BPPV is a condition in which a good many improve with a canalith repositioning manoeuvre (the Epley manoeuvre). If it has been confirmed, receiving this procedure first is the order.

However, many come to us after the repositioning. That is where the spinning sensation has gone but a light-headed feeling and a sense of instability remain, and where it keeps recurring.

What we look at then is tension in the back of the neck, below the occiput, and in the shoulders. After experiencing dizziness, people unconsciously stiffen the neck, and there are cases where this sustains the remaining instability. We address this part with acupuncture and Chuna.

Where recurrence is frequent we look together at sleep, fatigue and the whole-body condition.

Spinning for a few seconds up to about a minute when you turn your head in a particular direction or lie down is the typical pattern. If you note when and in which posture it arises, it helps the examination.