Balance/Dizziness Services

Vertigo Treatment in Denver and Surrounding Areas

If you’ve ever felt like the room is spinning when you lie down, roll over, or tilt your head, there’s a good chance you may be experiencing Benign Paroxysmal Positional Vertigo (BPPV). At Colorado Ear Care, we specialize in diagnosing and treating BPPV for patients in Lakewood and Louisville, CO.

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What Is BPPV?

BPPV is an inner ear disorder that causes brief episodes of vertigo a spinning sensation triggered by changes in head position.

Here’s what the name means in plain language:

Benign: not dangerous or life-threatening
Paroxysmal: sudden and short-lived episodes
Positional: brought on by certain head positions or movements

People use the word “dizzy” to describe many sensations: feeling faint, unsteady, off-balance, or lightheaded. Compared with general dizziness, however, BPPV is different because it typically causes true vertigo, where you feel like you’re spinning or the room is spinning around you, often with predictable triggers (like rolling over in bed).

Who Gets BPPV?

BPPV can happen at any age, but it’s most common in adults 50 and older and is reported more often in those assigned female at birth. Studies also estimate that about 20% of people evaluated for dizziness are diagnosed with BPPV, so it’s an important condition to recognize.

What Are the Symptoms of BPPV?

BPPV symptoms can feel dramatic or even scary, especially the first time. Episodes often happen suddenly and may come and go over days or weeks.

BPPV episodes are typically brief — often less than one minute, though the unsteady or “off” feeling afterward can linger. Common symptoms include:

Vertigo: You feel like you’re spinning or the room is spinning

Dizziness or lightheadedness

Balance problems or unsteadiness

Nausea and vomiting

Blurred vision

Nystagmus: involuntary, rapid eye movements that can occur during an episode (an important clue for diagnosis)

Typical Triggers of BPPV

Not everyone experiences BPPV the same way. Symptoms vary from person to person, and the affected ear/canal can change what triggers feel most intense.

Symptoms commonly start with certain positional changes, such as when you:

Lie down or sit up

Roll over in bed

Tilt your head back (looking up)

Bend forward (looking down)

When to Seek Care for BPPV

If vertigo is sudden, intense, recurring, or interfering with daily life, it’s time to be evaluated, especially if you’re worried about falling or can’t safely drive or work.

Seek emergency care immediately if dizziness/vertigo occurs with any of the following symptoms, which can signal conditions requiring urgent treatment:

Severe headache

Fever

Vision problems

Hearing loss (especially sudden)

Difficulty speaking

Arm or leg weakness or numbness

Falling, fainting, or passing out

What Causes BPPV?

BPPV is caused by a mechanical problem in the inner ear, specifically the part responsible for detecting motion and balance.

A quick tour of the inner ear (simple version):

Semicircular canals: fluid-filled loops that sense head rotation
Otolith organs (utricle and saccule): sense gravity and linear movement
Otoconia: tiny calcium carbonate crystals that sit in the utricle and help detect movement

In BPPV, some otoconia become dislodged and migrate into a semicircular canal. When you move your head, these crystals shift inside the canal, sending confusing signals to the brain about your body’s position. That mismatch between what your inner ear senses and what your eyes/body feel can trigger sudden vertigo.

Why do crystals dislodge?

Often, BPPV is idiopathic, meaning there’s no clear cause. But known triggers and contributing factors can include:

Head injury or trauma

Inner ear inflammation or infection (such as labyrinthitis or vestibular neuritis)

Prolonged bed rest or recent surgery

Rarely, ear surgery

Risk Factors of BPPV

BPPV can occur without warning, and you can develop it without any risk factors. But your risk may be higher if you:

Are age 50 or older

Are assigned female at birth

Sustained a previous head injury

Have a history of inner ear or balance disorders

Have osteoporosis (bone thinning)

Diagnosing BPPV

If you’re experiencing BPPV symptoms, you’re probably looking for clarity and fast relief. An ENT specialist can often diagnose BPPV during a standard office visit, and many patients don’t need complex testing.

Your visit typically includes:

A review of symptoms and triggers

A focused physical exam

Positional testing to reproduce symptoms safely

The Dix–Hallpike test

The Dix–Hallpike test is the standard positional test used to confirm BPPV and help identify which ear and canal are affected. During the test, your provider guides you through specific head/body positions while observing symptoms and eye movements (nystagmus).

Just as important: an ENT specialist can also rule out more serious causes of dizziness and determine whether your symptoms suggest a different vestibular or neurologic condition.

BPPV Treatment Options

This is where the outlook gets encouraging: BPPV treatment is usually quick, non-invasive, and highly effective. Your best option depends on which canal is involved and your medical history.

Canalith Repositioning Procedures

The Epley maneuver

The Epley maneuver, a common type of canalith repositioning, is one of the most widely used and effective treatments for BPPV. Many cases improve significantly after one session, and published success rates frequently exceed 80% (often reported in the 80–90% range), though some patients need repeat visits.

How it works:
Your ENT specialist guides you through a series of head and body movements designed to move displaced otoconia out of the semicircular canal and back into the utricle, where they no longer trigger vertigo. Note that some people need more than one session, especially if symptoms have been present for a while or if multiple canals are involved.

What patients like about it:

Usually performed in-office

Typically takes about 15 minutes (varies by clinic and complexity)

No injections or incisions

Often provides rapid relief, sometimes the same day

At-Home Exercises

Some patients are given home programs such as Brandt–Daroff exercises or home versions of repositioning maneuvers.

These can be helpful, but they should not replace an evaluation, especially if you’re unsure whether it’s BPPV. Your ENT provider may:

Teach you the correct technique

Confirm which side/canal to target

Help you avoid positions that worsen symptoms unnecessarily

Medications

Motion sickness medications may temporarily reduce nausea or dizziness, but they:

Don’t fix the underlying cause (the displaced crystals)

Are not a long-term solution for BPPV

Should be used only under provider guidance (especially in older adults, for whom sedation can increase fall risk)

Is Surgery Ever Considered for BPPV?

Surgery for BPPV is rare. It is reserved for cases that do not respond to repositioning procedures and significantly impact the patient’s quality of life.

One option is canal plugging surgery, which blocks the affected canal so it no longer sends abnormal signals. Most patients never need this.

What to Expect After BPPV Treatment

Most people feel noticeable improvement after one or two canalith repositioning sessions, although you may experience mild unsteadiness for a short time.

Your provider may recommend temporary precautions (often for 24–48 hours), such as:

Sleeping slightly elevated

Avoiding rapid head movements

Being cautious with bending/looking up

Can BPPV Come Back?

Yes, it’s possible for BPPV to recur, but that doesn’t mean treatment “failed.” It often means crystals have shifted again and you may benefit from another repositioning visit. Follow-up care matters, especially if:

Symptoms return

Triggers change

Episodes become more frequent

You’ve had falls or near-falls

Complications of BPPV

BPPV itself isn’t dangerous, but untreated vertigo can be. The biggest concern is fall risk. Falls can lead to serious injuries such as fractures and head injuries, especially in adults 65 and older.

Chronic or recurring vertigo can also:

Affect driving confidence and safety

Interfere with work and caregiving

Reduce activity levels (which can worsen balance over time)

Increase anxiety about movement and daily routines

Commonly Asked Questions About BPPV

What does BPPV feel like?

BPPV symptoms come on suddenly and may last just seconds to a minute. You might feel as if the room is spinning, and the sensation may be accompanied by nausea or even a risk of falling. These episodes often happen when you:

Despite being brief, the disorientation from BPPV can significantly impact your safety and quality of life.

What causes BPPV?

BPPV originates in the inner ear, which helps the body detect movement and maintain balance. Tiny calcium crystals,called otoconia, help your balance system detect gravity and motion. If these crystals become dislodged and move into the inner ear’s semicircular canals, they can trigger false signals that make you feel dizzy when your head moves.

Contributing factors include:

Is there a non-invasive way to treat BPPV effectively?

The great news? BPPV is treatable, no surgery or medication needed.

At Colorado Ear Care, we offer Canalith Repositioning Maneuvers, a series of head and body movements that help move the dislodged crystals out of the sensitive parts of your inner ear. This treatment is:

Will BPPV come back?

In some cases, yes, especially if you have risk factors like vitamin D deficiency or chronic conditions such as migraines or diabetes. But the good news is that recurrence can be managed with follow-up care and additional treatments as needed. We recommend regular check-ins with your healthcare provider and monitoring your vitamin D levels. If symptoms return, our team in Lakewood or Louisville is here to help you get back on your feet.