In this blog, I share some common causes of BPPV.

BPPV is the most common inner ear problem, or vestibular disorder, and it is caused by crystals floating into a semi-circular canals in the inner ear – where they are not supposed to be.

People often wonder what causes this condition. It varies between individuals.

Below is a list of some of the answers that I give to my patients when they ask me about common causes of BPPV:

Common causes of BPPV include head injury, concussion, car accident or any trauma to the head or neck area.

The head trauma, or impact of a car accident, can cause a physical force that knocks the crystals off the membrane where they are supposed to be within the inner ear and causes them to float into the semicircular canal.

This happens because these adjacent parts of the inner ear share fluid.

Vertigo Detective Vocabulary Builder:


UTRICULE (Yoo-trickle) = the organ within the inner ear where the crystals originally came from

Another common cause of crystals breaking loose is hormonal changes, especially puberty, pregnancy and menopause for women.

Other common causes of crystals breaking loose include dehydration, stress, seasonal allergies and sinus infections.

In addition to those causes, normal aging is a common cause of crystals breaking loose in people over 65 years old. The membrane within the utricle that holds the crystals in the inner ear degenerates with normal aging and causes a higher incidence of BPPV in older adults.

The good news is that treatment results are usually very good, once you have sought out a Vestibular Specialist to assess for the location of the crystals and provide appropriate treatment for BPPV.

There are three semi-circular canals in each inner ear, so there exists six (6) total possible locations to find the BPPV crystals.

Any combination of multi-canal involvement can occur. The most complex cases of BPPV involve multiple canals in both ears.

The worst case I have seen was after two head traumas and I found crystals in five (5) out of six (6) canals. That took about six sessions to clear up completely.

Many of the healthcare providers who are trained in BPPV only test two out of the six possible canals to find crystals, leading to incomplete recovery in many cases.

Simple BPPV in one canal can be cleared in 1-2 sessions about 90% of the time.

There are many other causes of BPPV and associated diagnoses. I will continue to share as much information with you on this topic as I can in order to help you solve your case of vertigo.

A key tip to keep in mind is that, although common, BPPV is not the only possible cause of vertigo and many healthcare providers do not know how to assess it or treat it.

Many other root causes of vertigo exist that need to be considered and ruled out in complex cases. Consulting a Specialist in dizziness and vertigo is recommended, as well as notifying your Primary Care Doctor of your symptoms.


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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