Waking Up Dizzy in Sioux Falls? It Might Be Simpler Than You Think.
- Dr. Lucas Marchand
- Jun 9
- 5 min read
By Dr. Lucas Marchand, DC — MyChiro Mobile Chiropractic, Sioux Falls, SD
The description is always the same.
You roll over in bed — or sit up too quickly, or tilt your head back to look at a shelf — and the room starts spinning. Not a vague unsteadiness. A genuine, disorienting rotation that lasts anywhere from a few seconds to half a minute, then fades.
You lie still. It stops. You move again. It returns.
Most people who experience this assume something neurological is happening. A stroke. An inner ear infection. Something serious that requires imaging and specialist referral. They spend days or weeks anxious about symptoms that, in the majority of cases, have a mechanical explanation and a mechanical solution.
After nearly a decade of mobile chiropractic practice in Sioux Falls, I've seen this pattern regularly — not as the most common thing I treat, but consistently enough that I know how often it goes undiagnosed or mismanaged for months before someone finds the right answer.
That answer, more often than not, is a repositioning maneuver that takes less than five minutes.
What BPPV Actually Is
Benign paroxysmal positional vertigo — BPPV — is the most common cause of vertigo in adults. The name is more intimidating than the condition.
Benign means it isn't dangerous. Paroxysmal means it comes in sudden, brief episodes. Positional means it's triggered by specific head movements. Vertigo is the spinning sensation itself.
Inside the inner ear are three semicircular canals — fluid-filled loops oriented in different planes that detect rotational movement. Adjacent to these canals is a structure called the utricle, which contains tiny calcium carbonate crystals called otoliths or, more commonly, canaliths. These crystals are supposed to stay in the utricle, where they help detect linear acceleration and gravity.
Sometimes they don't.
When these crystals break loose and migrate into one of the semicircular canals, they move with the fluid during head position changes — sending a false signal to the brain that the head is rotating when it isn't. The brain receives conflicting information from the inner ear and the eyes. The result is vertigo.
The posterior semicircular canal is involved in roughly 85-90% of BPPV cases. This is why the classic trigger is rolling over in bed or tilting the head backward — movements that shift fluid and debris within that canal.
Why It Gets Misdiagnosed
BPPV is frequently missed for one simple reason: the episodes are brief and position-dependent, which makes them easy to dismiss or misattribute.
A patient who describes intermittent dizziness triggered by rolling over in bed is sometimes told they're dehydrated, that their blood pressure is low, or that they should follow up with a neurologist if it continues. All of those are reasonable responses to a vague complaint of dizziness. None of them address BPPV specifically.
The diagnostic test for BPPV is called the Dix-Hallpike maneuver — a specific head positioning sequence that attempts to reproduce the vertigo by moving the crystals within the affected canal. If the test produces characteristic nystagmus — a rapid, involuntary eye movement — in combination with the patient's vertigo, the diagnosis is confirmed.
It takes about two minutes to perform.
Most people with BPPV have never had this test done.
The Epley Maneuver — What It Is and Why It Works
The Epley maneuver is a canalith repositioning procedure — a sequence of head and body positions designed to move the displaced crystals out of the semicircular canal and back into the utricle where they belong.
It was developed by Dr. John Epley in the 1980s and has been extensively studied since. The evidence base is strong. A 2014 Cochrane review — one of the most rigorous forms of medical evidence — concluded that the Epley maneuver is safe and effective for posterior canal BPPV.
The procedure itself involves four or five sequential position changes, each held for approximately 30 seconds to allow the crystals to migrate under gravity. The entire sequence takes three to five minutes. Most patients experience a reproduction of their vertigo during the maneuver — which is actually a sign that the crystals are moving in the right direction.
Results are often immediate. Many patients sit up after the procedure and notice that the spinning has resolved or significantly reduced. Others require a second treatment session. A small percentage have recurrent BPPV and need periodic repositioning.
What This Looks Like in the Van
When someone in Sioux Falls contacts me with a description that sounds like BPPV — positional vertigo, triggered by lying down or rolling over, lasting seconds to a minute — the assessment begins with a history and the Dix-Hallpike test.
If the test is positive, the Epley maneuver follows immediately. The treatment table in the MyChiro van accommodates the full sequence comfortably. The patient doesn't need to drive across town, sit in a waiting room, or explain their symptoms to a front desk before seeing anyone.
They come to the door. We confirm the diagnosis. We treat it. Most of the time they feel better before I leave.
That's not always the case — some presentations require follow-up, and some dizziness is not BPPV and warrants medical referral. But for the straightforward posterior canal case, which represents the significant majority of BPPV presentations, the treatment window from first contact to resolution is often the same day.
When Vertigo Isn't BPPV
Not all dizziness is BPPV, and it's important to say that clearly.
Symptoms that warrant prompt medical evaluation rather than chiropractic assessment include vertigo accompanied by sudden severe headache, double vision, difficulty speaking or swallowing, weakness or numbness in the face or limbs, or any neurological symptom that doesn't fit the positional pattern of BPPV.
These presentations are uncommon but real, and they require imaging and specialist evaluation — not a repositioning maneuver.
BPPV-specific red flags also include: symptoms that don't resolve at all with the Epley maneuver after two or three attempts, dizziness that is constant rather than positional, or hearing loss accompanying the vertigo. These suggest a different inner ear diagnosis — Meniere's disease, vestibular neuritis, or labyrinthitis — that requires different management.
Good clinical care means knowing what you're treating, what you're not treating, and when to send someone elsewhere. BPPV is well within the scope of what chiropractic can address effectively. The presentations above are not.
What to Do If This Sounds Familiar
If you've been waking up dizzy in Sioux Falls and the description above matches your experience — positional, brief, spinning, triggered by rolling over or looking up — it's worth getting assessed.
The assessment is straightforward. The treatment, if indicated, is immediate. And unlike most healthcare experiences, you don't have to go anywhere to get it.
MyChiro comes to you — home, office, or driveway throughout Sioux Falls, Brandon, Tea, Harrisburg, Renner, and the surrounding area. Same-day appointments are usually available.
If you've been putting off figuring out what's causing your dizziness because the logistics of getting to a clinic feel like too much — that's exactly the barrier MyChiro was built to remove.
Schedule your visit here. Or call or text (605) 201-4862.
Frequently Asked Questions
What causes BPPV? BPPV is caused by calcium carbonate crystals in the inner ear migrating into the semicircular canals, where they disrupt the fluid-based balance system and send false signals to the brain.
How long does BPPV last without treatment? BPPV can resolve on its own in weeks to months, but the Epley maneuver typically resolves it in one to three treatment sessions — often the same day.
Is the Epley maneuver safe? Yes. It is a passive repositioning procedure with a strong evidence base and no significant side effects for the vast majority of patients.
Can a chiropractor treat vertigo? Yes — specifically BPPV, which is the most common form of vertigo in adults. The Dix-Hallpike test confirms the diagnosis and the Epley maneuver is the primary treatment.
Does MyChiro treat vertigo in Sioux Falls? Yes. Dr. Lucas Marchand performs the Dix-Hallpike assessment and Epley maneuver as part of mobile chiropractic visits throughout Sioux Falls and surrounding communities.
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