If your vertigo is caused by benign paroxysmal positional vertigo (BPPV), the problem is tiny calcium carbonate particles (“ear crystals” or otoconia) that have moved into one of the inner ear’s balance canals. The goal isn’t to remove the crystals, but to guide them back to the part of the inner ear where they belong.
1. Canalith repositioning maneuvers
The most effective treatment is a series of head and body movements performed by a healthcare professional or, in some cases, at home after you’ve been shown the correct technique.
Common maneuvers include:
- Epley maneuver (most commonly used for BPPV affecting the posterior canal)
- Semont maneuver
- Barbecue (Lempert) roll for horizontal canal BPPV
These maneuvers relieve symptoms in most people within one to three treatments.
2. Avoid prolonged bed rest
Once the spinning settles, gentle movement is generally better than staying still. Remaining active helps your brain adapt to changes in balance.
3. Vestibular rehabilitation
If dizziness persists, a physical therapist trained in vestibular therapy can prescribe exercises to improve balance and reduce symptoms.
4. Medications
Medicines such as meclizine may temporarily reduce nausea or motion sickness but do not reposition the crystals or cure BPPV. They’re usually used only for short-term symptom relief.
5. When to seek medical evaluation
See a healthcare professional if:
- It’s your first episode of severe vertigo.
- Vertigo lasts for hours rather than brief episodes triggered by position changes.
- You have hearing loss, ringing in one ear, severe headache, fever, or ear pain.
- Symptoms keep returning despite repositioning maneuvers.
Get emergency care immediately if vertigo is accompanied by:
- Weakness or numbness on one side
- Trouble speaking or understanding speech
- Double vision or sudden vision loss
- Difficulty walking that is much worse than expected
- Loss of consciousness
- A sudden, severe headache unlike any you’ve had before
These symptoms could indicate a stroke or another serious condition.
Can you do the Epley maneuver at home?
Yes—but it’s best to do so only after a clinician has confirmed BPPV and identified which ear and which canal are affected. Doing the wrong maneuver, or doing it for the wrong ear, may not help and can sometimes make symptoms worse.
If you’ve been diagnosed with BPPV before and your current symptoms feel the same, I can explain the appropriate maneuver step by step
