I Have Vertigo. Should I Try The Epley Manoeuvre?

by Joon Nah     BScPT
Certified Vestibular Physiotherapist
updated Nov 16, 2023

So you’ve woken up, rolled over in bed and suddenly felt the entire room spinning uncontrollably around you.  You visit your doctor, go to emergency, or nervously google online and the diagnosis that seems to make the most sense is: BPPV (Benign Paroxysmal Positional Vertigo).

So you google “treatment for BPPV” and most of the results bring up something called “The Epley Manoeuvre” or “Epley’s Maneuver”.

If you’re feeling hesitant about trying it, you’re not alone, and you’re not completely wrong.

1.  You are not sure if what you have is BPPV

2.  The many videos of the treatment online seem to look different from each other

3.  You are not sure if you can perform it correctly

4.  You’ve performed it before and it made you feel worse

The Epley is certainly an effect treatment for specific types of BPPV and we administer it daily in our clinic.  What you may not know is that the Epley can only treat 4 types of BPPV.  Our inner ear however, is capable of being afflicted with 12 different types!  So there is some risk that this manoeuvre will not be applied to the correct vestibular problem.  Along with this, is the probability that the manoeuvre, though the correct one, won’t be performed properly.

NOTE: There are many other causes for dizziness beyond BPPV. Click here to learn about the 10 most common.

Does this really matter?

In some cases, no.  However our vestibular physiotherapists are increasing seeing patients where this home manoeuvre has complicated their problem.  A well-done, appropriately applied Epley can move dislodged calcium carbonate crystals back in place.  In improper one can sometimes move these crystals into a different canal, or worse, can adhere them to a structure called the cupula in the deeper part of the inner ear canals.  This “cupulolithiasis” type of BPPV can be more much difficult to treat.

My advice?  I recommend the home or self-Epley treatment option for patients who meet the following criteria:

• You’ve had BPPV before, and it’s been properly diagnosed (We find it often isn’t).
• Your prior episodes have been completely resolved with the Epley (usually only takes 1-3 attempts).
• The symptom patterns of your current episode are very similar to your prior episodes.
• You are confident that you (or your helper) can perform the Epley correctly.

Cornerstone’s Dizziness Clinics has experienced vestibular physiotherapists that can expertly diagnose your type of BPPV, and treat it with the Epley, BBQ roll, Gufoni’s, Semont’s or any other appropriate manoeuvre. Contact us today and let us help.

About the author

Joon Nah

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