What is the home Epley maneuver?

The home Epley maneuver is a type of exercise. It 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 1 minute. These symptoms may be more frequent at times. You may also have upset stomach (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
  • Meniere’s disease
  • Other problems with the balance-related part of your inner ear (vestibular system). These can include nerve inflammation (vestibular neuronitis).

The home Epley maneuver is safe and inexpensive. It often works well to treat the symptoms of BPPV.

Your healthcare provider may advise the home Epley maneuver if your health history and physical exam support that you have BPPV. Your provider may also advise that you see a vestibular therapist for treatment.

Your provider may first do the original Epley maneuver in their office. They may teach you the home Epley maneuver. You may need to do the exercise if you still have symptoms after you leave your provider’s office. It may also be helpful to know how to do this exercise if your BPPV comes back after a few months or years.

What are the risks of home Epley maneuver?

This exercise 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 exercise 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 exercise first. Or you may want to read a brochure with pictures.

Your healthcare provider will tell you how often to do this exercise. They may ask you to do it 3 times a day until your symptoms have been gone for 24 hours. Your provider will also tell if your right or left ear is causing your symptoms.

Do 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. Your head should be reclined and touching the bed. 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.

Do 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 and touching the bed. 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 exercise. In some cases, it may take a few times for it 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 exercise.

Your healthcare provider may advise not doing certain positions for a while after your symptoms have gone away. For example, you may need to sleep propped up on 2 pillows. This is to keep your neck from extending straight.

If you still have symptoms after doing the home Epley maneuver, call your provider. You may not be doing the exercise the correct way. The home Epley maneuver only works to treat vertigo from BPPV. If this exercise doesn't work, you may have other conditions that are causing your symptoms of 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. But BPPV often comes back. This might happen if another calcium crystal ends up in your semicircular canals. If your vertigo comes back, do the home Epley maneuver again to see if your symptoms go away. If the exercise 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 you will get the results
  • Who to call after the test or procedure if you have questions or problems
  • How much you will have to pay for the test or procedure