For people with benign paroxysmal positional vertigo (BPPV), dizziness often occurs when
changing head position during everyday activities. The condition develops when tiny calcium crystals
inside the inner ear become displaced and enter one of the semicircular canals involved in balance. As the
head changes position, these crystals interfere with normal signals from the inner ear to the brain, creating
the sensation that the room is spinning.
Standard treatment for BPPV focuses on canalith repositioning maneuvers, which are specific
head and body movements designed to move displaced inner-ear crystals out of the affected canal and
back to where they belong, relieving vertigo symptoms. While this approach is effective for many people,
researchers continue to investigate whether addressing nearby muscles and joints may further improve
balance and recovery.
A recent randomized controlled trial explored whether treating the jaw and surrounding soft
tissues could enhance recovery. The study included 41 adults with BPPV who all received standard
treatment. Half of the participants also received temporomandibular joint (TMJ) mobilization and soft
tissue therapy once a week for four weeks. Both groups experienced significant improvements in
dizziness. However, the group receiving the additional TMJ mobilization and soft tissue therapy
demonstrated significantly greater improvements in jaw function and balance performance. These
findings suggest that addressing jaw dysfunction may improve certain aspects of balance, even though it
did not produce additional reductions in dizziness compared with standard care alone.
The connection between the jaw and balance may seem surprising. Maintaining balance depends
on the brain integrating information from several sources, including the inner ear, vision, and sensory
signals from muscles and joints. Researchers have proposed that dysfunction involving the
temporomandibular joint or nearby muscles could alter some of this sensory information and potentially
influence balance. However, the mechanisms behind this relationship are not yet well understood, and the
study does not establish that TMJ dysfunction causes or contributes to BPPV itself.
For people recovering from BPPV, a comprehensive evaluation may look beyond the inner ear,
especially if balance problems persist after the vertigo has improved. Because each person’s symptoms
and contributing factors are different, treatment decisions should always be based on a thorough
evaluation and individualized care plan.
Chiropractors are trained to evaluate musculoskeletal conditions that may influence movement,
posture, and balance. They can identify findings that may require referral to another healthcare provider
when appropriate and provide conservative care based on each patient’s needs. For some individuals, this
may include manual therapy, soft tissue techniques, and exercises designed to improve movement and
function as part of a coordinated approach to recovery.
Brent Binder, D.C.
4909 Louise Dr. Suite 102
Mechanicsburg, PA 17055
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