I hear the same questions about recurrent BPPV from a lot of people. In this blog, I will cover three frequently asked questions (FAQs) about recurrent BPPV.

For each answer, I also included links to check out research that helps to further explain my answers to these frequently asked questions. I typically define recurrent BPPV as a new onset of BPPV that occurs at least one week after the previous episode of BPPV has been successfully treated.

Learn more about BPPV

FAQ #1:  What can I do to prevent recurrent BPPV?

BPPV treatment has a high rate of success. Yet there is also a fairly high rate of recurrence.

Overall, BPPV is not considered a preventable health condition. Most cases of recurrent BPPV are considered idiopathic, which means there is no known cause.

Three general recommendations I typically mention to my patients are:

  • Stay hydrated or avoid dehydration.
  • Manage your stress level. Use stress management techniques if needed.
  • Talk to your doctor about supplementing Vitamin D if your levels are deficient on a blood test (below 30).

Certain recurrent BPPV risk factors are associated with higher rates of BPPV, so they are worthy of further discussion. Of these, some risk factors are potentially modifiable, while other risk factors are not.

To examine risk factors, I think it is important to discuss related research and share my clinical experience because modifiable risk factors are specific to the individual. I can not speak to an individual’s situation through this article.

I would encourage you to discuss any risk factors for recurrent BPPV that might apply to your situation with your doctor. Together, you and your healthcare provider can determine if any risk factors are potentially modifiable and what you may be able to do about it.

To learn more about this topic, I published two blog articles wherein I discussed three research publications on risk factors for recurrent BPPV.

Article 1  – Recurrent BPPV risk factors

Article 2  – BPPV Recurrence: What Does The Research Say?

I also wrote an article discussing my clinical experience and tips regarding this topic, which you can find at the link below.

BPPV Recurrence

However, there is not currently a generally accepted international consensus about recurrent BPPV risk factors. This is a topic that still requires further investigation.

FAQ #2: Can barometric pressure changes cause recurrent BPPV?

The short answer is: Yes, that is possible.

A new onset or recurrence of BPPV can be preceded by changes in barometric pressure.

For example, I have a cluster of patients – myself included – who frequently experience BPPV when the barometric pressure changes dramatically.

To review a research study that found an association between BPPV and barometric pressure changes, click the link below.

Barometric Pressure and the Incidence of BPPV

Key Point: Keep in mind that migraines and vestibular migraines may also be triggered by changes in barometric pressure. It is important for patients and clinicians to distinguish between recurrent BPPV and migraine episodes that may be triggered by barometric pressure changes.

Read more about vestibular migraines here.

FAQ #3: What treatment should I try?

BPPV treatment has a high rate of success in resolving positional vertigo.

The type of BPPV treatment depends on the type of BPPV, the ear involved, and the location of the BPPV particles within that ear. There are a lot of BPPV treatments and they are specific to those variables.

When patients experience recurrent BPPV, they often assume that they will need same type of BPPV treatment as their previous episode of BPPV.

Although that is true for some patients with recurrent BPPV, that is not always the case.

Therefore, I recommend consulting with a vestibular PT or doctor for evaluation of any recurrent BPPV.

To emphasize the importance of getting re-evaluated for any recurrent BPPV, I often share a research study that drives home this point:

The Patterns of Recurrences in Idiopathic Benign Paroxysmal Positional Vertigo and Self-treatment Evaluation

The key research finding regarding the type of recurrent BPPV was that only 24% of patients showed recurrence of BPPV in the same canal on the same side.

Therefore, the researchers concluded that self-administration of specific BPPV treatments based on what helped with a previous episode of BPPV has limited value.

I agree with their findings and I do not suggest randomly attempting BPPV treatments that helped resolve positional vertigo in the past. Doing so can cause symptoms to worsen and canal conversions, which can complicate recovery.

I always recommend consulting with a vertigo expert as soon as you notice an episode of recurrent BPPV. I believe that is the best course of action.


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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