Concussion Dizziness vs. BPPV: How to Tell the Difference

March 31, 2026

Dizziness is one of the most common symptoms after a concussion—but not all dizziness is caused by the concussion itself.

In fact, many people with a concussion actually develop a condition called BPPV (benign paroxysmal positional vertigo), which requires a very specific type of treatment.

Understanding the difference between concussion-related dizziness and BPPV is key to getting the right treatment, and feeling better faster!

This is Blog #5 in our series about Concussion Rehab Therapy.

👉 If you’d like to start with the first post, you can find it here: What is a Concussion? A Physical Therapist Explains

What Does Concussion-Related Dizziness Feel Like?

Dizziness after a concussion is often described as:

• Feeling off balance or unsteady
• Lightheaded or foggy
• Motion sensitivity (feeling worse with movement)
• Difficulty focusing the eyes
• Symptoms that last minutes to hours

This type of dizziness is usually related to:

• The vestibular (inner ear) system
• The brain’s processing of balance information
• Visual and eye coordination issues

👉 Learn more here:
Dizziness After a Concussion: Causes and Treatment

What Is BPPV?

BPPV (benign paroxysmal positional vertigo) is a common inner ear condition where tiny crystals become displaced within the balance system.

This causes brief episodes of spinning vertigo with certain head movements.

BPPV is especially important to recognize because:

👉 It is very common after a concussion
👉 It has a specific, highly effective treatment

What Does BPPV Feel Like?

BPPV has some very distinct characteristics:

• A spinning sensation (vertigo)
• Triggered by position changes (lying down, rolling in bed, looking up)
• Symptoms last seconds, not minutes or hours
• Episodes are brief but intense
• Often worse when getting in/out of bed

Key Differences: Concussion Dizziness vs. BPPV

Concussion-Related Dizziness

• Feels like imbalance, fogginess, or motion sensitivity
• Can last minutes to hours
• Often constant or triggered by activity
• Related to brain, vestibular system, or vision

BPPV

• Feels like spinning (vertigo)
• Triggered by specific head movements
• Lasts only seconds
• Caused by displaced inner ear crystals

Think you have BPPV? Click here to learn the top 3 signs of BPPV and how to treat it!

Why This Matters

This distinction is critical because the treatment is completely different.

• Concussion-related dizziness → vestibular rehab, balance training, gradual exposure
• BPPV → repositioning maneuvers (often rapid relief)

If BPPV is missed, people may continue to feel dizzy longer than necessary.

Can You Have Both?

Yes, and this is very common.

After a concussion, someone may have:

• Vestibular dysfunction and
• BPPV at the same time

That’s why a thorough evaluation is so important.

How Physical Therapy Can Help

At Gordon Physical Therapy, we specialize in identifying the exact cause of dizziness.

Your evaluation may include:

• Positional testing for BPPV
• Balance assessment
• Eye movement testing
• Vestibular function testing
• Neck evaluation

Treatment depends on the cause:

If BPPV Is Present

• Canalith repositioning maneuvers (like the Epley Maneuver)
• Often provides quick relief

If It’s Concussion-Related

• Vestibular rehabilitation
• Balance training
• Eye coordination exercises
• Gradual return to activity

If the Neck Is Involved

• Cervical spine treatment
• Mobility and muscle work

When Should You Seek Treatment?

You should consider an evaluation if:

• You feel spinning when lying down or rolling in bed
• Dizziness persists more than 1–2 weeks
• Symptoms are not improving
• You feel off balance or unsteady
• Dizziness interferes with daily activities

The sooner you identify the cause, the sooner you can start the right treatment.

Concussion Rehab Series

This is the final article in our Concussion Rehab Series:

Start here with blog #1: What Is a Concussion? A Physical Therapist Explains

Also read:

• Blog #2: Dizziness After a Concussion: Causes and Treatment
• Blog #3: Headaches After a Concussion: When to Seek Treatment
• Blog #4: Concussion vs. Whiplash – What’s the Difference?

Schedule a Concussion Evaluation

If you’re dealing with dizziness after a concussion, you don’t have to guess what’s causing it.

At Gordon Physical Therapy, we specialize in diagnosing and treating both concussion-related dizziness and BPPV.

📞 Call today to schedule a concussion evaluation and start your recovery!

Concussion-dizziness vs. BPPV FAQ Section

How do I know if my dizziness is BPPV or a concussion?

BPPV causes brief spinning with position changes, while concussion-related dizziness tends to last longer and feels more like imbalance or fogginess.

Can a concussion cause BPPV?

Yes. Head injuries can displace inner ear crystals, leading to BPPV.

How is BPPV treated?

BPPV is treated with repositioning maneuvers performed by a trained provider, often with rapid improvement.

Can BPPV go away on its own?

Sometimes, but it may persist without treatment. Therapy can resolve symptoms more quickly.

What is the best treatment for dizziness after a concussion?

Treatment depends on the cause and may include vestibular therapy, BPPV treatment, balance training, and neck rehabilitation.

Call today to start your recovery!