Why is the Room Spinning?!

By: Ryan Cavanaugh, PT, DPT

Have You Ever Stood Up and Felt Like the Room Was Moving Around You?

If you’ve ever gotten out of bed or stood up from a chair and suddenly felt like the room was spinning, you may have experienced BPPV (Benign Paroxysmal Positional Vertigo). This condition occurs when tiny crystals (otoconia) inside your ear become dislodged and end up in the wrong part of the inner ear, leading to dizziness and vertigo.

Symptoms and Causes of BPPV:

Brief episodes of spinning or feeling like the world around you is moving when you change positions
In some cases, the spinning may seem constant but will stop when the head is still
Nausea
Dizziness
Anxiety

How Does BPPV Affect Balance?

Your inner ear plays a crucial role in maintaining balance. It has two main components that work together:

Balance Crystals (Utricle) – These tiny crystals act like gravity sensors for your brain. For example, if you bend over to tie your shoes, the crystals move in the direction that you are bending. This alerts your brain to your body’s changing position.
Balance Tubes (Semicircular Canals) – These are fluid-filled tubes that help detect how fast you are moving. When bending over to tie your shoes, the tubes send signals to your brain about your speed of movement.

When a crystal from the utricle moves into a semicircular canal, it causes the fluid to splash around. This miscommunication tells your brain that you are moving when you are still, creating the sensation of spinning. The dizziness typically subsides once the head stops moving because the crystal settles.

What Can Be Done to Correct This?

BPPV is highly treatable! The first step is a comprehensive vestibular exam by a trained physical therapist to rule out any other potential causes. If BPPV is confirmed, treatment involves a series of repositioning maneuvers.

These maneuvers work by guiding the dislodged crystal out of the semicircular canal, similar to moving a marble through a maze. Depending on how many canals are affected, resolution may take just one treatment or a few sessions over a couple of weeks.

Recent Research Findings

Recent studies suggest that maintaining healthy vitamin D levels may reduce the risk of recurring BPPV episodes.

Safety Recommendations

Improve Home Lighting: Ensure good lighting, especially at night, to help your brain stay oriented and reduce fall risk.
Move Slowly: BPPV is often triggered by positional changes like rolling in bed, looking up or down, or getting in and out of a chair. Take your time when transitioning positions.
Use Visual Focus: When moving, keep your eyes fixed on a stable spot in front of you to help maintain orientation.
Seek Treatment Quickly: The sooner you begin therapy, the faster your symptoms will resolve.

If you’re experiencing symptoms of BPPV, don’t wait—consult a vestibular specialist and take the first step toward relief!