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The Epley Maneuver is an exercise prescribed to treat Benign Paroxysmal Positional Vertigo symptoms—otherwise known as BPPV. BPPV stems from problems with debris in your inner ear. When this debris moves around the ear canal, it sends incorrect messages to your brain about how your head is moving, causing dizziness. The purpose of the Epley Maneuver is to move debris from the sensitive part of the ear to a less sensitive part. It is highly effective if prescribed for BPPV, but there are a few reasons why it may not be working for you. Learn more about the Epley Maneuver.
How to Perform the Epley Maneuver
Caution: we highly recommend trying the Epley Maneuver with a physical therapist, so they can guide you through the exercise. It is very common to feel temporarily worse before you feel better. During the exercise, the dizziness will likely get worse, and this often causes people to vomit. A PT will ensure you are taken care of.
The Epley Maneuver can be completed by following the steps below. If you want to give the Epley a try, we recommend starting the maneuver on the side where you are most symptomatic. For example, if you experience vertigo every time you lie on your right side, start the maneuver on the right side.
Sit upright in a bed with your legs extended fully in front of you.
Turn your head 45 degrees to the side that is causing you the most dizziness.
Keep your head turned at a 30-degree angle away from the bed as you lie down. Remain in this position until the dizziness subsides (approximately 30 seconds to two minutes).
Turn your head the other way, at a 90-degree angle, stopping when it is 30 degrees away from that side of the bed. Remain in this position until the dizziness subsides (approximately 30 seconds to two minutes).
Continue facing the same direction and roll onto your side. Stay in this position until the dizziness stops.
Most commonly, symptoms ease right after people perform the Epley Maneuver. In some cases, you may need to perform this exercise multiple times for it to work. It only needs to be performed while symptoms are present, it is not necessary at any time if your dizziness has subsided.
If The Epley Maneuver Doesn’t Work For You
The Epley Maneuver can help to resolve vertigo if it is prescribed correctly. The good news is, statistically, 80% of BPPV cases originate from loose crystals in the posterior canal. Chances are, it will work for you!
However, there are multiple factors to consider in order to prescribe the correct maneuver to ease your symptoms. Each ear has three semicircular canals, and on top of this, there are two different ways that debris, otherwise referred to as crystals, can cause issues. They can either be lodged or loose. The Epley Maneuver targets only one of the three semicircular canals—the posterior. It can only help if the crystals are loose within that canal. If lodged, it will not be effective in resolving vertigo. This is where this is a risk. If the issue is not from loose crystals in the posterior canal, you may feel worse after performing the maneuver.
An evaluation will include a close look at which ear, which canal, and which crystals are causing problems. Sometimes, people have multiple canals involved.
Get Help With Vertigo
Feeling discouraged with your dizziness? Our vestibular physical therapists can help you. We will evaluate which ear, which canal, and which “crystal issue” is contributing to your vertigo symptoms. With this information, we can prescribe you the most effective maneuver. Don’t get discouraged, we’re here to help. Reach out to us by filling out this form or texting, or calling us at 202-922-7331.