffens the neck, and a stiff upper neck can itself contribute to dizziness. Gentle manual therapy helps when neck pain and dizziness travel together.
Vertigo treatment at Physio Buddy
Dr. Maitri Kothari (BPT, MPT) has treated vertigo and balance problems across 10+ years of practice, backed by advanced neurological physiotherapy training. A first session at our Chandkheda clinic includes a detailed history (what triggers it, how long it lasts, what else comes with it), positional testing, and usually the first repositioning manoeuvre the same day. You leave with clear instructions for the next 48 hours and a plan for follow-up.
For patients too dizzy or too anxious to travel, and for elderly patients at fall risk, we bring the treatment home. Home visit physiotherapy covers Chandkheda, Motera, Gandhinagar and nearby North Ahmedabad, and the manoeuvres work just as well on a firm bed at home as on a clinic plinth.
What you can do right now
- Sit down immediately when an episode starts, and hold something stable until the spinning passes.
- Move deliberately rather than freezing entirely; avoiding all head movement actually slows recovery.
- Note which movements trigger the spinning and which side feels worse, this detail speeds up our diagnosis.
- Do not drive or climb ladders on days the vertigo is active.
- Avoid self-administering repositioning manoeuvres from videos until the affected canal has been properly identified; the correct manoeuvre depends on it.
Recovery timeline
Typical BPPV responds quickly: many patients improve substantially within one to three repositioning sessions over one to two weeks. The lingering unsteadiness usually settles over another two to four weeks of vestibular exercises. Recurrences happen, which is not a failure of treatment but the nature of the condition, and returning patients usually settle even faster because we already know their pattern. Other vestibular problems, such as recovery after inner ear infections, follow a slower arc of four to eight weeks of graded rehab.
Book an assessment
There is no need to live around your vertigo, sleeping propped on three pillows and dreading the bed. Call or WhatsApp +91 78619 29326 or use our contact page to book a vestibular assessment in Chandkheda or at home.
Frequently Asked Questions
Can physiotherapy really cure BPPV?
For typical BPPV, repositioning manoeuvres are the recognised first-line treatment worldwide, and success rates are high, often within one to three sessions. We say 'resolve' rather than 'cure' because BPPV can recur, but each episode responds to the same treatment, and we teach you exactly what to do if it comes back.
What happens during an Epley manoeuvre?
You lie back with your head turned in a specific sequence of positions, each held for about 30 to 60 seconds, while gravity moves the loose crystals out of the sensitive canal. It briefly reproduces the spinning, which is expected and passes quickly. Most patients tolerate it well and feel clearly better afterwards or by the next day.
Is vertigo treatment painful or risky?
The manoeuvres are gentle and drug-free. The main sensations are brief spinning and occasionally mild nausea during the procedure. We screen your neck and medical history first and adapt positions where needed, for example for patients with neck stiffness or recent surgery.
Do you treat vertigo at home?
Yes. Many vertigo patients understandably do not want to travel while symptomatic, and elderly patients with unsteadiness are safer assessed at home. We do home visits across Chandkheda, Motera, Gandhinagar and nearby North Ahmedabad, and repositioning manoeuvres work well on a firm bed.
My spinning stopped but I still feel floaty and unsteady. Is that normal?
Very common. After the crystals are repositioned, the brain needs a little time to recalibrate its balance system, which can leave a floating or unsteady feeling for days to weeks. Vestibular rehabilitation exercises speed this up considerably, so do mention it at your follow-up.
Should I just take vertigo tablets instead?
Vertigo suppressant tablets can ease nausea in the acute phase, but they do not move the crystals, so they treat the sensation rather than the cause, and long-term use can actually delay the brain's natural compensation. For BPPV, repositioning plus rehab addresses the mechanical problem itself. Discuss medication questions with your doctor; the two approaches can work side by side.
How much does vertigo physiotherapy cost in Ahmedabad?
Clinic sessions in Ahmedabad typically range from Rs 300 to 800, and home visits cost somewhat more. Since BPPV often needs only a handful of sessions, the total course is usually modest. WhatsApp us on +91 78619 29326 for an exact quote.