Rolling over in bed, sitting up or bending over to tie your shoelaces are simple movements you make every day. But if you have a common form of dizziness, these ordinary tasks can be frightening.

The movements can leave you feeling as if you’re spinning, sometimes even nauseated and about to vomit. When episodes occur several times a day, it becomes almost impossible to function.

Dizziness is the third most frequent reason people seek medical attention – most frequent for adults age 75 and older. More than 90 million Americans have experienced dizziness at some time. The condition challenges doctors and frustrates those affected because it has many causes and few good treatments.

But now clinicians have something more to offer. A new, relatively simple office procedure is resolving or significantly improving a common form of dizziness.

Benign Positional Vertigo is a mechanical disorder of the inner ear. Particles that sit in the central area called the utricle are dislodged and displaced into the semicircular canals. The particles cause the canals to become gravity sensitive. When the position of the head is changed, the particles move and a brief period of vertigo is experienced. Eye movement, called nystagmus, also occurs but sometimes is not felt by the individual. Your physical therapist can test for this condition at North County Physical Therapy.

BPV's exact cause is unknown. An upper respiratory infection or a blow to your head that jostles internal ear structures can lead to the dizziness. But most cases are probably a natural result of aging.

During the past few years, clinicians have found a new treatment for BPV increasingly successful, called the Canalith Repositioning Procedure. It involves five simple maneuvers for positioning your head.
 
Each position progressively moves debris from the posterior semicircular canal into a tiny baglike structure called the utricle. Here debris likely attaches to sticky membrane walls where it no longer can cause dizziness.

One treatment often eliminates dizziness immediately, If not, a repeated attempt may loosen debris that remains trapped in the semicircular canals. The procedure can also be redone if dizziness recurs.

After the procedure, you have to keep your head upright for 48 hours, even while you sleep. This allows time for the particles to settle inside the utricle. You also may need to wear a neck collar to prevent tilting your head. The Dix-Hallpike maneuver is used to confirm the diagnosis and identify which canal is involved. The particles can be repositioned by using the Epley maneuver, which moves the particles out of the canals, and back to their proper place in the central utricle.

Standard treatment of BPV involves a variety of approaches, including avoiding problem positions, doing difficult head exercises and taking medications that may make you drowsy and less aware of your dizziness.

The new repositioning procedure improves on standard approaches because it is:

• More effective—Traditional head exercises help displace particles. But they’re uncomfortable and you may have to repeat them daily. Most people stop doing the exercises before they have any effect. Another approach—trying to wait out the problem—can take weeks or months. For some people, the months can seem like years and the dizziness may still not go away.
• Better tolerated—Repositioning is usually a one-time treatment compared to the days required for traditional exercises. The maneuvers are more comfortable than standard exercises. There is also none of the drowsiness associated with medications.
•  Easy to perform—The procedure lasts between 10 and 30 minutes and can be done during a regular office visit.
• Inexpensive—It requires no special equipment, costly testing, or medications.

The Canalith Repositioning Procedure is not designed to treat any other form of dizziness except BPV. To be considered for the treatment, the Dix-Hallpike must confirm you have BPV.

One common test involves quickly changing from a sitting to a reclining position, then back to sitting. If you have BPV, your eyes rapidly move in one direction while lying down and then in another when you sit up.

Repositioning also may not be appropriate if you have neck problems such as arthritis. The need to extend and turn your neck during maneuvers may aggravate pain or worsen your condition.

A home program is issued to reduce the rate of recurrence of BPV. This will be provided to you by your physical therapist.

Up until recently, this condition was treated with rest or medication. Now, we know this conservative approach is painless, safe and effective.