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Epley Maneuver (Manual)

What is the Epley Maneuver?

The Epley maneuver is an exercise performed to treat a form of vertigo or dizziness caused by a medical disorder called BPPV (benign paroxysmal positional vertigo). It is usually carried out by a certified, experienced physician or physical therapist.

What is BPPV?

BPPV is a disorder of your inner ear. It occurs when small pieces of bone-like calcium deposits (canaliths) in your ear break free and float inside small canals in the inner ear. The condition makes you have brief but intense episodes of vertigo where you feel that you are spinning or that everything is spinning around you.

How Epley Maneuver Works and What is its Significance?

The Epley maneuver, also called canalith repositioning or particle repositioning, is designed to work with gravity where your head is placed at an angle. Tilting the head helps to move the crystals out of the small canals and reposition them where they belong. The procedure typically brings quick relief from vertigo which otherwise can limit your activities and make you feel sick.

Preparing for Epley Maneuver

Your physician will prepare you for the procedure by asking you to:

  • Dress comfortably to enable free movement of your head
  • Stop eating 4 hours before the procedure
  • Take medication that prevents nausea
  • Bring someone with you to drive you home

Epley Maneuver Procedure

The Epley maneuver consists of a series of head movements performed manually and takes about 15 minutes to complete. During the procedure you will:

  • Sit upright on a treatment table with your legs fully extended in front of you.
  • Turn your head at a 45-degree angle toward the side that is causing vertigo.
  • Quickly lie down on your back keeping your head turned at the 45-degree angle.
  • Wait anywhere between 30 seconds and 2 minutes as required.
  • Rotate your head halfway (90 degrees) in the opposite direction without raising it.
  • Turn your body with your head at 45 degrees so that it is in line with your head.
  • Again, wait anywhere between 30 seconds and 2 minutes as required.
  • Then roll onto your side with your head slightly angled while you look down at the floor.
  • Finally, return carefully to the sitting position with your head tilted down.

Your physician may ask you to do it 3 times a day until you have gone 24 hours without vertigo. If the symptoms reappear, you can do it at home even without help.

After Care

Following the Epley maneuver, you may need to use a soft cervical (neck) collar for a specific period to maintain proper head position and avoid movements. Your physician may further instruct you to:

  • Stay as upright as possible for at least six to seven days
  • Avoid bending over quickly or lying down quickly
  • Abstain from any kind of activity that involves head movement
  • Sleep propped up at a 45-degree angle on two pillows for two nights
  • Avoid sleeping on the affected ear or side for six to seven days

In most cases, symptoms go away right after the maneuver, but sometimes it may take a week or two for the procedure to work.

Advantages and Disadvantages of Epley Maneuver


  • Easy to perform and safe for most people
  • Highly effective for people with BPPV
  • Quick relief from vertigo or dizziness
  • Ensures normal activity and function
  • Both long-term and short-term option
  • Inexpensive with no adverse effects


  • Unsuitable to treat vertigo caused by something other than BPPV

Risks or Complications

Though rare, the Epley maneuver comes with minor risks such as:

  • Neck or back injury
  • Recurrence of vertigo
  • A feeling of nausea or light-headedness


The Epley maneuver may not be suitable for people with health conditions that limit their ability to move. They mainly include but are not limited to:

  • Neck or back problems
  • High blood pressure
  • History of retinal detachment


The Epley maneuver should be carried out by a medical professional at his or her office or at home by an individual experiencing BPPV. Therefore, first ask your physician whether the procedure is safe for you. If yes, the physician may first do the Epley maneuver in his or her office and show you how to perform it correctly so you can do it at home as needed.

The Epley maneuver has proven to be the most effective way to treat BPPV but needs to be done correctly to avoid complications. If you are experiencing BPPV, Regenerative Therapy Services and Pain Management Treatment can help you by performing the Epley maneuver procedure in Houston, TX. Have your Epley maneuver done by Regenerative Therapy Services and Pain Management Treatment to improve BPPV symptoms and start feeling well and steady again.