Disclaimer: New or sudden dizziness should be assessed by a doctor to rule out cardiac or neurological causes before physiotherapy. This article is for general educational purposes only. © 2026 Better Physiotherapy Bundoora.
If you experience sudden spinning vertigo when rolling over in bed, looking up, or bending forward — you may have BPPV, the most common vestibular disorder in adults. The remarkable news: it can often be completely resolved in a single physiotherapy session. Other vestibular conditions, including dizziness after concussion, also respond very well to vestibular rehabilitation physiotherapy.
BPPV — Benign Paroxysmal Positional Vertigo
BPPV is caused by tiny calcium carbonate crystals (otoconia) that normally sit in one part of the inner ear becoming dislodged and floating into the fluid-filled canals. When the head moves, these crystals send abnormal signals to the brain, triggering intense, brief vertigo.
Classic symptoms:
- Sudden spinning sensation lasting 5–30 seconds
- Triggered by specific head positions: rolling over in bed, looking up, bending forward
- May be accompanied by nausea
- Usually resolves spontaneously within 30 seconds once movement stops
Treatment: The Epley manoeuvre — a sequence of head and body positions guided by your physiotherapist that moves the crystals back to their correct position. Research shows an 80–90% success rate after one or two treatments. Most patients leave their appointment without vertigo for the first time in weeks or months.
Vestibular Hypofunction
Vestibular hypofunction occurs when the inner ear on one or both sides is functioning below normal — often following a viral infection (vestibular neuritis or labyrinthitis), Ménière's disease, or aging. Symptoms include chronic dizziness, unsteadiness, and difficulty focusing in busy environments. Vestibular rehabilitation exercises train the brain to compensate for the reduced inner ear input, progressively reducing symptoms over 6–12 sessions.
Post-Concussion Vestibular Dysfunction
Dizziness and balance problems are among the most common and persistent symptoms after concussion. Vestibular physiotherapy is a key component of post-concussion management, using graduated exercises to restore vestibular function and reduce dizziness and visual sensitivity.
Falls Prevention
For older adults, balance impairment significantly increases falls risk. Vestibular physiotherapy and targeted balance training reduce falls risk by improving proprioception, strength, and the reflexes that keep us upright. This is covered under NDIS, My Aged Care, and Medicare EPC for eligible patients.
Frequently Asked Questions
I get dizzy when I roll over in bed. Is that BPPV?
Almost certainly yes. Brief, intense vertigo triggered by specific head movements — rolling in bed, looking up, bending forward — is the classic presentation of BPPV. It is caused by calcium crystals that have become displaced in the inner ear. A physiotherapist can confirm this with a quick test (Dix-Hallpike) and treat it with the Epley manoeuvre, often in a single session.
Is it safe to drive if I have vertigo?
No. Vertigo causes sudden, unpredictable spinning sensations that make driving extremely dangerous. You should not drive until your symptoms are fully resolved and you have been cleared by your physiotherapist or doctor.
Can physiotherapy treat dizziness after a concussion?
Yes. Post-concussion dizziness and vestibular dysfunction are common and respond well to vestibular physiotherapy. This is a more complex presentation than BPPV and requires a course of graduated vestibular rehabilitation exercises.
What is the difference between vertigo and dizziness?
Vertigo is a specific sensation of spinning — either the room spinning around you or a sensation of spinning yourself. Dizziness is a broader term covering lightheadedness, unsteadiness, and imbalance. True vertigo almost always has a vestibular (inner ear or brain) cause, while dizziness can have many origins including cardiovascular, neurological, and musculoskeletal.
Ashley Haleel
Physiotherapist & Owner — Better Physiotherapy Bundoora