Réhabital
BPPV Treatment (Benign Paroxysmal Positional Vertigo)
Rolling over in bed and watching the room spin for twenty seconds is unsettling — and it is the signature of BPPV, the most common cause of vertigo. At Réhabital in Côte Saint-Luc, vestibular physiotherapy identifies which canal is involved and repositions the displaced crystals with precise manoeuvres. Most people improve markedly within one to three visits.
Book an AppointmentUnderstanding This Condition
Benign paroxysmal positional vertigo happens when tiny calcium carbonate crystals (otoconia), normally anchored in the utricle of the inner ear, break loose and drift into a semicircular canal. Every head-position change moves those crystals, falsely stimulating the canal and sending the brain a rotation signal that does not match reality. The result is intense but brief spinning — typically ten to sixty seconds. The posterior canal is involved in roughly 85% of cases, the horizontal canal in most of the rest. Assessment relies on specific positional tests (Dix-Hallpike, roll test) that deliberately provoke the vertigo so we can observe the nystagmus, whose direction and duration reveal exactly which canal is affected. That precision matters: the treatment manoeuvre differs by canal, and the wrong manoeuvre may do nothing or shift the crystals into another canal.
Common Symptoms
Common Causes
Idiopathic (no identified cause)
In more than half of cases no specific trigger is found. Age-related weakening of the otoconia is the most common factor after 50.
Head trauma or whiplash
Even a moderate impact can dislodge otoconia. Post-traumatic BPPV is often bilateral and may need more sessions.
Prolonged immobilisation
Bed rest after surgery or illness encourages crystals to settle into a canal.
Prior inner-ear disorders
Vestibular neuritis or Ménière’s disease raises the risk of secondary BPPV.
Metabolic factors
Vitamin D deficiency and osteoporosis are associated with higher recurrence rates, which sometimes warrants further medical work-up.
Our Treatment Approach
The physiotherapy assessment starts with a detailed history — triggers, duration, associated symptoms — to rule out causes that are not BPPV. We then perform the appropriate positional tests to locate the affected canal. Treatment is a repositioning manoeuvre — Epley or Semont for the posterior canal, Lempert (barbecue roll) for the horizontal canal — performed slowly, respecting each pause so the crystals can migrate. The session ends with clear instructions for the next 24 to 48 hours and, when needed, habituation and gaze-stabilisation exercises for residual unsteadiness. If your symptoms do not fit the BPPV picture — constant vertigo, sudden hearing loss, neurological signs — we refer you for medical assessment without delay.
What to Expect at Your First Visit
The first visit takes about 60 minutes. Positional testing deliberately provokes brief vertigo, which is expected. After the manoeuvre a heavy-headed or unsteady feeling may last a few hours to a few days. Most patients need one to three sessions.
At-Home Self-Care Tips
- Get out of bed slowly, pausing a few seconds in sitting.
- Avoid sudden head movements for 24 to 48 hours after the manoeuvre.
- Sleep slightly propped up the first night if advised.
- Do not stay still too long — normal movement supports compensation.
- Note which positions trigger vertigo to review at the next visit.
- Make the home safer (night lighting, rugs) to reduce fall risk.
Prognosis & Recovery Timeline
Repositioning manoeuvres succeed in over 80% of cases within one to three sessions. Recurrence affects roughly 15 to 30% of people within a year, but usually clears in a single visit when treated early.
When to See Us at Réhabital
See us if spinning vertigo appears with position changes. Seek urgent medical care for continuous vertigo, sudden hearing loss, slurred speech, double vision or one-sided weakness.
Why Réhabital Clinic
Our physiotherapy team in Côte Saint-Luc assesses BPPV with structured positional testing rather than applying a generic manoeuvre, which meaningfully improves the odds of resolving it in the first visit.
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Address
D4-5800 Cavendish Blvd
Côte Saint-Luc, QC H4W 2T5
Phone
(438) 842-3550Hours
Mon–Fri: 10AM–8PM
Sun: 10AM–4PM
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