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Understanding BPPV and the Epley Manoeuvre: Your Guide to Finding Relief and how Osteopaths can help

Do you sometimes experience sudden, intense dizziness when you change the position of your head, such as when rolling over in bed or looking up? This could be a symptom of a common inner ear condition known as BPPV or Benign Paroxysmal Positional Vertigo. In this comprehensive guide, we'll explore what BPPV is, its causes, symptoms, and the highly effective Epley Maneuver, a simple treatment that can help you find relief from this troublesome condition.

What is BPPV?

Benign Paroxysmal Positional Vertigo, or BPPV, is one of the most common causes of vertigo, a sensation of spinning or dizziness. It occurs when tiny calcium particles, known as canaliths, become dislodged from their usual position within the inner ear. These canaliths then float into one of the ear's fluid-filled canals, disrupting normal balance signals sent to the brain.

Causes of BPPV:

The exact cause of BPPV is often unclear, but it can result from various factors:

1. Aging: BPPV is more common in older adults.

2. Head Injury: A head injury or trauma can dislodge the canaliths.

3. Inner Ear Disorders: Certain inner ear disorders can make you more susceptible to BPPV.

4. Prolonged Immobility: Long periods of bed rest or inactivity can trigger BPPV.

5. Viral Infections: Certain viral infections affecting the inner ear can lead to BPPV.

Common Symptoms of BPPV:

Recognizing the symptoms of BPPV is crucial for early diagnosis and treatment. Typical symptoms include:

- Intense vertigo triggered by head movement.

- Nausea and vomiting.

- A spinning sensation.

- Brief episodes of dizziness, usually lasting less than one minute.

- Unsteadiness or loss of balance.

Diagnosing BPPV:

A healthcare provider, often an Ear, Nose, and Throat (ENT) specialist or a neurologist, can diagnose BPPV through a combination of medical history, physical examination, and specialized tests. The Dix-Hallpike test is commonly used to confirm BPPV. During this test, the patient's head is moved into specific positions to trigger vertigo, helping to identify which ear and canal are affected.

Treating BPPV with the Epley Manoeuvre:

The good news is that BPPV is highly treatable, and one of the most effective treatments is the Epley Maneuver. Developed by Dr. John Epley, this simple yet precise procedure aims to reposition the displaced canaliths in the inner ear to their correct location. It can often provide immediate relief from vertigo symptoms.

Here's a step-by-step guide to the Epley Manoeuvre:

Step 1: Sitting Position

1. Start by sitting upright on a bed or exam table.

2. Keep your legs extended straight in front of you.

Step 2: Head Turn

1. Turn your head 45 degrees to the side that causes dizziness (usually the side that triggers vertigo during the Dix-Hallpike test).

2. Hold this position for about 30 seconds.

Step 3: Lying Down

1. Quickly lie down, keeping your head in the same turned position.

2. Allow your head to hang slightly over the edge of the bed or table, maintaining the 45-degree head turn.

3. Hold this position for about 1-2 minutes.

Step 4: Head Turn to the Opposite Side

1. Slowly turn your head 90 degrees in the opposite direction (the direction opposite to where you initially felt dizziness).

2. Hold this position for about 30 seconds.

Step 5: Roll Over

1. Roll your body and head in the direction you turned your head, so you are now facing the floor.

2. Hold this position for about 30 seconds.

Step 6: Sit Up

1. Finally, sit up slowly, still keeping your head turned to the side at a 45-degree angle.

2. Stay in this position for a few minutes.

The Epley Manoeuvre works by guiding the dislodged canaliths back into the utricle of the inner ear, where they no longer cause balance problems. Many patients find immediate relief after a single manoeuvre, while others may require additional treatments.

Precautions and Considerations:

- This manoeuvre should only be performed by a trained healthcare professional or under their supervision.

- It may not be suitable for everyone, and your doctor, osteopath or physiotherapist will determine if it's appropriate for your specific condition.

- Side effects, such as short-lived dizziness or nausea, are possible but typically resolve quickly.


BPPV can be a distressing condition, but it's essential to know that effective treatments like the Epley Maneuver exist. If you suspect you have BPPV or are experiencing any of the mentioned symptoms, seek medical advice from a qualified healthcare provider. Early diagnosis and appropriate treatment can significantly improve your quality of life and help you regain your sense of balance.

In this article, we've explored what BPPV is, its common causes, symptoms, and the Epley Manoeuvre as a trusted treatment option. By understanding the condition and its remedies, you're taking the first step toward finding relief from the discomfort and dizziness associated with BPPV. Remember, you don't have to suffer in silence—help is available, and you can regain your balance and peace of mind.

Book online or call now for an appointment at Eastbourne Osteopathy


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