Epley Maneuver for Benign Paroxysmal Positional Vertigo
The Epley maneuver, also known as repositioning maneuver, is used to treat benign paroxysmal positional vertigo (BBPV). Benign paroxysmal positional vertigo is a disorder of the inner ear. Its symptoms include repeated vertigo. A spinning sensation is felt when there are changes in head position. BBPV is the most common reason behind vertigo.
The Epley maneuver functions by utilizing gravity and allowing floating particles of the inner ear to be relocated. The floating particles then move back into another section of the inner ear, relieving the patient’s vertigo. The maneuver is typically performed by a chiropractor. There are a number of positional sequences to the Epley maneuver.
The patient is initially in an upright and sitting position. Their legs are extended outward fully and the head is rotated towards the side of the affected ear at 45 degrees.
The patient is quickly forced down backwards, with the head held at 30 degrees. The affected ear is now pointing in the direction of the ground.
The patient remains in this position for 1-2 minutes, then their head is turned 90 degrees to the side opposite the affected ear.
The patient is kept in this position for 1-2 minutes.
The head and neck are kept in a fixed position.
The patient then rolls onto their shoulder, their head rotating another 90 degrees in the same direction that they are already facing.
The patient, then, is now looking down at a 45 degree angle.
The patient is brought to an upright sitting position, while still maintaining that 45 degree angle of the head.
The patient holds this sitting and upright position for 30 seconds.
The entire procedure may be repeated two more times, for a total of three times.
During these procedural steps, the patient is likely to experience some dizziness at every step. After this treatment, the patient may be given a soft collar as a reminder to not move their head. They are recommended to not bend over, lie back, move the head up and down, or tilt the head. The collar is removed before going to bed, however. At this point, horizontal movements of the head and neck should be performed to help those body areas retain proper mobility. This further prevents stiff neck muscles.
It may be that restricting activity may help treatment outcomes, though it is not known for sure. However, those patients who do not follow any activity restriction protocols typically need more treatments sessions, as compared to patients who do limit activity.
The ultimate goals of the Epley maneuver is to work to restore the equilibrium of the vestibular system, which is part of the ear system, and works to maintain balance. The maneuver should be performed by a trained chiropractor who specializes in these treatments, like Dr. Hamilton D.C., to ensure that the maneuver is done properly. Otherwise, the free floating particles that may be causing the vertigo may not be dislodged properly, and the vertigo will continue. Come see us, we are happy to help, call for your appointment today.