Dizziness is common after a car crash, but it can feel different from one person to another. You may feel like the room is spinning, become unsteady while walking, feel lightheaded when standing, or feel disoriented when moving your head.
One possible cause is a problem involving tiny stones inside the inner ear. This condition is called benign paroxysmal positional vertigo, or BPPV.
BPPV can often be treated, but it is only one possible cause of dizziness. A concussion, neck injury, medication, blood pressure changes, and other health problems can cause similar symptoms. Finding the correct cause is important because different problems require different care.
At Billings Chiropractic Injury Clinic, Dr. Mitchell and our clinical team are trained to evaluate patients for BPPV and perform the guided movements used to treat it when appropriate. We also evaluate for other crash-related problems that may be causing or contributing to the dizziness.
What Can Cause Dizziness After a Car Crash?
Dizziness is a symptom, not a diagnosis. Possible causes after a collision include:
- BPPV or another inner-ear problem
- Concussion or another brain injury
- Injury to the neck
- Migraine
- Medication side effects
- Dehydration or low blood sugar
- Changes in blood pressure
- Anxiety or changes in breathing
- A problem affecting the brain, nerves, or blood vessels
- More than one injury at the same time
For example, someone may have both BPPV and a concussion. Another person may have an inner-ear problem along with a painful neck injury.
The type of dizziness, what triggers it, how long it lasts, and what other symptoms occur can provide important clues.
What Is BPPV?
BPPV is an inner-ear problem that causes short periods of spinning when the head moves into certain positions.
Your inner ear contains tiny stones called otoliths. These stones help your brain understand movement, gravity, and the position of your head.
A head injury or sudden force may knock some of these stones loose. When the loose stones move into the wrong area of the inner ear, they can send confusing messages to the brain.
Your eyes, inner ears, brain, and neck normally work together to help you stay balanced. If these areas send conflicting information, you may suddenly feel like you or the room is spinning.
A car crash may cause this problem even if your head did not strike anything. The National Institute on Deafness and Other Communication Disorders identifies head injury as one possible cause of BPPV.
What Does BPPV Mean?
Each part of the name describes the condition:
- Benign means it is not usually caused by a life-threatening disease.
- Paroxysmal means the symptoms begin suddenly and occur in episodes.
- Positional means certain head positions trigger the symptoms.
- Vertigo means a false feeling of spinning or movement.
“Benign” does not mean the symptoms are unimportant. BPPV can interfere with driving, working, sleeping, walking, bending, exercising, and other daily activities. It can also increase the risk of falling.
What Does BPPV Feel Like?
BPPV usually causes sudden spinning after a certain head movement. The spinning often lasts less than one minute, but it can feel intense.
Common triggers include:
- Rolling over in bed
- Lying down or sitting up
- Looking upward
- Bending forward
- Turning the head quickly
- Getting into or out of a vehicle
- Reaching for something above your head
Some people also experience nausea, poor balance, unusual eye movements, or a lingering feeling of being unsteady.
Constant lightheadedness or dizziness that does not change with head position may have another cause. This is one reason every case of dizziness should not automatically be called BPPV.
How Does BCIC Evaluate BPPV?
Dr. Mitchell and the clinical team at Billings Chiropractic Injury Clinic have received training in the examination procedures used to identify BPPV.
The evaluation begins with questions about:
- What the dizziness feels like
- Which movements bring it on
- How long each episode lasts
- When the symptoms began
- Whether nausea occurs
- Whether you have headaches or concussion symptoms
- Whether you have neck pain or limited neck movement
- How dizziness affects driving, work, sleep, and other daily activities
We may then carefully move your head and body into certain positions while watching for dizziness and specific eye movements. These findings help determine whether loose inner-ear stones are likely causing your symptoms and which ear may be involved.
The examination may also include checking:
- Balance and walking
- Eye movement and vision
- Coordination
- Hearing changes or ringing in the ears
- Neck pain and movement
- Concussion symptoms
- Nerve and brain function
- Other warning signs that may require referral
Feeling dizzy when you move your head does not prove that you have BPPV. The dizziness could come from the inner ear, brain, neck, or another medical condition. Our job is to look at the entire pattern rather than assume every case of post-crash dizziness has the same cause.
Can BCIC Treat BPPV?
When the examination supports a diagnosis of BPPV, Dr. Mitchell is trained to perform the guided head and body movements used to treat it.
These movements are often called repositioning maneuvers. They are designed to guide the loose stones back to an area of the inner ear where they are less likely to cause dizziness.
The correct maneuver depends on which ear is involved and where the stones appear to be located. The patient’s neck condition must also be considered before treatment.
This is especially important after a car crash. Neck pain, limited movement, ligament injury, or other problems may make some positions difficult or unsafe. Dr. Mitchell can modify the examination or treatment when appropriate and determine whether another type of care or referral is needed.
Instructions for these maneuvers are easy to find online. However, trying them without knowing the cause of your dizziness may not help and could make your symptoms worse. An incorrect maneuver may move the stones into another area without fixing the original problem.
Could the Dizziness Be From a Concussion?
Dizziness and balance problems are also common concussion symptoms. A concussion should be considered when dizziness occurs with:
- Headaches
- Nausea
- Mental fogginess
- Memory or concentration problems
- Blurred vision
- Sensitivity to light or sound
- Unusual tiredness
- Sleep changes
- Mood or personality changes
The Centers for Disease Control and Prevention explains that concussion symptoms may appear immediately or develop hours or days after the injury.
BPPV and concussion can also occur together. Treating the loose inner-ear stones would not address the other effects of a concussion. This is why Dr. Mitchell’s evaluation considers more than one possible cause.
When Dizziness May Be an Emergency
Most dizziness is not caused by a life-threatening condition. However, dizziness combined with certain warning signs requires immediate medical attention.
Call 911 or seek emergency care if dizziness occurs with:
- New weakness or numbness
- Facial drooping
- Slurred speech
- Confusion or unusual behavior
- Difficulty staying awake
- Double vision or sudden vision loss
- A sudden or severe headache
- Loss of coordination
- Inability to stand or walk safely
- Repeated vomiting
- Fainting
- Chest pain or trouble breathing
- Seizure activity
- Symptoms that are severe or quickly getting worse
Why Proper Diagnosis and Documentation Matter
Dizziness can greatly affect daily life. You may stop driving, hold onto walls while walking, avoid bending over, sleep in only one position, or become afraid to move your head.
Your medical record should describe:
- When the dizziness began
- Whether it feels like spinning, lightheadedness, or poor balance
- Which movements trigger it
- How long each episode lasts
- Other symptoms that occur with it
- How it affects driving, work, sleep, walking, and household activities
- Examination findings
- Treatment provided
- How the symptoms respond to care
Without identifying the likely cause, treatment may focus on the wrong problem. Careful documentation also helps determine whether the dizziness is improving, changing, or requires referral to another healthcare professional.
Have Your Dizziness Evaluated at BCIC
If dizziness began after a car crash, do not assume it is simply part of having a sore neck. You also should not assume that every spinning sensation is caused by loose inner-ear stones.
At Billings Chiropractic Injury Clinic and the Auto Injury Center, Dr. Mitchell is trained to evaluate BPPV and perform the appropriate repositioning maneuvers when the examination shows they are needed and safe.
We also evaluate for concussion, cervical spine injury, and other possible causes of dizziness. If the findings suggest a condition that requires another type of provider, we can make the appropriate referral.
Finding the cause creates a better foundation for appropriate care, accurate documentation, and recovery.
