5 Factors That Can Cause BPPV (Benign Paroxysmal Positional Vertigo)

Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of dizziness, creating brief but intense spinning sensations triggered by certain head movements.

Many people are surprised to learn that BPPV happens because tiny calcium crystals in the inner ear (otoconia) become dislodged and move into the semicircular canals, confusing the balance system.

But what actually causes these crystals to move out of place? Let’s break down 5 of the most common factors that can lead to BPPV.

1. Head Trauma or Concussion

Even a mild bump to the head can jostle the delicate structures of the inner ear. For athletes, car accident survivors, or anyone who’s had a fall, head trauma is one of the most common causes of BPPV. Sometimes symptoms start immediately, while in other cases they develop weeks later.

2. Age-Related Changes

As we age, the structures in the inner ear become more fragile, and the calcium crystals are more likely to break loose. This is why BPPV is especially common in adults over 50. In fact, research suggests age-related degeneration of the vestibular system plays a large role in recurrent dizziness. We also know that woman are more affected than men.

3. Inner Ear Infections or Disorders

Conditions like vestibular neuritis, labyrinthitis, or even chronic ear infections can increase the likelihood of BPPV. These issues inflame or disrupt the inner ear, making it easier for crystals to move where they shouldn’t.

“What About Diabetes, Osteoporosis & Viruses?”

• Diabetes: Increases BPPV risk, especially when combined with hypertension and vascular stress.

• Osteoporosis: Strongly associated with BPPV and its recurrence; bone health matters.

• Herpes Zoster: Some patients report it, but the science is not yet definitive.

• COVID: There have been some recent studies that state COVID and long COVID can cause some vestibular pathologies. This could be due to prolonged bed rest, medications, increased inflammation, or a number of different reasons.

4. Prolonged Positioning

Spending long periods lying down, such as after surgery or extended bed rest, can sometimes trigger BPPV. Similarly, certain sleep positions — like lying on the same side night after night — may contribute to crystal displacement over time.

5. Migraines

People with vestibular migraines are at higher risk for BPPV. The exact connection isn’t fully understood, but it’s thought that changes in blood flow and sensitivity in the vestibular system may make the inner ear more vulnerable.

What to Do If You Suspect BPPV

If you’re experiencing dizziness or spinning when rolling over in bed, looking up, or bending down, BPPV could be the cause. The good news? BPPV is very treatable with vestibular physical therapy. At Rebalance Physical Therapy, we use infrared goggles during positional testing to confirm the diagnosis and guide you through specific maneuvers to move the crystals back where they belong. At Rebalance we go a step further and assess the health of your inner ear as a whole so you can be sure that even after we clear your crystals you will be walking around with confidence and no lingering brain fog, balance issues, or feelings of being off or not yourself!

You don’t have to live with the fear of spinning episodes!

👉 Ready to stop the spin? Book a consult with Rebalance Physical Therapy today and get back to steady ground.