Category: Nervous System
How to do the Epley manoeuvre at home: the four head positions, hold times, which side to start on, and the red flags that mean see a doctor.
1. First, confirm the pattern matches. This is for vertigo triggered by a change in head position, lasting seconds to under a minute, then settling. If your dizziness is constant, lasts hours, or comes with any of the red flag symptoms listed in the safety section, STOP. This is not the right remedy and you need a doctor. 2. Work out which side is affected. Usually it is the side you turn toward when the spinning starts. If you are not sure, a clinician can identify it with a Dix Hallpike test, and doing the manoeuvre on the wrong side will not help. 3. Sit upright on the bed with the pillow positioned so it will sit under your shoulders when you lie back. Turn your head 45 degrees toward the affected side. 4. Keeping your head turned at 45 degrees, lie back quickly so your shoulders land on the pillow and your head extends back about 20 degrees below horizontal. Vertigo will usually start here. Hold this position for 30 seconds, or until the spinning stops if it lasts longer. 5. Without lifting your head, turn it 90 degrees to the opposite side, so it is now turned 45 degrees toward the unaffected side. Hold for 30 seconds. 6. Roll your whole body onto that same side so you are lying on your shoulder, and turn your head a further 90 degrees so you are looking down at the floor at roughly 45 degrees. Hold for 30 seconds. 7. Sit up slowly, keeping the chin tucked slightly down, and sit still for a few minutes before standing. Getting up fast here is how people fall. 8. Repeat the whole sequence up to three times in a session if symptoms persist. Many people are clear after one or two sessions. 9. Expect to feel unsteady or slightly off for the rest of the day, which is normal. Do not drive immediately afterwards. 10. If it has not resolved after several sessions across a few days, see a doctor or ask for referral to vestibular physiotherapy. Do not keep repeating it indefinitely on a wrong diagnosis.
Loose calcium crystals have drifted into a balance canal in your inner ear, where they move when you move and trick your brain into sensing rotation. The sequence uses gravity to walk them back out.
If symptoms persist beyond a few days of correct attempts, stop and get assessed. Recurrence after successful treatment is common, at around 36%.
Not for constant or long lasting dizziness, light headedness on standing, or dizziness with any neurological symptom such as new hearing loss, double vision, severe headache, weakness, numbness or slurred speech, all of which need urgent medical assessment. Not for anyone with neck disease, recent neck injury or cervical spine surgery. Not for children.
Cochrane review CD003162 (Hilton and Pinder): across 11 randomised controlled trials, the Epley manoeuvre was significantly more effective than sham or control for resolving vertigo, and superior to Brandt Daroff exercises. Recurrence after treatment is high at around 36%.
Best for an adult whose vertigo is clearly triggered by head position and lasts under a minute, who has no neck problems and no neurological symptoms, and who has ideally had the diagnosis confirmed once by a clinician so they can then manage recurrences at home.
acute
Assessed by a Cochrane systematic review of 11 randomised controlled trials, which found it significantly more effective than a sham manoeuvre and better than Brandt Daroff exercises.
Back to the PlantRx Remedy Library
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.