How to Prevent BPPV from Coming Back | Stop Recurrent Vertigo!

Updated February 23, 2026

If you’ve had BPPV (Benign Paroxysmal Positional Vertigo) before, you know how disruptive it can be. The spinning sensation, the nausea, the fear of moving your head — it’s not something you want to experience twice.

One of the most common questions I hear from patients is: “How do I prevent BPPV from coming back?”

Let’s break down why BPPV sometimes recurs — and what you can do to reduce the chances of another episode.

What Causes BPPV in the First Place?

BPPV occurs when tiny calcium crystals in your inner ear — called otoconia — become dislodged and move into one of the semicircular canals.

These canals help detect head movement. When crystals end up where they don’t belong, they disrupt the balance signals sent to your brain. The result is brief but intense spinning vertigo with position changes like:

• Rolling over in bed

• Looking up

• Bending forward

• Getting in or out of bed

The good news? BPPV is highly treatable using repositioning maneuvers like the Epley Maneuver or Gufoni Maneuver.

The frustrating part? It can come back.

How Common Is Recurrent BPPV?

Recurrence is not rare.

Research suggests that:

• About 15–20% of people experience recurrence within one year

• Up to 50% may have recurrence within 5 years

Some people have a single episode and never deal with it again. Others may experience repeat episodes periodically.

Why Does BPPV Keep Coming Back?

In many cases, we don’t know the exact reason.

However, recurrence may be more likely if you:

• Are over age 50

• Have a history of head trauma

• Have migraines

• Have underlying inner ear disorders

• Have osteoporosis or low vitamin D

Sometimes crystals simply dislodge again without a clear trigger.

Can You Prevent BPPV from Recurring?

There is no guaranteed way to permanently prevent BPPV. However, there are steps you can take that may reduce recurrence risk or minimize symptoms.

1️⃣ Follow Post-Treatment Precautions (First 24–48 Hours)

After a repositioning maneuver, some clinicians recommend:

• Sleeping slightly elevated

• Avoiding extreme head movements

• Avoiding lying on the affected side

While research is mixed on how necessary these precautions are, they may help in the short term.

2️⃣ Address Underlying Risk Factors

If you have:

• Migraines

• Vitamin D deficiency

• Balance issues

• Repeated head trauma

Managing those conditions may reduce recurrence risk.

There is some evidence suggesting low vitamin D levels may increase BPPV recurrence rates.

3️⃣ Seek Vestibular Rehabilitation If Episodes Are Frequent

If BPPV keeps coming back, working with a physical therapist trained in vestibular rehabilitation can help:

• Confirm the correct canal is being treated

• Ensure the maneuver is performed properly

• Improve overall balance confidence

• Rule out other causes of dizziness

Sometimes people believe they have recurrent BPPV when something else is actually causing their dizziness.

What If Your Vertigo Doesn’t Feel the Same?

Not all vertigo is BPPV.

If your symptoms:

• Last longer than a minute

• Occur without position changes

• Include neurological symptoms (weakness, vision changes, speech difficulty)

• Do not improve with repositioning maneuvers

You should seek medical evaluation immediately.

When to See a Physical Therapist for Recurrent BPPV

If you’ve had multiple episodes, don’t just wait it out.

A vestibular physical therapist can:

• Perform positional testing

• Identify the affected canal

• Treat the issue efficiently

• Educate you on what to expect

At Gordon Physical Therapy in Spokane Valley, WA, we regularly treat patients with BPPV and recurrent vertigo using evidence-based vestibular rehabilitation techniques.

If you’re local and need help, we’re here to guide you through it safely.

👉 Call or text us at (509) 892-5442 to get started with vertigo treatment!

Final Thoughts

BPPV recurrence can feel frustrating, but it doesn’t mean something is seriously wrong.

Most recurrent episodes are treatable and manageable with the right approach.

If you’ve had BPPV before, understanding the risk factors and knowing what to do early can make a big difference in how disruptive the next episode feels.

If you’re struggling to diagnose and treat your BPPV, please reach out to us any time so we can help!

– Luke Gordon, DPT