BPPV Physiotherapy in Burlington: Understanding Dizziness and Vertigo Treatment
- Folarin Babatunde PT PhD
- Oct 4
- 6 min read
Cogent Rehab Blog
Folarin Babatunde PT PhD MScSEM MScPT BScPT
October 5, 2025
What Is BPPV (Benign Paroxysmal Positional Vertigo)?
If you experience dizziness or spinning when turning your head, Benign Paroxysmal Positional Vertigo (BPPV) may be the cause. At Cogent Physical Rehabilitation Center in Burlington, our physiotherapists specialize in diagnosing and treating BPPV, one of the most common causes of vertigo.
BPPV happens when tiny calcium crystals (otoconia) inside the inner ear become displaced and move into one of the semicircular canals, disrupting your sense of balance.When this happens, your brain receives mixed messages about movement, leading to dizziness and imbalance.
Anatomy of the Inner Ear
The inner ear has three semicircular canals—posterior, horizontal, and anterior—that detect head movements, and two otolith organs (utricle and saccule) that sense gravity.In BPPV, the misplaced crystals in these canals cause inappropriate fluid movement (endolymph flow), leading to vertigo when you move your head.
Common Causes of BPPV
Although BPPV can occur without a clear cause, physiotherapists often see cases related to:
Head or neck injury - such as after a motor vehicle accident.
Inner ear infection or inflammattion - labyrinthitis or vestibular neuritis
Age-related degeneration of the vestibular system
Prolonged bed rest or post-surgical inactivity
Vestibular migraine or post-concussion symptoms (Concussion Physiotherapy in Burlington)
BPPV is more common in women and older adults and may recur if left untreated.
Symptoms of BPPV
If you live in Burlington and experience any of the following, you may have BPPV:
Sudden spinning sensation or dizziness when rolling over in bed or looking up
Unsteady balance or fear of falling
Nausea during dizzy spells
Abnormal eye movements (nystagmus) when dizzy
These episodes are brief (usually less than one minute) but can happen several times per day making it difficult to go about your daily activities. If left untreated, BPPV may lead to reduced confidence and increased fall risk — particularly in older adults.
Learn more about Falls Pprevention Physiotherapy in Burlington
Types of BPPV and Physiotherapy Treatment Maneuvers
At Cogent Rehab Burlington, our physiotherapists identify which canal is affected and apply the appropriate repositioning maneuver to move the crystals back where they belong.
Diagnosis: Identifying the Affected Canal
During your BPPV physiotherapy assessment in Burlington, we perform specialized vestibular tests to identify the cause of your dizziness:
Dix-Hallpike Test – for posterior canal
Supine Roll Test – for horizontal canal
Head-Hanging Test – for anterior canal
Eye movement patterns (nystagmus) confirm which canal is involved, guiding precise treatment.
Physiotherapy Treatment for BPPV in Burlington
At Cogent Physical Rehabilitation Center, we provide evidence-based vestibular rehabilitation therapy (VRT) to correct BPPV safely and effectively.
1. Posterior Canal BPPV
Epley Maneuver – sequential repositioning to guide crystals back to the utricle.
Semont Maneuver – rapid side-to-side motion effective when Epley isn’t tolerated.
2. Horizontal Canal BPPV
Gufoni Maneuver – effective for both geotropic and apogeotropic BPPV.
Barbecue Roll Maneuver (Lempert) – involves gradual head rotations to reposition debris.
3. Anterior Canal BPPV
Deep Head-Hanging Maneuver – repositions crystals from the anterior canal.
Our Burlington physiotherapists tailor each maneuver to your symptoms, comfort, and medical history.
Vestibular Rehabilitation and Home Exercises
After repositioning maneuvers, your physiotherapist may teach you vestibular rehabilitation exercises to enhance recovery and reduce dizziness recurrence, including:
Brandt-Daroff Exercises
Gaze Stabilization (VOR) Drills
Balance and Coordination Training
These exercises help retrain your brain to adapt to new balance signals and improve movement confidence.
Safety First: Screening Before Treatment
Before beginning treatment, Cogent Rehab physiotherapists perform a vertebral artery test to ensure that neck movements used in repositioning maneuvers are safe.This is especially important for patients with neck stiffness, vascular conditions, or cervical spine issues.
When to See a Physiotherapist in Burlington
Book an appointment to see one of the physiotherapists with Vestibular Rehab at Cogent Rehab if you:
Feel dizzy when turning your head, looking up, or rolling in bed
Struggle with balance or feel unsteady while walking
Have dizziness following a concussion, fall, or whiplash injury
Prompt treatment can shorten recovery time and prevent falls.
How Long Does Vertigo Last With BPPV?
The spinning sensation (vertigo) caused by Benign Paroxysmal Positional Vertigo (BPPV) typically lasts a few seconds to a minute during each episode. However, the pattern and duration of symptoms can vary depending on the canal affected and whether the condition has been treated. You may have clusters of episodes over several hours or days, followed by mild imbalance for a few days as your brain recalibrates.
Typical Timeline for BPPV vertigo
Can BPPV Come Back?
Unfortunately, yes - BPPV can happen again after succesfful treatment. Studies show that about 30–50% of people experience recurrence within 5 years with some reporting multiple episodes during their lifetime. BPPV recurrence may happen due to age-related changes in the inner ear, head injury or whiplash, inner ear infections or inflammation, prolonged bed rest or inactivity, migraine or vascular factors.
To reduce recurrence, your Cogent Rehab physiotherapist will:
Teach vestibular and balance exercises
Provide guidance on sleep posture and movement habits
Schedule follow-ups for patients prone to dizziness
The good news: recurrent BPPV usually resolves again with one or two repositioning sessions.
Does medication cure BPPV?
No. Medications may reduce nausea or motion sickness but they don’t correct the displaced crystals that cause BPPV. Since BPPV is caused by displaced calcium crystals (otoconia) inside the inner ear, the only effective treatment is to see a Physiotherapist to help reposition those crystals back into their correct chamber through specific head and body maneuvers.
Can I do the Epley Maneuver at Home?
You can, but only after professional instruction.The Epley maneuver is effective for posterior canal BPPV, yet performing it incorrectly can worsen dizziness or target the wrong ear.
At Cogent Physical Rehabilitation Center Burlington, we:
Confirm which ear/canal is involved
Demonstrate the correct technique safely
Provide home exercise plans if appropriate
Monitor progress and adjust if symptoms persist
If you attempt it at home and your dizziness worsens, book an appointment immediately.
Why Choose Cogent Physical Rehabilitation Center Burlington
At Cogent Rehab Burlington, we combine accurate and comprehensive vestibular assessment tools, evidence-based repositioning techniques, individualized recovery programs, and education to prevent dizziness recurrence. Our goal is to help you rebuild balance, promote recovery, and enhance confidence in your movement.
As a locally owned Burlington physiotherapy clinic, we prioritize one-on-one care, comfort, and trust — no rushed appointments, ever.
We Don't Just Stop The Spinning - We Help You Stay Steady
Don’t let dizziness or vertigo limit your life.
Our vestibular physiotherapists at Cogent Physical Rehabilitation Center Burlington can help you find the exact cause of your dizziness and guide you through safe, effective BPPV treatment so you can move with confidence again.
Contact us today at (905) 635-4422 or book your consultation today.
Sources
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Bhattacharyya N, Gubbels SP, Schwartz SR, Edlow JA, El-Kashan H, Fife T, Holmberg JM et al. Clinical practice guideline: Benignb paroxysmal positional vertigo (Update). Otolaryngol Head Neck Surg. 2017;156(3_suupl):S1-S47.
Kim H-J, Kim J-S, Choi K-D, Choi S-Y, Lee S-H, Jung I, PArk JH. Effect of self-treatment of recurrent benigh paroxysmal positional vertigo: A randomizee clinical trial. JAMA Neurol. 2023;80:244-250.
Saishoji Y, Yamamoto N, Fujiwara T, Mori H, Taito S. BMC Prim Care. 2023;24:262.
Epley manoeuvre's efficacy for benign paroxysmal positional vertigo (BPPV) in primary-care and subspecialty settings: a systematic review and meta-analysis
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