Brainstorm about BPPV Recurrence

There is a fairly high rate of BPPV recurrence, especially in people with migraines.

If you have previously suffered from vertigo, you may have been successfully treated for BPPV.

Although BPPV can be successfully treated, it is never “cured” because you may experience a BPPV recurrence at some point. That means you may find that the vertigo symptoms come back again.

At the time that you recognize that you have BPPV again, I recommend for you to return to the healthcare provider who successfully treated you in the past.

It is important to seek more vestibular care if you have BPPV or any type of “motion activated dizziness.”

Is a BPPV Recurrence Preventable?

Many of my patients ask me what they can do to prevent the BPPV crystals from coming back.

Research is clear that doing BPPV treatment maneuvers is not effective to prevent a new onset of BPPV.

The BPPV treatment maneuvers are only necessary and effective for a new case of BPPV or after a BPPV recurrence.

Generally, BPPV is not considered “preventable.”

The basic plan for anyone who suffers with vertigo from BPPV is to seek treatment for each vertigo episode as soon as possible.

Seek BPPV Treatment

BPPV treatment can reduce dizziness and vertigo, as well as prevent falls.

In this article, I discuss some consequences of ignoring a BPPV recurrence.

You can use this blog to search for a provider in your area who can perform “particle repositioning maneuvers” for BPPV, if you suffer a BPPV recurrence.

Although you may find many videos online with treatments like the Epley maneuver, I do not recommend for you to attempt to treat yourself for BPPV.

I recommend seeking professional help for each BPPV recurrence, because past episodes of BPPV have limited predictive value for the type of BPPV you might get in the future.

If you suffer a BPPV recurrence, you may need different treatment maneuvers than you needed in the past. Therefore, I suggest you consult a vestibular professional for evaluation for each BPPV recurrence.

Once you complete your vertigo treatment plan, you will always need to be aware of the symptoms of a BPPV recurrence.

Even though there is technically no way to prevent a new onset of BPPV, I do encourage my patients to address any risk factors that are associated with BPPV.

I have created a list of some possible reasons that a patient may have recurrent BPPV. Some of these reasons below may be managed, but other risk factors for recurrent BPPV are unmodifiable.

Possible Reasons for BPPV Recurrence

  • Stress
  • Dehydration
  • Hormonal changes (such as during puberty, pregnancy, or menopause)
  • Changes in barometric pressure
  • Traveling
  • Jarring impact
  • Head Trauma
  • Fall with impact (hard landing)
  • Herpes breakout
  • Virus affecting ear
  • Dental work
  • Sinus congestion
  • Sinus infection
  • Inflammation affecting the ears
  • Auto-immune disease (like Hashimoto’s thyroiditis)
  • Tobacco smoking
  • High blood pressure
  • High cholesterol
  • Diabetes
  • Low Vitamin D level (below 30)
  • Restricted blood flow to the ear due to problems with neck alignment, such as from poor posture
  • Atlas subluxation (C1 bone alignment problem which can affect blood flow to one or both of the ears)
  • Normal aging that causes degeneration of the utricle (which contains the membrane that is supposed to have BPPV crystals)
  • History of recurrent ear infections or swimmer’s ear during childhood (that caused inner ear damage)
  • Inner ear damage from repeated vertigo attacks from Meniere’s disease
  • History of vestibular neuritis or labyrinthitis that damaged the inner ear
  • Genetic predisposition to motion sensitivity (lifelong car sickness)


This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.

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