Why Loose Ear Crystals Make You Dizzy and How To Fix Them

You roll over to your right side in bed … and suddenly, the room starts rolling over, too. For a couple of days afterward, the world spins each time you turn to the right.

This condition, called benign paroxysmal positional vertigo (BPPV), can be downright scary. And when it happens repeatedly, it can become hard for you to work and do other everyday activities.

If you’ve heard that these bouts of vertigo and dizziness are related to something called “ear crystals,” you probably have a few questions.

Neurologist Neil Cherian, MD, an expert on dizziness, has the answers you’re looking for about loose ear crystals, including what causes them and how to fix them.

What are ear crystals?

Otoconia, commonly called “ear crystals,” are tiny calcium carbonate particles in the chambers of your inner ear. You may also hear them called “ear rocks” or “ear stones.” And you can think of them as gravity sensors.

“Imagine a hill with blades of grass, and on top of each blade is a crystal,” Dr. Cherian illustrates. “Together, these crystals form an interconnected matrix. Whenever the blades of grass move, so do the crystals.”

In this analogy, the blades of grass represent cilia, tiny hair-like structures attached to nerves in your inner ear. When the crystals on top of the cilia move, it stimulates the nerves to fire. That tells your brain that your head is moving.

Usually, this elaborate crystal matrix is a reliable motion-sensing map. But if some of those crystals break free and drift into parts of your ear where they don’t belong, symptoms like dizziness and vertigo can set in quickly.

What causes ear crystals to get loose and make you dizzy?

So, what’s the connection between crystals and dizziness? It all has to do with three fluid-filled semicircular canals in your inner ear.

“When the crystals are connected, that fluid only moves when your head moves, and it settles down when your head stops moving,” Dr. Cherian explains. “If the crystals are disconnected, though, they keep moving in the fluid for up to a few seconds afterward.

“Your brain has to figure out, ‘Why is there movement when I don’t see it?’ That’s what causes dizziness and vertigo, the feeling that you’re moving when you’re not.”

You’re at higher risk of developing loose ear crystals if you:

• Are age 65 or older
• Have experienced a significant head injury
• Have had a viral inner ear infection (though Dr. Cherian notes that this isn’t always easy to diagnose or assess)

Symptoms of loose ear crystals

The main symptoms of loose ear crystals are:

• Vertigo: Different from dizziness, vertigo is the sensation that you or your surroundings are moving or spinning.
• Nystagmus: These rapid, uncontrollable and repetitive eye movements may or may not be easily noticeable.
• Imbalance: “This may or may not accompany the vertigo,” Dr. Cherian says. “It can sometimes be the only symptom of loose crystals.”

But BPPV can cause other symptoms, too, like:

• Lightheadedness or other forms of dizziness
• Nausea and/or vomiting
• Blurred vision

Healthcare providers can diagnose BPPV based on your symptoms and a medical evaluation. And they’ll specifically look for those rapid eye movements that are often a telltale sign of BPPV.

“If your eyes continue to move in response to false movement cues, that gives your doctor another way to confirm that you have BPPV,” Dr. Cherian says.

How it’s treated

BPPV exercises, called canalith repositioning procedures (CRP), can help move your ear crystals back where they belong. The most well-known procedure is the Epley maneuver, and it’s easy to do on a bed or the floor. But it’s important to learn the right way to do it, or you risk making BPPV worse.

“When these exercises are done in a medical setting, the success rate for these exercises is up to 90%,” says Dr. Cherian. “So, learning to do them properly on your own can be quite effective for BPPV.”

But he adds that you should stop doing these exercises once your BPPV clears.

If you find that doing the Epley maneuver isn’t helping you, it may be because:

• You’re not doing it correctly.
• You have too many loose crystals.
• Crystals have drifted into more than one semicircular canal.
• You’re trying to treat the wrong ear.
• Both of your ears are affected.
• Something else is causing your dizziness.

In these cases, seek help from an otolaryngologist, aka an ear, nose and throat (ENT) specialist. Or go straight to a vestibular physical therapist, who can diagnose and treat BPPV. They can help with additional exercises to move ear crystals back into place.

One more thing: If your dizziness and vertigo have you so nauseated that you can’t hold down liquids — or if you experience weakness, numbness, tingling or changes in vision — it’s important to get emergency medical care.

“Seek help sooner rather than later,” Dr. Cherian stresses. “These could signal a more serious problem, like a stroke.”

Final thoughts

Having BPPV is sort of like coming down with the common cold: “We can identify it, and we can help you get through it sooner than you could on your own,” Dr. Cherian says. “But unfortunately, we can’t fully prevent it.”

If your symptoms are related to a head trauma, he adds that you may notice that you have fewer problems with loose ear crystals as you heal. But for the most part, it’s hard to predict the outlook for BPPV from one person to the next.

“Episodes of BPPV can last for a few seconds, a few days, a few weeks or a few months,” Dr. Cherian clarifies. “But because BPPV is so common and so fleeting, it’s hard to get good data on its incidence.”

If you’re experiencing BPPV, it’s important to work with your healthcare provider to master the Epley maneuver. This will allow you to put a quick stop to the spinning sensations and lightheadedness you feel when crystals get loose — so you can get back to feeling like you’re on steady ground.