The Home Epley Maneuver to Treat BPPV

The home Epley maneuver can help you treat your vertigo caused by benign paroxysmal positional vertigo (BPPV). The exercise helps to reposition the crystals in the semi-circular canals of your inner ear to relieve the spinning sensations of vertigo.

If you have developed dizziness due to vertigo, then you understand how devastating this problem can be. The spinning of the room can limit your ability to move in bed, rise from bed, stand up from sitting or walk around normally.

If your vertigo is caused by BPPV, then physical therapy can help you learn the correct things to do in order to manage your BPPV and quickly return to normal activity and function. Your physical therapist can perform special tests to assess your BPPV and can offer you exercises and strategies to help decrease your symptoms.


See Your Healthcare Provider for a BPPV Diagnosis

African American doctor talking to patient in office
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BPPV is caused by displacement of the tiny calcium deposits inside the specialized structures of your inner ear (vestibular system). When these deposits move, they interact with the nerves of the vestibular system and cause your brain to have difficulty interpreting your head position. This causes the spinning sensation that is a primary symptom of BPPV.

Several exercises may be prescribed for you to do to treat your BPPV. Exercises like the Brandt-Daroff maneuver, the Semont maneuver, and the Epley maneuver can help you recover quickly from vertigo caused by BPPV.

Your physical therapist can help decide which is the correct exercise for you. An important component of your physical therapy program is to learn how to self-manage your condition.

The home Epley maneuver is an exercise you can try yourself to manage your symptoms caused by BPPV. Before starting this exercise, be sure to visit your healthcare provider. Sometimes vertigo may be caused by other problems like a stroke or infection, and performing the home Epley exercise for these conditions will not be effective.


Starting the Home Epley Maneuver

Vertigo caused by BPPV is often due to a vestibular system dysfunction on one side. You will need to know which side is the affected side. Usually, your vertigo symptoms will occur when you lie down on the affected side. If you lie on your left side and your symptoms occur, then the left vestibular system is most likely the affected side.

To start the home Epley maneuver, sit on your bed with your legs out straight. There should be enough space behind you to lie down, and a pillow should be placed on the bed. The pillow should be placed so that when you lie down, it supports your mid-back and allows your head to bend slightly backward.

Position yourself close to one edge of your bed, as you will need to sit up when completing the home Epley maneuver. Be sure someone is with you to help keep you safe during the exercise, as this maneuver typically causes your vertigo symptoms of spinning and dizziness.


Turn Your Head to One Side and Lie Down

Once you are positioned on your bed properly, turn your head about 45 degrees to the side that causes your dizzy symptoms. Once your head is turned, lie down on your back so your head is slightly extended, but still turned to one side.

Once you get into this position, it is common to experience your vertigo symptoms. Don't worry; your spinning symptoms will pass within 30 to 60 seconds. Stay in position until the spinning stops.

Once the dizziness and spinning stop, move on to the next step.


Turn Your Head to the Opposite Side

Once you are lying down on your back with your head to one side, slowly rotate your head to the opposite, non-affected, side. Your head should be turned about 45 degrees in the opposite direction.

This position may once again cause dizziness. Try to relax and wait 30 to 60 seconds for the spinning to subside. Once your vertigo has stopped, proceed to the next step.


Roll Onto Your Side

With your head rotated to the non-affected side, roll onto your side. Your head should remain turned and you should be facing down once you roll onto your side.

Occasionally this position causes slight vertigo, but often not. Remain on your side for 30 seconds or until spinning subsides, and then perform the final step in the home Epley maneuver.


Return to a Seated Position

To complete the home Epley Maneuver, slowly return to the seated position on the edge of your bed. Remain seated for a few minutes to ensure that you are not dizzy before standing up.

Typically, one repetition of the home Epley maneuver is required to treat your symptoms caused by BPPV. You may need to repeat the maneuver once or twice later in the day.

After performing the home Epley exercise, it's typically recommended that you remain upright for 24 to 48 hours. Some physical therapists recommend sleeping with pillows propped up behind you to remain slightly upright after the Epley maneuver.

If your symptoms persist after trying the home Epley maneuver, then you should visit your healthcare provider to ensure the correct diagnosis of BPPV has been made and to seek out alternative forms of treatment for your vertigo.

The home Epley maneuver can be an effective method to self-manage your vertigo symptoms caused by BPPV. It can help you quickly resolve your dizzy symptoms and can help you return to normal activity and function.

8 Sources
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Additional Reading

By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.