New Research Reveals a Potential Way to Reduce Vertigo Recurrence
- Julian Simpson
- 1 day ago
- 5 min read
Written by Dr Julian Simpson — Chiropractor with 15+ years of experience, Board Member of the Chiropractic Australia Research Foundation, and author/reviewer of 800+ health articles.
New Research Reveals a Potential Way to Reduce Vertigo Recurrence
Can Combining Treatments Improve Outcomes for BPPV?
If you've ever experienced sudden spinning sensations when rolling over in bed, looking up, or changing position, you may have experienced Benign Paroxysmal Positional Vertigo (BPPV).
BPPV is one of the most common causes of vertigo and dizziness, affecting thousands of Australians every year. While it is considered a benign condition, the symptoms can significantly impact quality of life, confidence, mobility, and day-to-day activities.
New research suggests that combining traditional repositioning manoeuvres with additional medical management may improve outcomes and reduce the likelihood of symptoms returning.
What is BPPV?
BPPV occurs when tiny calcium carbonate crystals, known as otoconia, become dislodged from their normal position within the inner ear.
These crystals can migrate into one of the balance canals, where they interfere with the vestibular system's ability to accurately detect movement and position.
Common symptoms include:
Vertigo (spinning sensations)
Dizziness when changing position
Nausea
Balance difficulties
Unsteadiness when walking
Motion sensitivity
Fear of movement due to symptom flare-ups
Although BPPV is usually not dangerous, it can significantly affect a person's confidence, independence, and ability to perform everyday activities.
Why Does BPPV Keep Coming Back?
One of the biggest frustrations for many sufferers is recurrence.
Research suggests that up to one-third of people with BPPV may experience another episode within 12 months.
Several factors appear to increase recurrence risk, including:
Female gender
Migraine history
Osteoporosis
Vitamin D deficiency
Diabetes
High cholesterol
High blood pressure
Increasing age
Because of this, healthcare providers continue searching for ways to reduce relapse rates and improve long-term outcomes.
The Epley Manoeuvre: The Gold Standard Treatment
The Epley manoeuvre remains one of the most effective treatments for posterior canal BPPV.
The procedure involves a series of carefully guided head and body movements designed to return displaced crystals back to their proper location within the inner ear.
Numerous studies have shown the Epley manoeuvre can:
Reduce vertigo symptoms
Improve balance
Eliminate positional dizziness
Decrease abnormal eye movements (nystagmus)
Improve quality of life
For many patients, significant improvement can occur after only one or two treatments.
What Did the New Research Discover?
Researchers followed 80 patients diagnosed with BPPV and compared two treatment approaches:
Group One
Received the Epley manoeuvre alone.
Group Two
Received the Epley manoeuvre plus a medication called flunarizine for two weeks.
After treatment, the combined treatment group demonstrated:
Higher overall treatment success rates
Greater improvements in dizziness symptoms
Better balance performance
Reduced disability from vertigo
Improved blood flow measurements
Lower recurrence rates over the following 12 months
Most notably, recurrence rates were significantly lower in the combined treatment group.
Only 5% of patients experienced symptom recurrence compared to 20% of those who received the Epley manoeuvre alone.
Why Might Blood Flow Matter?
Researchers are increasingly exploring the connection between blood flow and inner ear health.
The vestibular system relies on a very small artery for its blood supply. Unlike many other parts of the body, this artery has limited backup circulation.
Reduced blood flow may contribute to:
Degeneration of balance structures
Increased vulnerability of inner ear tissues
Greater risk of otoconia becoming dislodged
Recurrent vertigo episodes
While more research is needed, these findings suggest that vascular health may play a greater role in dizziness and vertigo than previously understood.
The Role of Vestibular Compensation
Another important finding relates to something called vestibular compensation.
When the balance system is disrupted, the brain works to adapt and recalibrate through a process known as neuroplasticity.
Effective vestibular compensation helps individuals:
Recover balance more quickly
Reduce dizziness
Improve confidence with movement
Return to normal activities sooner
The study suggests that some treatments may help support this adaptation process, potentially explaining why certain patients recover more quickly and experience fewer recurrences.
What Does This Mean for People Experiencing Vertigo?
The research reinforces several important points:
Early Assessment Matters
The sooner the cause of dizziness is identified, the sooner appropriate treatment can begin.
Accurate Diagnosis Is Essential
Not all dizziness is caused by BPPV. Symptoms may also arise from:
Vestibular disorders
Neck dysfunction
Concussion
Migraines
Cardiovascular conditions
Neurological disorders
A thorough assessment is critical.
Long-Term Management Is Important
While repositioning manoeuvres remain highly effective, addressing underlying contributors such as balance deficits, mobility restrictions, physical deconditioning, and general health factors may help improve long-term outcomes.
How Chiropractic Care May Help
At Health Wise Chiropractic, we regularly assess patients experiencing dizziness, headaches, neck pain, postural dysfunction and balance concerns.
Many people with dizziness also experience:
Neck stiffness
Reduced cervical mobility
Headaches
Muscle tension
Postural strain
A comprehensive assessment can help identify contributing musculoskeletal factors while ensuring patients receive appropriate referral for vestibular or medical evaluation when required.
Looking for Help with Dizziness or Vertigo in Sunbury?
If you're experiencing recurring vertigo, dizziness when rolling over in bed, balance issues, or neck-related symptoms, it's important to have the cause properly assessed.
At Health Wise Chiropractic in Sunbury, we provide evidence-informed assessments and care for patients experiencing dizziness, headaches, neck pain and mobility concerns.
Our goal is to help identify contributing factors, improve function, and guide you towards the most appropriate management pathway.
References
Based on research published in 2026 investigating the effects of combining flunarizine with the Epley manoeuvre for Benign Paroxysmal Positional Vertigo (BPPV), including outcomes related to symptom improvement, balance, recurrence rates and vestibular function.
How Chiropractic Care May Help
At Health Wise Chiropractic, we take a comprehensive approach to posture-related care.
Treatment may include:
We focus on addressing both the symptoms and the underlying biomechanical stress contributing to neck dysfunction.
About the Author
Dr Julian Simpson is an Australian chiropractor with over 15 years of experience in musculoskeletal healthcare and rehabilitation.
He is a Board Member of the Chiropractic Australia Research Foundation and has reviewed and written more than 800 evidence-based health articles focused on spinal health, rehabilitation, sports injuries and conservative care approaches.
His treatment focus includes:
Chiropractic adjustments
Sports chiropractic
Massage therapy
Shockwave therapy
Laser therapy
Non-surgical spinal decompression
Dr Simpson provides patient care through Healthwise Chiropractic, serving communities including Sunbury, Melton, Diggers Rest and surrounding regions.
Reference
Zhu Y, Zhou H, Fan D, Li X, Yang J. Observation of the therapeutic effect of flunarizine capsules combined with the Epley manoeuvre in the treatment of benign paroxysmal positional vertigo. Ann Hum Biol. 2026 Dec;53(1):2669064. doi: 10.1080/03014460.2026.2669064. Epub 2026 May 28. PMID: 42209266.
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