What Are the Treatments for Positional Vertigo?

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Vertigo causes severe stress in those who suffer from it. Balance problems and a constant feeling that you are spinning make it necessary to find treatment. One form of the condition, positional vertigo, is the most commonly treated.

Vertigo causes a constant feeling of spinning.
Vertigo causes a constant feeling of spinning. (Image: Ingram Publishing/Ingram Publishing/Getty Images)

The Facts

Positional vertigo, which is often called benign paroxysmal positional vertigo or BPPV, creates dizziness for sufferers because of the debris that collects in the inner ear. The debris, called otoconia, are hardened crystals of calcium carbonate that come from the area of the ear canal called the utricle. Damage to the utricle in the form of a head injury, infection or other ear disorder can cause the debris to reach parts of the inner ear that are highly sensitive.

Positional vertigo creates dizziness because of debris in the inner ear.
Positional vertigo creates dizziness because of debris in the inner ear. (Image: Ninell_Art/iStock/Getty Images)

Physical Therapy

Doctors, physical therapists and audiologists often treat positional vertigo with physical therapy. Patients perform a series of movements called canalith repositioning that require slow maneuvers of the head. According to the Mayo Clinic, the movements are designed to move particles from the canals of the inner ear to an open area called the vestibule, where they cause less complication. Patients hold each position for less than one minute after symptoms of vertigo cease. The treatment requires one or two visits. Following treatment, however, patients must avoid lying flat or moving their ear below shoulder level for several days to allow the particles that caused the condition to be absorbed into the fluids of the inner ear.

Doctor Timothy C. Hain says canalith repositioning requires movements of the head into four positions. He also says BPPV reoccurs within one year in about 30 percent of the patients treated by canalith, also known as the Epley maneuver. Hain says about half of those who experience BPPV have recurrence of the condition within the following five years.

Hain suggests another maneuver for some sufferers. This physical therapy, Brandt-Daroff Exercises, also involves movements and can be performed at home. He says they succeed in curing positional vertigo in 95 percent of all cases but require harder work. Hain suggests sufferers move between four positions, sitting upright on the edge of a bed and then rotating between lying on each side and sitting upright. Each position is held for two minutes, and Hain suggests 15 repetitions each day for a total of 30 minutes of therapy. He recommends that patients do the movements daily for three weeks, although most patients experience complete relief after 10 days.

Positional vertigo may be treated with physical therapy.
Positional vertigo may be treated with physical therapy. (Image: Brankica Tekic/iStock/Getty Images)

Surgery and Drug Treatment

In some cases, canalith repositioning fails to produce results and doctors sometimes recommend surgery. In the procedure, the surgeon places a plug into the inner ear that keeps particles from contacting the portion of the inner ear canal that is causing the dizziness. According to the Mayo Clinic, the surgery succeeds in eliminating the vertigo 90 percent of the time, but approximately 5 percent of those who receive the surgery experience long-term hearing loss.

According to the University of Michigan Health system, position vertigo also can be treated with medicine. The medicine used most frequently is meclizine, which is taken up to four times daily to treat the vertigo and associated nausea and vomiting. The drug causes drowsiness.

Doctors may recommend medication such as meclizine.
Doctors may recommend medication such as meclizine. (Image: Wavebreakmedia Ltd/Wavebreak Media/Getty Images)

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