The Epley maneuver is a specific type of exercises that is used to treat BPPV (benign paroxysmal positive vertigo).  Its main focus is to reposition calcium crystals in order to alleviate the symptoms of dizziness,  spinning and loss of balance.   Once your therapist has introduced you to the maneuver and instructed you on its proper execution, you may choose to do this exercise in the comfort of your home.

Before we look at the Epley maneuver, however, let’s take a more detailed look at BPPV.

WHAT IS BENIGN PAROXYSMAL POSITIVE VERTIGO?

BPPV is an inner ear disorder in which changes to the position of the head lead to a sudden vertigo or a feeling that the room is spinning.  In a healthy person, the semicircular canals of the inner ear send information to the brain when the motion is detected.  However, when calcium crystals get detached from the utricle and end up in the semicircular canals, they send incorrect signals to the brain, causing a feeling of dizziness or spinning.

BPPV may be triggered by rolling in bed, tilting head side to side or backward, or turning quickly.  The condition is sometimes referred to as “top shelf” vertigo because by looking up at the top shelf you get dizzy and off balance.

Symptoms of BPPV range from mild to severe.  Some patients may feel a slight discomfort of dizziness, while others may feel nausea, vomiting, difficulty to get up, stand and walk around without losing balance.  Some people are unable to work during acute bouts.  Vertigo may last anywhere from 30 seconds to as long as a few minutes.  Usually one ear is affected.

The causes of BPPV may be related to an ear infection, age or trauma.  People with an acute episode of BPPV become very frightened thinking they are having a stroke and end up in the emergency room.  However, BPPV is not a sign of a serious problem and symptoms may resolve on their own.

WHAT IS THE TREATMENT FOR BPPV?

BPPV is treated with the Epley maneuver designed by Dr. John Epley.  The focus of the treatment is to reposition calcium crystals from the semicircular canals back to the utricle.  It is achieved through a series of head movements.  The treatment is introduced on the first visit.  The patient is given home exercise program to perform the Epley maneuver at home.

A TYPICAL TREATMENT SESSION

To get an idea of what a typical treatment looks like, consider the right ear as the source of the problem.  A typical treatment may go as follows:

  • Begin in a sitting position.
  • Turn your head 45° to the right
  • Keeping your head turned, lie back quickly. Your head should now be reclined, and your shoulders should be on the pillow.
  • Wait 30 seconds
  • Turn your head 90° to the left without raising it. In this position, your head will face 45° to the left.
  • Wait another 30 seconds
  • Turn your body and head another 90° to the left.
  • Wait another 30 seconds (last time)
  • Finally, sit up on your left side

ONCE THE MANEUVER IS COMPLETED

Many people experience immediate relief following the maneuver. Others, however, require a few sessions in order for the procedure to work. In some cases, individuals still have mild symptoms for up to a few weeks after the maneuver. Typically, though, symptoms subside and there is no need for continual treatment.

Even after the symptoms are gone, doctors may advise patients to avoid certain positions. For example, instead of keeping a straight neck, it may be a good idea to keep your head propped up on a few pillows.  

The Epley maneuver is available at Excel Physical Therapy.  Our dedicated physical rehabilitation experts will give you the relief and care you deserve. Contact us today if you would like more information or to schedule an appointment.

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