Your healthcare provider may suggest the home Epley maneuver if your health history and physical exam support that you have BBPV. Your healthcare provider may also suggest that you see a vestibular therapist for treatment.
Home Epley Maneuver
The home Epley maneuver is a type of exercise help that helps to treat the symptoms of benign paroxysmal positional vertigo (BPPV). You can do this exercise at home.
BPPV is caused by a problem in your inner ear. Your semicircular canals are found inside your ear. They detect motion and send this information to your brain. The utricle is a nearby part of the ear. It contains calcium crystals (canaliths) that help it detect movement.
Sometimes these crystals detach from the utricle and end up inside the semicircular canals. When these crystals move inside the canals, they may send incorrect signals to your brain about your position. This can make you feel like the world is spinning. This is called vertigo.
Dr. John Epley designed a series of movements to dislodge the crystals from the semicircular canals. These movements bring the crystals back to the utricle, where they belong. This treats the symptoms of vertigo.
The original Epley maneuver was designed to be done with a healthcare provider. The home Epley maneuver is similar. These are a series of movements that you can do without help, in your own home.
Why might I need the home Epley maneuver?
You may need to try the home Epley maneuver if you have symptoms of BPPV. In BPPV, vertigo may come on with certain head movements. It may last for up to a minute. These symptoms may be more frequent at times. You may also have nausea and vomiting.
Often BPPV happens without any known cause. Sometimes there is a cause. Causes of BPPV can include:
- A head injury
- Problems after ear surgery
The home Epley maneuver is safe and inexpensive. It often works well to treat the symptoms of BPPV.
Your healthcare provider may suggest the home Epley maneuver if your health history and physical exam support that you have BBPV. Your healthcare provider may also suggest that you see a vestibular therapist for treatment.
Your healthcare provider may first do the original Epley maneuver in his or her office. He or she may teach you the home Epley maneuver. You may need to do the home Epley maneuver if you still have symptoms after you leave your healthcare provider’s office. It may also be useful to know how to do this maneuver if your BPPV comes back after a few months or years.
What are the risks of home Epley maneuver?
The home Epley maneuver is safe. It may be helpful to have someone at home with you while you go through the movements. This can give you peace of mind in case your vertigo gets worse in the middle of the treatment.
People with health conditions that limit their ability to move may not be able to do the home Epley maneuver safely. These issues can include neck or back disease, vascular conditions, and retinal detachment. Ask your healthcare provider if the home Epley maneuver is safe for you.
How do I get ready for the home Epley maneuver?
You can do the home Epley maneuver on a bed. You start by sitting on the bed. You need to have a pillow in place so that when you lie back it will be under your shoulders.
What happens during the home Epley maneuver?
You may find it helpful to watch a video of the home Epley maneuver first. Or read a brochure with pictures.
Your healthcare provider will tell how often to do this procedure. He or she may ask you to do it 3 times a day until your symptoms have been gone for 24 hours. Your healthcare provider will also tell if your right or left ear is causing your symptoms.
Follow these steps if the problem is with your right ear:
- Start by sitting on a bed.
- Turn your head 45 degrees to the right.
- Quickly lie back, keeping your head turned. Your shoulders should now be on the pillow, and your head should be reclined. Wait 30 seconds.
- Turn your head 90 degrees to the left, without raising it. Your head will now be looking 45 degrees to the left. Wait another 30 seconds.
- Turn your head and body another 90 degrees to the left, into the bed. Wait another 30 seconds.
- Sit up on the left side.
Follow these steps if the problem is with your left ear:
- Start by sitting on a bed.
- Turn your head 45 degrees to the left.
- Quickly lie back, keeping your head turned. Your shoulders should now be on the pillow, and your head should be reclined. Wait 30 seconds.
- Turn your head 90 degrees to the right, without raising it. Your head will now be looking 45 degrees to the right. Wait another 30 seconds.
- Turn your head and body another 90 degrees to the right, into the bed. Wait another 30 seconds.
- Sit up on the right side.
What happens after the home Epley maneuver?
Most people say their symptoms go away right after they do the maneuver. In some cases, it may take a few times for the procedure to work. Some people may have mild symptoms for a couple of weeks. Once your symptoms go away, there is no need to keep doing the maneuver.
Your healthcare provider may suggest avoiding certain positions for a while after your symptoms have gone away. For instance, you may need to sleep propped up on 2 pillows, to keep your neck from extending straight.
If you still have symptoms after doing the home Epley maneuver, call your healthcare provider. You may not be doing the maneuver the right way. Or you may have another problem that’s causing your symptoms of vertigo. The home Epley maneuver only works to treat vertigo from BPPV. But many other conditions can cause vertigo.
You should be able to be active after doing the home Epley maneuver. Make sure your vertigo has really gone away before doing anything dangerous, such as driving.
With the help of the home Epley maneuver, your vertigo may go away for weeks or even years. BPPV often comes back, though. This might happen if another calcium crystal ends up in your semicircular canals. If your vertigo comes back, do home Epley maneuver again to see if your symptoms go away. If the maneuver doesn’t work, call your healthcare provider.
Next steps
Before you agree to the test or the procedure make sure you know:
- The name of the test or procedure
- The reason you are having the test or procedure
- What results to expect and what they mean
- The risks and benefits of the test or procedure
- What the possible side effects or complications are
- When and where you are to have the test or procedure
- Who will do the test or procedure and what that person’s qualifications are
- What would happen if you did not have the test or procedure
- Any alternative tests or procedures to think about
- When and how will you get the results
Who to call after the test or procedure if you have questions or problems - How much will you have to pay for the test or procedure
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- Vestibular Disorders
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Home Remedies for Vertigo
The spinning sensation and dizziness you get from vertigo can limit your activities and make you feel sick. Depending on the cause, though, some simple maneuvers you can do at home might bring relief.
The most common type of this condition is BPPV (benign paroxysmal positional vertigo). It happens when small crystals of calcium get loose in your inner ear. You may feel it when you’re getting in or out of bed, or tilting your head up. People over age 60 are more likely to get BPPV. It’s also the easiest type of vertigo to treat.
Before you try to treat it yourself, see your doctor. If you have vertigo, you’ll need to know what type it is and which ear has the problem. To determine affected side:
- Sit on bed so that if you lie down, your head hangs slightly over the end of the bed.
- turn head to the right and lie back quickly.
- Wait 1 minute.
- If you feel dizzy, then the right ear is your affected ear.
- If no dizziness occurs, sit up.
- Wait 1 minute.
- Turn head to the left and lie back quickly. 8.Wait 1 minute. 9.If you feel dizzy, then the left ear is your affected ear.
If you have BPPV, certain actions can move the calcium crystals that cause the problem out of your ear canal. That should bring relief.
Your doctor or a therapist can show you how to do these moves.
Epley Maneuver
If your vertigo comes from your left ear and side:
- Sit on the edge of your bed. Turn your head 45 degrees to the left (not as far as your left shoulder). Place a pillow under you so when you lie down, it rests between your shoulders rather than under your head.
- Quickly lie down on your back, with your head on the bed (still at the 45-degree angle). The pillow should be under your shoulders. Wait 30 seconds (for any vertigo to stop).
- Turn your head halfway (90 degrees) to the right without raising it. Wait 30 seconds.
- Turn your head and body on its side to the right, so you’re looking at the floor. Wait 30 seconds.
- Slowly sit up, but remain on the bed a few minutes.
- If the vertigo comes from your right ear, reverse these instructions. Sit on your bed, turn your head 45 degrees to the right, and so on.
Do these movements three times before going to bed each night, until you’ve gone 24 hours without dizziness.
Semont Maneuver
This exercise is for dizziness from the left ear and side:
- Sit on the edge of your bed. Turn your head 45 degrees to the right.
- Quickly lie down on your left side. Stay there for 30 seconds.
- Quickly move to lie down on the opposite end of your bed. Don’t change the direction of your head. Keep it at a 45-degree angle and lie for 30 seconds. Look at the floor.
- Return slowly to sitting and wait a few minutes.
- Reverse these moves for the right ear.
Again, do these moves three times a day until you go 24 hours without vertigo.
Half-Somersault or Foster Maneuver
Some people find this maneuver easier to do:
- Kneel down and look up at the ceiling for a few seconds.
- Touch the floor with your head, tucking your chin so your head goes toward your knees. Wait for any vertigo to stop (about 30 seconds).
- Turn your head in the direction of your affected ear (i.e. if you feel dizzy on your left side, turn to face your left elbow). Wait 30 seconds.
- Quickly raise your head so it’s level with your back while you’re on all fours. Keep your head at that 45-degree angle. Wait 30 seconds.
- Quickly raise your head so it’s fully upright, but keep your head turned to the shoulder of the side you’re working on. Then slowly stand up.
You may have to repeat this a few times for relief. After the first round, rest 15 minutes before trying a second time.
Brandt-Daroff Exercise
Here’s what you need to do for this exercise:
- Start in an upright, seated position on your bed.
- Tilt your head around a 45-degree angle away from the side causing your vertigo. Move into the lying position on one side with your nose pointed up.
- Stay in this position for about 30 seconds or until the vertigo eases off, whichever is longer. Then move back to the seated position.
- Repeat on the other side.
You should do these movements from three to five times in a session. You should have three sessions a day for up to 2 weeks, or until the vertigo is gone for 2 days.
Follow Up
For the rest of the day after doing any of these exercises, try not to tilt your head too far up or down. If you don’t feel better after a week of trying these moves, talk to your doctor again, and ask them what they want you to do next.
You might not be doing the exercises right, or something else might be the cause of your dizziness.
Show Sources
Harvard Health Letter: “Self-Help Videos to Stop Vertigo Work for Some, Not All.”
Vicky Hildner, University of Colorado, Denver.
Johns Hopkins Medicine: “Benign Paroxysmal Positional Vertigo.”
Neurology: “Self-treatment of benign paroxysmal positional vertigo.”
University of Texas, Department of Otorhinolaryngology — Head & Neck: “Home Epley Maneuver.”
National Health Service (U.K.): “The Brandt-Daroff Exercise.”
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