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Anyone who has ever suffered from a bout of vertigo knows how debilitating it can be. Several years ago I rolled over in bed and the world started spinning. When I tried to get up from the side of the bed, once again the room began tilting and I became nauseated. Thus began my introduction to the upside down world of vertigo (BPPV). I am not the only one to suffer. Here is a message from a reader:
Q. I suffered for more than a month with vertigo. My doctor prescribed a 7-day “bubble pack” of steroid, an antihistamine, and meclizine for dizziness. None of it helped much.
Then I found the Epley maneuver. A licensed physical therapist did this simple procedure and in one session my vertigo was gone! Please tell people about this.
A. Vertigo (a sensation of spinning or whirling) can be caused by several conditions. If the diagnosis is vertigo (BPPV), also known as benign paroxysmal positional vertigo, then medications won’t help very much. That’s because little calcium crystals (canaliths) have moved out of their normal position within the ear canal. Rolling over in bed or changing head position can be very disorienting.
The Epley Maneuver for Vertigo (BPPV):
The Epley maneuver, named for ear surgeon John Epley, involves rotating the head through several positions to reorient the crystals. We encourage people to be evaluated by an otolaryngologist and have a skilled therapist perform the maneuver initially. An article in the journal Neurology (July 24, 2012) reported that YouTube videos can successfully assist patients with BPPV learn how to mange the procedure at home.
When I (Joe) went to the otolaryngologist (ENT specialist) I was tested to make sure nothing bad was going on. Then a skilled audio technologist performed the Epley. Within minutes I was feeling better for the first time in weeks. When I asked her if people come to the doctor’s office after years of frustration she confided that it happens all the time. People with vertigo (BPPV) are often put on medications that don’t work all that well. They suffer for months or years when a relatively simple procedure could end their misery.
In my case, the benign positional vertigo came back. Once agin the Epley maneuver helped reverse the problem. Apparently this is not that unusual. The crystals in the ear canal can move around and the procedure may have to be repeated periodically to get them back where they belong. Here are some stories from readers who had similar experiences:
CFH reports:
“I too have had BPV [benign positional vertigo]. I went to see my ENT and after a normal hearing test was sent to a physical therapist who performed the Epley maneuvers which worked very well for me. I went for two treatments and was given exercises to do at home. Good luck, as it is a miserable feeling.”
CG met Dr. Epley and reports:
“I live in the same city as Dr. Epley, so when he was still practicing, I was lucky enough to be treated by the good doctor himself. You can learn to do the Epley maneuvers at home, but it’s best to find an Ear, Nose & Throat doctor (ENT) or a vestibular physiotherapist trained in the maneuvers first, if possible. Performing the maneuvers incorrectly can prolong the misery.”
Mary shares this story:
“I have had the Epley done to me a few times, and silly as it seems, it works. I went to an audiologist and she did this. I was amazed. No meds, no needles and it didn’t take very long, Who knew? This is wonderful help for those of us that have this problem. I didn’t even know there were crystals in my inner ears, Thank Goodness for this.”
Jerry
USA, Tennessee
I’m lucky enough to have three sources of healthcare: A great PCP doctor, a wonderful cardiologist, and — despite what we read in the news — a caring Veterans Administration (VA) team. On my last routine visit to the VA, I offhandedly mentioned that I have had minor headaches for years, so the doctor immediately thought, “brain problems.”
She did an in-office test for balance and said she would feel better to schedule me for a CAT scan. A week or so later, I received word that the CAT scan did not reveal anything that she thought would contribute to my imbalance, so she requested approval for physical therapy (PT) sessions. I started to just ignore that, believing that PT couldn’t do anything about balance. I couldn’t have been more wrong. After an initial evaluation meeting with the therapist, our second session consisted of a series of tests for BPPV, after which she performed the Epley Maneuver. Performing it twice that same day, the vertigo was gone!
She told me of the rapid eye movement during the vertigo, but naturally I didn’t know this was happening. I’ve been tested in subsequent PT sessions, and so far I haven’t experienced the vertigo again. She did tell me that it would probably return some time later, but that she would teach me how to take care of this at home. My first thought after this was that it was akin to magic! Never would have expected this result after years of putting up with this problem.
Lori
Illinois
I recently took a dose of OTC Mucinex (containing Dextromethorphan HBr and Guaifenesin) to clear up mucus buildup and congestion from a persistent chest cold. Now, a few days later, I am experiencing extreme BPV symptoms whenever I bend over or lie on my left side. I experienced severe life-changing BPV several years ago that lasted several months and never wish to go through that again. Now I am wondering if the drugs contained in the Mucinex may have caused the crystals in the inner ear to dislodge, causing new BPV episodes. Has anyone else experienced a link between these mucus-loosening drugs and the occurrence of new BPV episodes?
Sherri Burich
Oh my gosh, yes! I’ve been taking Robitussin with Dextromathophan HBr and Guaifenesin, since about March, due to a horrible cough from what has turned out to be pulmonary fibrosis.
I went to the hospital for a biopsy, that was supposed to be a one night stay.
The day I was to leave, I got out of bed and walked. Suddenly, the whole world was upside down and spinning. I had nystagmus, and threw up for days! I was seeing double, and would fall over, if not using a walker.
That was over 3weeks ago. Things are better, but have not resolved, and that was with the Epley maneuver performed several times. I hope it’s the cough syrup!
Thank you for this post.
Ali
Louisiana
Last Tuesday, I had a couple of falls while skiing. On Wednesday evening, after landing at airport, I felt horrible dizziness. Vomited when I got home. The next day was awful. Couldn’t get out of bed for the vertigo and nausea. I encourage everyone to go to an ENT and not a regular doctor. Anti vertigo meds don’t work. I had an ENT do the Epley Maneuver (which made me throw up but I was desperate to feel better) today I feel slightly better. I’m scared this will come back in the future though.
Zelda
CA
I performed the Epley maneuver on my husband when he had 2 severe bouts of BPPV 6 months apart last year. He couldn’t handle the procedure without vomiting from the vertigo so I gave him some Bonine first.
Once he was knocked out & the room wasn’t spinning he was able to handle the procedure, though he did beg me to wait until later because he was so sleepy. I did a search on YouTube & found the videos I needed.
Geralyn
Minnesota
I have had vertigo since 1992. I tried the drugs and the therapy for vertigo but nothing worked. The doctor told me that the last resource would be to cut the nerves in my ears but then I would be deaf. Why would I want to do that?! I have observed when I get vertigo worse than normal and have found that Spring and Fall are the worst times of the year. Fall is worse than Spring because of the hurricanes. Spring has thunderstorms. I live in MN. Vertigo worsens when the weather worsens for me. This past week I was unable to do anything because of the vertigo caused by hurricane Matthew. It’s hard working around the house, especially when I have to be on a ladder. I wonder if there is an herb or spice that would help?
lee
North Carolina
i also have vertigo. it happens when i lie down or turn over when i sleep. last time i had it was two years ago,went to phlysical therapy for eight treatments,sitting,laying down,turning etc,finally was cured,have it again. i am in my eighties,do i do pt again,or go to ent,or can someone give me the exercises so i can do this at home. thanks.
William
Louisiana
I had nearly daily bouts of vertigo over a period of 3-4 years. I had to go on disability and then retired because of it. None of the initial medications made any difference and a couple of trips to a clinic in Memphis for perfusions did no good either. I wound up at a neurologist’s office after our GP advised it. He did a couple of simple tests in his office that led him to believe I had a problem in the brain stem. He prescribed two drugs and wrote a long letter on my behalf to the insurance company to get approval for their use. Over an extended period, I had the episodes less frequently. He thought I might always have them about once a week, but I haven’t had more than a momentary problem for the past 10-years and we gradually reduced the meds to zero before that time.
Jim
Cary, North Carolina
What incredible timing! A week before I read this article, I was ‘grounded’ by this very issue. I made contact with an ‘online’ doctor and was given a grim list of the possible causes and told I needed to be checked out by my family physician. I delayed going to a local doctor thinking that the symptoms were getting better or at least manageable.
Then I read this article and the lights went off in my head in addition to the wandering crystals! I viewed several clips on YouTube and performed the procedure on myself. I feel much better now, although I still seem to have a bit of residual dizziness. No more vertigo, though. At least I know what it is now. Thanks for the timely article!
Monique
Madison
I also have BPPV but my crystals are in the anterior canal, so an exercise different than the Epley maneuver (which is for BPPV in the posterior canal) is recommended. I have great physical therapists but they are having a hard time clearing the crystals. Does anyone have any info on stubborn anterior canal BPPV?
Charles
Easton, PA
This article is good as far as it goes, but it doesn’t tell people what the actual procedure is. I have successfully used a similar (identical?) procedure as clearly described (and illustrated) in American Family Physician, June 1996.
Fran
Florida
I had the Epley maneuver for vertigo. It worked like a charm. I’m relieved to know that if my vertigo comes back, I can get it fixed it easily.
Peter
England
Search for Epley maneuver on Youtube. There’s one video from the US that shows clearly and slowly what to do.
Chris
I call the treatment, “throwing myself on the bed”! I sit on the edge of the bed in the middle and fold my arms and turn my head to the right and fall side ways to the left and then the same thing with my head turned to the left and fall sideways to the right!! It may take more than one or two times, and sometimes a couple of days, but it works! My Nurse Practioner showed me and gave me a paper on it from Iowa City.
vern
WA
How is the Epley maneuver performed?
kim
I had terrible vertigo for months years back. Doctors couldn’t explain it & said I’d have to take drugs forever. I went on my own wellness journey and discovered my vertigo is caused by food allergies – nuts and chocolate.
Gilian
Florida
I’ve had BPPV for years and had attacks on and off – some mild and some severe. I went to a balance clinic about 15 years ago and had about an hour of tests and treatment ending up with the Epley manoeuver. Quite honestly I felt so rotten during the Epley and for some time afterwards that I have avoided having it done again.
Dorothy Lau
Spring Lake, NJ
I have had the Epley Maneuver about 3 times in the past 10 years. As soon as I fell the dizziness my doctor give me a therapy perscription and I go to SOAR to get the maneuver with a therapist qualified for the maneuver. I cures it right away.
Rick
My X girlfriend suffered from BPVP that is until she stopped taking Paracetamol and the symptoms went away. Most Doctors do not have a clue on how to preform the Epley maneuver so they rely on their prescription pad with very little success I guess you could define the syndrome as medication induced, very similar to NSAID induced kidney stones leading to eventual kidney failure.
Cindy
Missouri
I hope you were treated by a well educated audiologist and not a technologist. A minor correction – the canaliths are in the inner ear, not the ear canal. They’d fall out if they were in the ear canal!
Janet
florida
It works great. I got hit in the head with a softball which, to quote my ENT “knocked the rocks out of my head” causing vertigo. This procedure fixed it immediately. No fuss, no bother, no drugs and no waiting. Amazing.
Ginny
Raleigh, NC
I have had BPPV for years and the only thing that has helped me is Flonase nasal spray because mine is allergy-induced. I have had the Epley maneuver done several times, but it did not work. I did some sleuthing and found out that when it started, certain trees were in bloom and it stopped whenever the goldenrod died! Whatever works for you, please use it, but this is what I have discovered about mine.
anil
WASHINGTON
I went to the ER one night with vertigo and was prescribed a pack of medications and never took any of them. I did some research and discovered that wine and coffee were the possible culprits.
I stopped drinking both and the vertigo has never come back.
Lisa
Oregon
Vertigo makes you feel out of control, but this simple procedure really helped me. I still have occasional bouts but learned ways to manage thanks to my physical therapist who was trained in using the Epley maneuver.
Pam
Texas
I have suffered with BPPV for about 2 years. It would come & go. I had heard about the Epley but kept thinking it would go away & naturally it didn’t. I finally gave in & found an ENT doc that would do the Epley for me. They want you to sleep sitting in a recliner at a 45 deg. angle the first night. That didn’t work for me, because when I finally went to sleep I feel that my head fell forward & that messed it up. So I had to go back to the doc & he did it again. This time he recommended me get a neck collar, like for whiplash. That time it worked & I now sleep on 2 pillows. So far I don’t have any symptoms.
Gary
60016
I dont have the calcium crystals, But I do get Vertigo bad enough that I have to stay motionless in bed to keep from being nauseous. I found this out, after having to much salt (I ate a whole bag of Cheetos) the vertigo set in. I no longer add salt to anything (except watermelon Ha). We get to much salt as it is in our processed food. Now it has been several years since a severe bout of vertigo for me. Cutting back on the salt fixed it for me. Hope this helps someone.
Gary B
Jo
Florida
I have had this problem for quite a few years. I underwent a series of tests, including an MRI, until being given the instructions for doing the procedure outlined above. It was not called Epley at the time. I still have occasional bouts of vertigo and as soon as I feel it coming on I start the treatment and usually within a day it is gone. Sometimes if I have let it go too long before I start, it will last a couple days but I have never had to go back to a doctor to have anything done.
Marci
England
I had read about this manoeuvre here previously, so last week when I suffered my first ever episode…I immediately reacted to it by moving my head about in different orientations. The dizziness, which was horrific in that it did not go away standing or lying down, disappeared quickly when I did this!