If someone has a BPPV, or positional vertigo, gravity-assisted maneuvers can be done to put get the BPPV debri out of the semicircular canal. Maneuvers will clear it so that it no longer causes a problem. In 31-61% of the cases, however, continued feelings of lightheaded or dizziness, especially with walking, can persist. This is termed Residual Dizziness. Residual Dizziness is more common in the elderly.
Why? There could be several reasons. The sloughing off of the organ in the inner ear can lead to unequal loads which can confuse the brain. If you are use to having the BPPV there (years), the brain has to adapt to it not being there -- it changes the dynamics. Another reason is if the BPPV changes positions or moves to a different canal with a maneuver (rather than being completely cleared), it can change positions or even move to a different canal. Also, there can be a link with anxiety playing a role with BPPV, slowing down the rehab process. Whatever the cause, though, know that balance or dizziness (including nausea or wobbliness) can persist. It is not always a quick fix.
What can be done about it? Vestibular Rehabilitation Physical Therapy. Since we know that imbalance and dizziness can likely be two symptoms of the same problem, we have to look at the components that lead to both. Is it a strength or musculoskeletal issue? Are there neurological (brain) issues? Is it an issue with your eyes (vision or motor control of eyes)? Is it an issue with your feet (neuropathy or orthopedic issue)? Are you relying on your feet more than your eyes? Are you relying on your eyes more than your feet? Is your vestibular system working for you or against you? Are you not even using it anymore? The imbalance between the use of your eyes, feet, and inner ear (vestibular) is called Sensory Mismatch. Figuring out these issues is key to developing an effective plan for rehab to get you back on your feet, feeling safer, more confident and without anymore feelings of dizziness. It can help if your in your 20's, but it's especially effective as our patients get older, because, as we age, we are less active and don't exercise our inner ear/vestibular system as much as before.