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Research indicates that implementing the Epley maneuver is efficacious in alleviating vertigo induced by benign paroxysmal positional vertigo (BPPV). BPPV is a condition characterized by the liberation and circulation of calcium fragments within the inner ear, resulting in sensations of dizziness and potential nausea. Professionals suggest that the Epley maneuver may dislodge these fragments from the inner ear, thereby mitigating your symptoms. Consult your healthcare provider to perform the Epley maneuver. If approved by your physician, you may be able to execute it at home should your symptoms recur.
Procedures
Undergoing the Maneuver Administered by a Physician
Schedule an appointment with your doctor if this is your initial Epley maneuver. If you are encountering vertigo and have recently received a diagnosis of BPPV, it is imperative to visit a doctor who will perform the Epley maneuver to readjust the crystals in your inner ear. Only a doctor or therapist should conduct this maneuver if you are experiencing BPPV for the first time. However, they will provide instructions on how to self-administer it in case your symptoms reoccur in the future.
Recognize the Importance of Professional Guidance for the Maneuver. Prioritize having the maneuver conducted by a doctor before attempting it independently. Although it's feasible to perform the maneuver at home (as outlined in Method Two), undergoing the procedure with a doctor initially offers insights into its correct execution. Attempting it without proper guidance may exacerbate vertigo by further displacing ear crystals!
- If you're already familiar with the correct procedure, you can proceed to method two to refresh your memory on the execution process.
Expect Vertigo During the Initial Step of the Maneuver. During the first step, the doctor will seat you on the edge of a table or bed with your head facing forward. She will then swiftly turn your head 45 degrees to the right and immediately lay you down on the table, maintaining the 45-degree angle. You'll be instructed to stay in this position for 30 seconds.
- Your head will be positioned off the examination table or, if there's a pillow behind your back, your head will rest on the table. The objective is to have your head lower than the rest of your body while lying down.
Prepare for Head Rotation by the Doctor. While maintaining the previous position, the doctor will reposition herself and swiftly rotate your head 90 degrees to the opposite side (leftward). Be attentive to any vertigo sensations, which typically subside after 30 seconds in this new position.
- Pay close attention to any vertigo sensations you experience, as they're likely to cease after 30 seconds in the new position.
Roll onto Your Side. Subsequently, the doctor will instruct you to roll onto your left side while simultaneously swiftly rotating your head to the right (angling your nose toward the floor). Visualize lying on your right side in bed, facing downwards into your pillow. Maintain this position for 30 seconds.
- Ensure the direction of rotation and nose alignment is accurate. Note that if the issue is on the right side, your body and head will be rotated to the left, and vice versa.
Resume a Seated Position.
Following the 30-second interval, the doctor will promptly raise you into a seated position. You shouldn't experience vertigo at this point; if you do, the maneuver can be repeated until vertigo subsides. Sometimes, multiple maneuvers are necessary to reposition all inner ear crystals correctly.
- For left-sided BPPV, the same procedure should be conducted with reversed directions.
Give Yourself Time to Recover Post-Maneuver. Following your doctor's appointment, you may receive a soft neck brace to wear for the remainder of the day. Your doctor will provide instructions on sleeping and moving to prevent vertigo recurrence, detailed in Part 3 of this guide.
Performing the Maneuver Independently
Understand When to Execute the Maneuver at Home. Reserve at-home maneuver attempts solely for diagnosed BPPV cases. If there's uncertainty regarding the cause of your vertigo, defer to professional guidance. The home maneuver closely mirrors the doctor-performed one with slight adjustments.
- Avoid attempting the Epley maneuver at home if you've recently experienced neck trauma, have a history of stroke, or limited neck mobility.
Position Your Pillow Correctly. Arrange a pillow on your bed so that when you recline, it supports your back while positioning your head lower than your body. Sit on the bed, turning your head 45 degrees to the right.
- Having someone assist you during this process is beneficial, particularly for timing, as each position should be maintained for 30 seconds.
Lay Down Swiftly. While maintaining the 45-degree left head rotation, swiftly recline until the pillow supports your shoulders, positioning your head lower than your shoulders. Your head should rest on the bed, maintaining the 45-degree angle facing right. Maintain this position for 30 seconds.
Rotate Your Head 90 Degrees to the Left. While lying down, swiftly turn your head 90 degrees to the opposite side, which is the left. Avoid lifting your head during this movement to prevent restarting the maneuver. Maintain this position for another 30 seconds.
Shift Your Entire Body (Including Your Head) Leftward. From your left-facing position, reposition your body so that you're lying on your right side. Your head should face downwards, with your nose touching the bed. Note that your head will be turned more than your body.
Maintain the Final Position Before Sitting Up. Stay in the last position, lying on your right side with your head facing downward and nose touching the bed, for another 30 seconds. After the time is up, sit up. You can repeat this self-maneuver 3 to 4 times daily until vertigo sensations subside. For BPPV on the left side, reverse the sides during the exercise.
Choose to Perform the Maneuver Before Bedtime. Especially if attempting the Epley maneuver independently for the first time, consider doing it just before bedtime. This allows you to sleep off any inadvertent dizziness or vertigo that may occur, preventing disruptions to your daytime activities.
- Once you're comfortable with the maneuver, feel free to perform it at any time during the day.
Post-Maneuver Recovery
Wait for 10 minutes before departing the physician's office. This brief wait allows any debris in your inner ear to settle, reducing the risk of triggering vertigo again immediately after the maneuver. After approximately 10 minutes, you can resume your normal activities for the day.
- After this period, it's safe to proceed with your usual routine.
Utilize a soft neck collar throughout the day. Following the maneuver performed by a healthcare professional, you'll receive a soft collar (or neck brace) to wear for the remainder of the day. This collar helps stabilize your head movements, preventing inadvertent displacement of inner ear crystals.
Sleep with your head and shoulders elevated. On the night of the maneuver, aim to sleep with your head elevated at a 45-degree angle. Achieve this by propping yourself up with pillows or reclining in a chair.
Maintain an upright head position during the day. Keep your neck straight and your head facing forward to minimize movement. Avoid activities that involve tilting your head backward, such as dental appointments or hairdressing. Additionally, refrain from exercises that involve excessive head movement, and avoid tilting your head back more than 30 degrees.
- When showering, position yourself directly under the showerhead to avoid tilting your head backward.
- If shaving, bend your body forward rather than tilting your head backward.
- Avoid positions that typically trigger BPPV for at least one week following the Epley maneuver.
Evaluate the outcome. After a week of avoiding activities that may provoke BPPV symptoms, test yourself by attempting movements or positions that previously triggered vertigo. If the maneuver was effective, you should not experience vertigo when attempting these actions. While symptoms may return in the future, the Epley maneuver provides temporary relief for approximately 90% of individuals with BPPV.
Helpful Tips
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Always have a healthcare professional perform the maneuver before attempting it yourself.
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Ensure your head remains lower than the rest of your body throughout the procedure.
Important Warnings
- Be cautious and avoid moving too quickly to prevent neck injuries.
- Stop the maneuver immediately if you experience headaches, vision changes, numbness, or weakness.
