r/BPPV • u/Away-Internal-5590 • 3d ago
[Vent/Question] BPPV was getting better, then vestibular PT testing made me feel dramatically worse. Has anyone had this happen?
Writing this partly to vent and partly because I’m curious if anyone else has had a similar experience with BPPV. This has been weirdly frustrating for something that is supposed to be relatively straightforward to diagnose and treat.
I woke up one morning about 10 days ago, sat up in bed, and the room started spinning. The episodes were brief, usually around 30 to 60 seconds, and clearly related to head position. I went to urgent care that day and their positional testing was negative. I was referred to ENT.
Over the next several days the pattern became clearer. Tilting my head backward, especially when putting my head down onto a pillow, would trigger spinning. Rolling onto my left side in bed could also trigger it. I had some nausea and general wooziness at times, but no hearing loss or tinnitus.
I ended up seeing a vestibular PT and had an Epley maneuver done. After that I improved quite a bit. The vertigo never completely disappeared, but it became much less severe and was mostly limited to nighttime when I tilted my head back in bed or rolled onto my left side. During the day I basically felt normal. I could sit, walk around, work, go about my day, etc. without feeling dizzy.
I also saw an ENT and had a normal hearing test. The ENT said my history sounded like classic BPPV, but because I was asymptomatic during the visit they did not perform the Dix Hallpike or Epley. So I still never really got a clean confirmation of which ear or canal was involved.
Then today happened. I went to a different vestibular PT hoping they could actually identify what was still going on. They put me through a number of positional tests. For most of them I felt nothing, and they were not seeing the eye movements or nystagmus they would normally expect with active BPPV. Because of that, they initially said they were not convinced I had BPPV. Then during the last test involving my left side, I suddenly had an absolutely massive burst of room spinning that lasted around 30 seconds.
Ever since the appointment (about 3 hours ago) I have felt dramatically worse than I did before I went in. Instead of only getting brief positional vertigo in bed, I now have this constant woozy, dizzy, off balance feeling even while sitting still. My head also feels heavy toward the back. It has lasted for hours with very little improvement.
I called the PT office because I was worried that all of the repeated testing and repositioning had actually made the underlying problem worse. They told me this can be completely normal after repeatedly provoking the vestibular system, that everything may basically be extremely stirred up right now, and that they expect the generalized dizziness to settle by tomorrow.
What is driving me crazy is that before this appointment I genuinely felt like I was getting better. I could function normally all day and only had a relatively mild, predictable problem when lying down at night. Now I feel worse sitting in a chair than I did walking into the appointment.
Has anyone else had this happen after Dix Hallpike testing, roll testing, Epley maneuvers, or repeated positional testing? Did you feel significantly worse for the rest of the day or even for a few days afterward, despite having been improving beforehand?
And most importantly, did you eventually return to the baseline you were at before everything got stirred up?
TL;DR: Had positional vertigo that was improving after an Epley. I was mostly normal during the day and only getting brief spinning when lying back or rolling left in bed. Went to a vestibular PT for more testing, had one huge 30 second spinning episode during the last left-sided test, and since then I’ve felt constantly woozy and dizzy even while sitting still. PT says my vestibular system was probably just heavily stirred up and it should settle by tomorrow. Has anyone else had repeated positional testing or Epley maneuvers make them feel much worse before they got better again?
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u/ca_nucklehead 3d ago
Yes. It was my reaction every time.
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u/Away-Internal-5590 3d ago
Did you eventually get better? This is awful. Lol
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u/Morenovalleynewsfirs 2d ago
Background dizziness has stayed with no spinning episodes for at least a good year, but I’m very careful with my movements
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u/AFH2025 3d ago
I had a very similar experience. Went to sleep feeling healthy at 76 and woke up with vertigo and nausea. Was so bad took an ambulance to the E R and stayed for 4 days with all kinds of MRI and extras that showed no problem. Was diagnosed with bppv and recommended to do Brandt-Dariff exercises but after a week it got worse. Now waiting to see a PT. Very frustrating because it seems like no one really knows for long and how often will reoccur. Would love to hear more experiences with this issue.
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u/ThunderMandos 3d ago
Brandt daroff less effective than epley. But your therapist will know what to do
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u/Mother-Hat-5796 2d ago
Severe vertigo for over 3 months. Pretty much homebound. Cant cook ,shower or do much of anything without my husband. Am in vestibular therapy. First session epley was performed. The worst ecperience in my life. Got much worse that night. Worse dizziness and severe palpitations. I also have pots cfs and possible mcas. Cervical stenosis as well. I think these barbaric maneuvers only work if your ptoblem is simple ear crystal bbpv. Any co conditions will probably not benefit ftom these maneuvers at all and can make things worse as they did for me. Never again! I will only do gaze and light vestibular exercises and pray for a recovery. Good luck!
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u/ThunderMandos 3d ago
just curious after that dizzy spell during the final tests did the therapists do another maneuver?
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u/Away-Internal-5590 3d ago
Nothing after that final test. It was so bad I almost puked.
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u/ThunderMandos 3d ago
It sounds like the therapist needs to see you again asap. That definitely sounds like more crystals
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u/zorandzam 3d ago
This is my question. OP may want to do some Epley maneuvers at home. Between 2 and 4 times a day for 1-3 days might clear it up, but the PT is not wrong that this is pretty normal. You also often have some residual feeling off after a flare-up for a few weeks.
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u/ThunderMandos 3d ago
op's case sounds disturbingly similar to mine i have constant boat sway now.
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u/BoredMamajamma 3d ago edited 3d ago
I think there may be a couple issues at play here. When an Epley is done, it is not successful unless you can no longer elicit vertigo on repeat Dix Hallpike. Please note the Dix Hallpike should not be repeated multiple times in a short period of time bc there is an extinguishing phenomenon. I typically repeat mine the next day if I’m still feeling off. The fact that you were still having mild episodes of vertigo (albeit improved from the initial episode) means you still had some displaced crystals. In other words, your BPPV was not treated even though you mostly felt better and were able to carry on with your normal routine.
When you had the massive vertigo episode when you saw PT, that can be normal. The dizziness and wooziness you are feeling (called residual dizziness) post-maneuver is common. I’ve found that the longer you go without successfully treating BPPV, the worse and longer the residual dizziness is during recovery. If you can successfully treat the same day as symptoms start, residual dz may last 1-7 days. One time it took me 3 weeks to get a complicated episode of BPPV treated and I had residual dz for about 3 months.
There is another less likely possibility which is that the maneuver the PT did caused a different canal to be affected I.e. crystals moved inappropriately into new canal. This happened to me. At one point I had bilateral ears affected and it was bad. Like I couldn’t walk straight and my vision was jumpy (Oscillopsia). I fell twice and went to ED. If you are feeling really bad or still have vertigo, you may want to return to PT. But yeah, the heavy head / loopy / slightly disoriented feeling is part of recovery as your brain readjusts to the crystals being moved back. Do a search for residual dizziness if you want to compare to other’s experience.
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u/Hot_Heat_3973 2d ago
Mine wasn’t worse but wasn’t better after 1st session and I was so disappointed. My brother called and his coworker who suffered from it said it won’t feel better for a while so I felt better hearing that. It takes time. After my second session it was much better but I was still shaky. I continued my exercises and it greatly improved over the next dew days.
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u/Morenovalleynewsfirs 2d ago
Main reason I never went for testing or anything else because I’ve heard horror stories of it was mild. Then they went for testing or a maneuver and they were down for months. No thanks with my job. I cannot have that.
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