BPPV (Benign Paroxysmal Positional Vertigo) Treatment in Perth (Malaga)

Vertigo assessment, repositioning manoeuvres, and balance rehabilitation

BPPV is one of the most common causes of brief, position-triggered vertigo (a spinning sensation). At Palms Physiotherapy & Allied Health (Malaga), we provide assessment and treatment for BPPV and other vestibular conditions, with a clear plan to reduce dizziness and improve confidence with movement.

What is BPPV?

Benign Paroxysmal Positional Vertigo (BPPV) occurs when tiny calcium carbonate crystals (“otoconia”) in the inner ear become displaced into one of the semicircular canals. When you move your head into certain positions, these particles can shift and trigger brief episodes of vertigo, often lasting seconds to around a minute.

BPPV is commonly triggered by movements such as:

• Rolling over in bed

• Getting in or out of bed

• Looking up or bending down

• Turning your head quickly

Common symptoms of BPPV

BPPV symptoms can vary, but often include:

• Brief spinning sensation (vertigo) with head movement

• Unsteadiness or feeling off-balance

• Nausea (sometimes vomiting)

• Symptoms that improve when you stay still

Some people also describe feeling “floaty,” “tilted,” or like they might fall when turning or changing positions.

Does Palms treat vertigo and dizziness?

Yes. The most common vestibular conditions we see include:

• BPPV (Benign Paroxysmal Positional Vertigo)

• Unilateral vestibular disorders (e.g., vestibular hypofunction)

• Ménière’s disease (note: management is often shared with ENT/medical teams)

Assessment helps determine what is most likely causing symptoms and whether physiotherapy treatment is appropriate.

How BPPV is diagnosed

BPPV is diagnosed through a detailed history and specific positional tests performed by a trained clinician. This may include the Dix–Hallpike test and/or other positional assessments to identify:

• Whether BPPV is present

• Which inner ear canal is affected (because treatment varies)

We also screen for red flags and symptoms that suggest medical review is needed.

Physiotherapy treatment for BPPV

The most effective treatment for BPPV is usually a canalith repositioning manoeuvre (a sequence of guided head/body positions) designed to move the displaced crystals out of the semicircular canal.

Canalith repositioning manoeuvres (e.g., Epley)

• Often provides rapid improvement for many people

• May require more than one treatment depending on the canal involved and symptom pattern

• You’ll be guided through what to expect and what to do after treatment

Vestibular rehabilitation (when needed)

If symptoms persist, balance confidence is reduced, or there is an additional vestibular issue, we may provide vestibular rehabilitation therapy (VRT), including:

• Balance retraining

• Gaze stabilisation exercises (as appropriate)

• Gradual movement exposure to reduce dizziness sensitivity

• Home exercises tailored to your presentation

Education and self-management

We’ll explain:

• Why symptoms are occurring

• What movements may temporarily provoke symptoms (and how to manage safely)

• How to reduce falls risk while symptoms settle

• When to return for review

Preventing recurrence of BPPV

BPPV can recur for some people. While it isn’t always preventable, helpful strategies may include:

• Seeking prompt assessment if positional vertigo returns

• Following your clinician’s guidance on safe movement and balance strategies

• Completing any prescribed vestibular exercises if recommended for your profile

Do I need a referral to see a physiotherapist for vertigo?

No referral is required to book in with us. However, it can be helpful to see your GP—particularly if:

• This is your first episode of vertigo

• Symptoms are severe, persistent, or unclear

• You need medication support for nausea (GPs can prescribe this)

If you have been prescribed medication for dizziness/nausea, please tell your physiotherapist, as this can influence assessment and symptom interpretation.

When to seek urgent medical review

Seek urgent medical attention if you have dizziness/vertigo with any of the following:

• New weakness, numbness, facial droop, slurred speech, or severe headache

• Fainting, chest pain, or severe shortness of breath

• New hearing loss, severe ear pain, or fever with significant unwellness

• Persistent vomiting or inability to keep fluids down

• Continuous severe vertigo that does not settle and is not position-related

Our Mobile Therapy Services

Please visit these other websites for further information:

Vestibular Disorders Association (VeDA) – Information on vestibular disorders, including BPPV.

• https://vestibular.org

Balance Disorders Australia – Support and resources for individuals experiencing balance issues.

• https://balancedisordersaustralia.com.au

Australian Hearing – Information on hearing and balance, including related conditions.

• https://www.hearing.com.au

Healthdirect Australia – General health information, including details on dizziness and vertigo.

• https://www.healthdirect.gov.au

The Australian Physiotherapy Association – Resources and information on physiotherapy practices for balance and vestibular disorders.

• https://australian.physio

Neurological Alliance Australia – Advocacy and resources for individuals with neurological conditions, including vestibular disorders.

• https://www.neuroalliance.org.au

Australian Institute of Health and Welfare (AIHW) – Health data and reports related to balance and dizziness.

• https://www.aihw.gov.au

The Vestibular Rehabilitation Special Interest Group – Professional resources for physiotherapists specializing in vestibular disorders.

• https://physiotherapy.asn.au

Royal Australian College of General Practitioners (RACGP) – Guidelines and resources for general practitioners on managing dizziness.

• https://www.racgp.org.au

Dizziness and Balance Disorders Clinic – A clinic focused on diagnosing and treating balance disorders.

• https://www.dizzinessandbalance.com.au

Important disclaimer: This webpage contains general information only and is not intended to be relied upon as personal clinical advice. While we aim to keep information accurate and up to date, it may not reflect the most current research or your individual circumstances. Palms Physiotherapy & Allied Health does not accept liability for decisions made based on this information without an individualised assessment by an appropriately qualified health professional. If you have concerns, please contact us to book an assessment or speak with your GP/medical team.