How the Epley Maneuver Can Help with Vertigo

This article is written for general understanding only and is not based on personal experience or medical expertise.

You probably remember the fun you had as a child spinning madly in circles until you got so dizzy you couldn’t stand anymore. There are so many fun things we did as children that we can’t do anymore as adults!

Imagine experiencing dizziness from everyday eye or head movements and an inability to control your eye movements. Such sudden dizziness spells can severely affect your ability to function and complete everyday tasks.

However, it is what it is like living with benign paroxysmal positional vertigo (BPPV).

For this article, I’ll provide a brief overview of BPPV before we explore the Epley Maneuver to see if it is effective in treating vertigo related to BPPV.

1 What is BPPV?

BPPV is a common inner ear disorder and most often occurs in adults over 50. Although it is not a severe condition and frequently resolves within a few weeks, its effects can be dangerous. Sudden vertigo can cause falls, leading to fractures, which is especially harrowing for older people.

BPPV can be the result of conditions like:

1.1 Labyrinthitis or Vestibular Neuritis

Labyrinthitis and Vestibular neuritis are inner ear infections that affect your balance. It causes dizziness and vertigo. Labyrinthitis also causes hearing loss and tinnitus ( a ringing in the ears.)

1. 2 Acoustic Neuroma

Acoustic Neuromas or Vestibular Schwannomas are slow-growing and noncancerous tumours. They form along the vestibulocochlear nerve that leads from the brain to the inner ear and plays a vital role in hearing and balance. It causes one-sided hearing loss, fullness in the ear, tinnitus, balance problems and vertigo.

The underlying cause of BPPV is calcium carbonate particles (otoconia) getting trapped in the semicircular canals or inner ear structures that control balance. The otoconia gets loose from an injury, infection, or due to age. With your head movements, they roll around and push on the semicircular canals’ hair-like structures (cilia), stimulating them.

A frequent recommendation for treating vertigo is the Epley Maneuver. Next, we will explore this treatment option, how it is done, and its risks and benefits.

2 The Epley Maneuver

The Epley manoeuvre consists of a series of head movements to treat symptoms of BPPV. It aims to move the otoconia back to their original position to stop the symptoms.

WARNINGS

• Although you can do the Epley manoeuvre at home, it is best to consult a medical professional. Never try this when you are alone since the treatment can worsen symptoms of vertigo, which can cause serious falls and injuries if done unaided.
• If you don’t perform the procedure correctly, it can cause neck injuries or increased vertigo symptoms.
• The information provided in this post is for informational purposes only and is not intended as medical advice. Always consult with a healthcare provider before attempting any new treatments or exercises, especially if you are experiencing symptoms of vertigo or other medical conditions.

Next, we will examine your doctor’s steps during the Epley manoeuvre.

1. Sit on the side of the consultation table and tilt your head to the side, which causes vertigo.
2. The doctor will let you quickly lay down flat on your back with your head slightly over the edge while keeping your head tilted in the same position.Your vertigo symptoms may get worse during this step.
3. Next, your doctor will gradually move your head to the opposite side.
4. Now, you rotate your body until it aligns with your head.
5. You will need to remain in this position for a few minutes.
6. During this last step, you will return to a sitting position.

It would be best to keep your head down and not lift it during any part of this treatment. The procedure takes about 10 minutes to complete.

* The Cleveland Clinic has an excellent illustration of this procedure.

3 Is the Epley Maneuver Effective?

It is essential to note that the Epley manoeuvre only helps people with vertigo caused by BPPV. Most people experience immediate relief after this treatment. However, some people may need several sessions to reduce their symptoms.

There are no specific aftercare prescriptions, although you should avoid sudden head movements and not bend over for the rest of the day.

The average success rate of the Epley manoeuvre is 80%, and healthcare providers often consider it the first treatment option for BPPV.

4 Risks and Benefits of the Epley Maneuver

Some people may experience symptoms like nausea, intense vertigo, and even vomiting after the procedure.

If you have health conditions like retinal detachment, vascular disease, or neck and back injuries, this treatment may not be feasible for you.

The main benefit is that it is a relatively safe treatment. Your doctor can perform it in his office and show you how to do it at home. If you don’t get symptomatic relief after the treatment, schedule a follow-up visit with your doctor to eliminate other conditions and explore alternate treatment options.

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While I haven’t experienced vertigo, I recently encountered a compelling perspective on its impact through Nin Mok’s book Suddenly Silent and Still. The book is available for pre-order on Amazon, and she will publish it on 15 January 2025. I had the privilege to read it as an ARC reader.

Although I’m not sure if Nin’s vertigo was due to BPPV and if the Epley manoeuvre is a treatment option for her, her book will give you insight into the debilitating effects of vertigo on managing daily activities.

After my article, Ménière’s Disease: A Struggle with Hearing and Balance, a reader asked if the Epley manoeuvre would help ease the vertigo symptoms of Meniere’s disease. From the research I’ve done for this article, it is clear that it will not since it is only indicated for treating vertigo caused by BPPV – because of the specific cause of vertigo in this condition.

Have you or someone you know experienced vertigo? If so, what strategies or treatments worked for you? Share your experiences or questions in the comments below—I’d love to hear your thoughts and continue the conversation about how we can manage vertigo effectively together!

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