It is so frustrating when someone's dizziness is corrected for a few days/weeks only to have it return. So why does it come back? I think there are a few reasons. First, we have to define it. What is it? What is the cause of it? If "it" is BPPV, then some would argue the reason it comes back is because it is a virus and viruses tend to return, if it's caused by Migraine then every Migraine may increase the likelihood of it coming back. If it is caused by a lack of blood flow and the cause of the lack of blood flow is not corrected, it could come back. If it is caused by hormonal changes, with monthly changes in hormones...it could come back. If it was because of a head injury and the inner ear is still traumatized, putting the rocks back may only last a short period of time until they fall out again. I often think of this issue as several tornadoes going through a town. You can't clean up the town until the tornadoes are gone. Actually, you can clean up the town, but you will just keep cleaning what you previously cleaned if the tornadoes do not quit coming.
So, when we put the rocks back, if the cause of the BPPV is not stabilized, the problem will continue to recur. At that point, doing repositioning maneuvers is helpful in the short term to help manage each recurrence.