Benign Paroxysmal Positional Vertigo (BPPV) Treatment at Physiocare Physiotherapy & Rehab Centre

Evidence-Based Treatments for BPPV Offered Across Physiocare Clinics

At Physiocare, treatment for BPPV is precise, targeted, and grounded in current vestibular rehabilitation evidence. Each modality is selected based on the specific pathology of this condition — displaced otoconia, disrupted semicircular canal mechanics, and impaired vestibulo-ocular reflexes.

Vestibular Exercises — Epley and Semont Maneuvers (Available at all locations: Greenbank, Carling, Westboro, Kanata, Stittsville, Barrhaven)

The Epley and Semont maneuvers are the gold-standard, first-line intervention for BPPV — specifically designed to reposition displaced otoconia back into the utricle where they cause no disruption.

• Why this treatment for BPPV specifically: The displaced crystals in the posterior or horizontal semicircular canal are the direct cause of the spinning sensation. The Epley maneuver guides the head through a precise sequence of positions, using gravity to move the otoconia out of the canal and back into the utricle.
• Semont maneuver is used as an alternative repositioning technique, particularly when canalith repositioning via Epley is not tolerated.
• These maneuvers directly address the acute phase of BPPV — when otoconia are actively free-floating and creating maximal symptom burden.
• Following repositioning, vestibular habituation and gaze stabilization exercises are prescribed to retrain the brain’s balance centres and reduce sensitivity to head movement.
• Vestibular Rehabilitation at Physiocare complements maneuver-based treatment with a complete program tailored to your specific canal involvement and symptom profile.

DNS — Dynamic Neuromuscular Stabilization (Available at: Westboro, Kanata, Stittsville)

BPPV does not only affect the inner ear — it disrupts the entire postural and neuromuscular system that keeps you upright and oriented in space.

• Why DNS for BPPV: Following repeated vertigo episodes, the body’s postural reflexes — particularly those that integrate vestibular, visual, and proprioceptive signals — become dysregulated. Patients often develop compensatory postures, muscle guarding, and altered movement patterns that persist even after the crystals have been repositioned.
• DNS uses developmental movement patterns (rooted in how the nervous system learns balance from birth) to retrain the deep stabilizing muscles of the spine, pelvis, and trunk — the same foundation that supports upright balance and gaze control.
• By re-establishing proper intra-abdominal pressure and diaphragmatic breathing patterns, DNS directly supports the postural stability systems that BPPV chronically undermines.
• This is particularly relevant in patients with recurrent BPPV or chronic imbalance, where the neuromuscular system has adapted poorly to repeated vestibular disruption.

Craniosacral Therapy (Available at: Westboro, Kanata, Barrhaven)

For patients with BPPV — particularly those with concurrent cervicogenic dizziness, post-concussion history, or heightened autonomic sensitivity — Craniosacral Therapy offers a gentle complementary layer of treatment.

• Why Craniosacral Therapy for BPPV: The cerebrospinal fluid system, cranial nerve pathways (including the vestibulocochlear nerve, CN VIII), and upper cervical fascial tensions all influence vestibular signal processing. Disruptions in this system — from trauma, chronic tension, or post-concussion changes — can amplify BPPV symptoms or slow recovery.
• Craniosacral Therapy applies very gentle, hands-on techniques to release restrictions around the cranial bones, sacrum, and spinal dura, reducing neural tension and supporting the self-regulatory capacity of the vestibular system.
• It is particularly beneficial for patients whose BPPV is accompanied by headache, neck stiffness, jaw tension, or post-concussion symptoms — conditions where standard repositioning maneuvers alone may not fully resolve the symptom picture.

Concussion Treatment at Physiocare is closely related for patients whose BPPV co-exists with post-concussion vestibular dysfunction.