Does BPPV Treatment Hurt?
Many people ask me if BPPV treatment hurts.
The answer is that BPPV treatment may cause some temporary discomfort.
During or after BPPV treatment, some patients also complain of mild to moderate pain in their head or neck.
Informed Consent: Risks and Benefits of Care
Signing an agreement to participate in care, called an “Informed Consent,” is an important step before starting BPPV treatment.
All healthcare providers must inform patients of the risks and benefits of medical care.
Risks of BPPV Treatment
- Spinning feeling (vertigo)
- Pressure in the head
- Neck pain
- Possibly a feeling of panic, if they are prone to panic attacks
- Nausea or vomiting, if that has been part of their original symptoms
- Headache or neck pain the next day, which can last for a few days
- Full body muscle soreness the next day that can last for a few days, especially if they have been inactive due to vertigo and they have gotten out of shape with weak muscles
- The patient might feel worse afterwards for a few hours if they have BPPV in both the right and left ears, since we can only treat one side per day. Treating BPPV one side can aggravate BPPV on the opposite side. A second treatment is needed to address the second side, if both ears are involved.
Prior Symptoms may be Temporarily Magnified during BPPV treatment
If they have been anxious or stressed, that may feel temporarily worse during the treatment. People who are prone to panic attacks might feel panicky.
If nausea or vomiting has been part of their BPPV symptoms, that may occur during or after the treatment.
Basically, I educate my patients that whatever they have been experiencing may be magnified during the treatment.
We take special precautions to manage any of these symptoms, if they arise during treatment.
Hopefully the treatment will resolve the root cause of their discomfort. That is the goal!
Pressure in the Head is a Common Complaint
Because the patient’s head typically is tilted downwards during BPPV treatment, many people feel pressure in their head.
Their forehead, sinuses, face, and top of the head might feel pressure from the blood rushing to their head while their head is down.
During BPPV treatment sometimes people say “I feel pressure in my head.”
I encourage them to hang in there by saying, “I know and I am sorry, but please bare with me. We will be done in a minute or two.”
Establish a Safe Word to Stop BPPV Treatment if needed
Before we start the BPPV treatment, we always establish that they can say “Stop” at any time and I will sit them up right away.
During my sessions, this “safe word” stops the BPPV treatment immediately.
I encourage people to try to get through it in order to get the benefits of resolving the BPPV symptoms.
Neck Pain is Possible
Sometimes people do complain of neck pain during or after the treatment.
BPPV treatment may require about 20-30 degrees of extension to the neck and about 45 degrees of rotation of the neck. For some people, this neck position can cause their neck to hurt during or after the treatment.
I am very aware of this problem, so I try my best to support their head and neck with my hands throughout the whole treatment to minimize neck pain.
For people with healthy, strong, and flexible necks, this is not usually a problem.
People with a history of neck pain, neck injury, or poor posture are more likely to complain of neck pain during or after treatment.
Typically I will recommend using a soft ice pack on their neck for 15-20 minutes to reduce any neck pain after BPPV treatment.
I will sometimes do a gentle, manual massage for the muscles of the neck during or after the BPPV treatment.
Some People get a Headache
If they need actual follow up care for their neck pain, I can do that at the next visit or I can send them to somebody else who specializes in orthopedics, but that is pretty rare.
Muscle Soreness may occur in People who are Sedentary
I have treated some older adults in their 70’s, 80’s, or 90’s who have been bed-bound for years due to vertigo.
Their muscles are so out of shape that they can feel full body muscle soreness for a few days after the BPPV treatment. Our treatment session might be the most that they have moved around in years!
The next day when I called to check on her, she said, “I am so happy that I am not dizzy anymore, but I am really sore all over!”
Many People Feel Better Afterwards
In one treatment, her vertigo was resolved! She felt fine afterwards – so fine that she drove up to Sacramento on the same day to go visit her family.
She had not been able to drive alone by herself for hours to see her family for awhile due to her vertigo problems, but right after the treatment she could.
Some people will bounce back really quickly, while for other people it may take them a day or two to bounce back and feel better.
Patients who are neurologically more sensitive may take a bit longer to bounce back.
Extra Rest and Good Sleep is Important
Most people need to rest or take a nap after BPPV treatment. I recommend that they plan to take it easy for the rest of the day and go to bed early.
Extra rest and a good night’s sleep can help their brain “reboot” after the neurological stress of BPPV.
I often recommend a few extra hours of sleep during the night after treatment to maximize recovery.
My after-care instructions include not to visit the hairdresser or dentist for at least 48 hours afterwards to allow the crystals to settle.
My Patients say “It’s worth it!”
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.