Understanding BPPV and Cervicogenic Vertigo: A Functional Approach to Dizziness

Dizziness is one of the most unsettling and disorienting symptoms a person can experience. Two of the most common non-life-threatening causes are Benign Paroxysmal Positional Vertigo (BPPV) and cervicogenic vertigo.  Although both involve balance issues, their origins and treatments are different—but often interconnected. Fortunately, a trained chiropractor and functional medicine practitioner can offer a highly effective, integrative approach to resolving both.

What is BPPV?

Benign Paroxysmal Positional Vertigo (BPPV) is a mechanical problem in the inner ear.  It occurs when tiny calcium crystals (otoconia), which normally help with balance, become dislodged and move into the semicircular canals of the inner ear. These canals detect rotational movement, and the presence of crystals where they don't belong causing the brain to receive confusing signals, triggering intense, brief episodes of vertigo—often when rolling over in bed, looking up, or bending down.

Symptoms of BPPV:

• Sudden spinning sensation with head movements

• Nausea or vomiting

• Imbalance or unsteadiness

• No hearing loss or tinnitus

Treatment:

The gold standard treatment is the Epley manoeuvre, a precise sequence of head and body movements that guide the loose crystals back to their proper location. A trained chiropractor can safely and effectively perform this manoeuvre and teach patients how to repeat it at home if needed.

What is Cervicogenic Vertigo?

Unlike BPPV, cervicogenic vertigo is caused by dysfunction in the upper cervical spine—often due to joint restrictions, muscle tightness, poor posture, or previous trauma like whiplash. The upper neck is packed with nerve endings and proprioceptors that send signals to the brain about head and body position. When these signals are distorted by spinal dysfunction, it can lead to dizziness or imbalance.

Symptoms of Cervicogenic Vertigo:

• Dizziness associated with neck movement or stiffness

• Headaches

• Neck pain or restricted mobility

• A sense of imbalance or “floating” rather than spinning

• Often chronic or recurring

Treatment: Cervicogenic vertigo responds well to:

• Chiropractic adjustments to the upper cervical spine

• Myofascial release and soft tissue therapy

• Postural correction and ergonomic coaching

• Functional movement and proprioceptive retraining

• Lifestyle strategies to reduce inflammation and restore neuromuscular balance

Can Both Happen Together?

Yes. Some patients experience both BPPV and cervicogenic vertigo—particularly after head or neck trauma, or due to prolonged poor posture (like tech neck).  In these cases, addressing both the inner ear and the cervical spine is essential for full recovery.

A Functional, Whole-Body Approach

A chiropractor trained in functional and lifestyle medicine goes beyond symptom relief to identify and correct the root causes of vertigo. This may include:

• Assessing vitamin D, magnesium, and inflammation levels

• Addressing postural habits and screen time

• Incorporating vestibular rehabilitation and neck mobility work

• Supporting sleep and stress management for nervous system regulation

Takeaway: You Don't Have to Live with Dizziness

Vertigo—whether from BPPV, cervicogenic causes, or both—is treatable.  With a targeted, holistic approach, you can regain your balance, confidence, and quality of life.

If you're experiencing dizziness, don’t wait for it to pass on its own.  Seek support from a practitioner who understands the full spectrum of contributing factors—mechanical, neurological, and lifestyle-related.

Dr. D Michael Elliott MSc, D.C. CFMP www.ablebodiedhealthcare.com