The Semont Maneuver to Treat BPPV

If you have developed dizziness and spinning sensations that occur as you move your head or change positions, then you may be suffering from benign paroxysmal positional vertigo (BPPV). This is a common cause of vertigo, and it can limit your ability to move around normally due to severe spinning sensations.

You may benefit from the skilled services of a physical therapist if you have vertigo from BPPV. They will evaluate your condition and provide strategies to eliminate your symptoms. One such strategy is to use the Semont maneuver, also known as the liberatory maneuver.

Two young women, focus on woman holding fingers to forehead
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What Is BPPV?

Benign paroxysmal positional vertigo is caused by tiny calcium crystals in the vestibular system in your inner ear. When these crystals move to an area where they do not belong, they interact with nerves that communicate information to your brain about your head and eye position. This interaction of calcium crystals, called canaliths, and the vestibular nerves cause vertigo and dizziness that is the hallmark sign of BPPV.

Correct treatment involves attempting to reposition the canaliths to help diminish your dizziness. Treatment may also focus on strategies to help you prevent future problems with BPPV.

If you have BPPV, there are a few things you should do right away. First, don't panic. Most symptoms of BPPV can be treated in a relatively short time period. A visit to your healthcare provider is in order as well to be sure your dizziness is not caused by some other problem.

If your physical therapist suspects that the canaliths are out of place and in the posterior canal of your vestibular organ, they may try to reposition them with the Semont maneuver.

Performing the Semont Maneuver

The Semont maneuver is one specific treatment that your physical therapist may use to help treat your BPPV. It is a simple procedure that should help your vertigo subside.

Your physical therapist will perform the Semont maneuver with you to ensure it is done properly and to make sure you remain safe during the procedure.

This is what you can expect during the Semont maneuver:

  • Sit on the edge of a treatment table or bed.
  • Your physical therapist will assess if your left or right vestibular system is affected by the BPPV. He or she will they manually turn your head about 45 degrees away from the affected side.
  • Your physical therapist will then quickly lie you down on the side that is affected by your BPPV. You should be looking up at the ceiling once your PT lies you on your side.
  • This position may cause dizziness. You should remain in the side-lying position until your symptoms resolve.
  • Your physical therapist will then move you up into the sitting position and then quickly help you over to your unaffected side, with your head in the same position. Your eyes should now be looking towards the floor.
  • This position may cause slight vertigo. Again, remain in the side-lying position until the vertigo passes.
  • Your physical therapist will then guide you back up into the seated position.

After the Semont maneuver is performed, you should try to remain upright for a few hours. Your PT may ask that you sleep with your head propped up on a few pillows to help you remain slightly upright overnight.

The Semont maneuver is used to reposition the calcium crystals in your vestibular system. If successful, your vertigo symptoms should be clear rapidly within a day or two. If they remain, your PT may choose to have you perform a different exercise called the Epley maneuver.

Sometimes both the Semont and Epley maneuvers are not fully effective in relieving your symptoms. Your physical therapist may prescribe Brandt Daroff exercises to help treat your BPPV. These exercises are not intended to reposition the calcium crystals in your vestibular system. Rather, they are used to help your body habituate and compensate for your BPPV.

A Word From Verywell

If you have dizziness and vertigo caused by BPPV, you may benefit from a visit to a physical therapist for treatment. They may utilize the Semont maneuver to help you eliminate your dizzy symptoms and return to your previous level of function quickly and safely.

1 Source
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  1. Cleveland Clinic. Benign Paroxysmal Positional Vertigo.

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.