Can you treat BPPV at home? What are the risks of a DIY Epley maneuver?

What can go wrong with a home Epley maneuver?

• Wrong side: treating the right ear when the crystals are in the left does nothing, or makes things worse
• Wrong canal: the Epley does not treat horizontal canal BPPV and can convert posterior canal BPPV into horizontal canal BPPV
• Wrong diagnosis: vestibular migraine, neck-related dizziness and central causes do not respond to maneuvers
• Neck strain or falls: the positions are hard with neck arthritis, and the spinning can cause a fall

Who should not try the Epley maneuver at home?

Talk to a clinician first if you have significant neck or back problems, a recent neck injury or surgery, known problems with the arteries in your neck, or a history of retinal detachment, or if your vertigo is constant, started with a head injury or comes with any neurological symptoms. These need a supervised assessment.

When is a home maneuver a good idea?

After we have confirmed posterior canal BPPV on a specific side with infrared video goggles, we may teach you a home maneuver to use if the same symptoms return. The guideline notes that self-treatment can help when patients are properly instructed¹, and a Cochrane review supports the Epley maneuver itself as safe and effective².

Where can I get a professional Epley maneuver near Alpharetta or Cumming?

Our Cumming and Alpharetta clinics test every canal and side under infrared goggles before treating, and recheck afterward. Patients come from Johns Creek, Milton, Suwanee and Forsyth County, with urgent appointments within 48 hours. Read our full Epley maneuver guide for step-by-step detail.

Where can I get help in Alpharetta, Cumming and nearby?

Dr. Manan Patel, PT, DPT, TPS and our team of physical therapists see patients from Alpharetta, Johns Creek, Milton, Roswell, Cumming, Suwanee, Sugar Hill, Buford, Duluth and Forsyth County at two North Atlanta clinics. Every visit is 60 minutes, one-on-one, and urgent appointments are available within 48 hours. We are in-network with Traditional Medicare, BCBS / Anthem and Tricare, and offer a $129 rate per visit for self-pay and out-of-network plans. Not sure where to start? Take the free symptom self-check, or visit our Alpharetta clinic or Cumming clinic page.

Related care

Related questions

• What is subjective BPPV, when you have positional vertigo without visible eye movements?Subjective BPPV means you have the typical brief spinning with position changes, but no nystagmus is seen during…2 min read · Patient question
• What is BPPV? Are loose inner ear crystals causing your spinning?Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. Tiny calcium carbonate crystals…2 min read · Patient question
• Why do I still feel wobbly after my BPPV crystals were cleared?Residual dizziness, a lingering floating, foggy or unsteady feeling after the spinning has stopped, is common after…2 min read · Patient question
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References

1. Bhattacharyya N, et al. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update). Otolaryngology–Head and Neck Surgery. 2017.
2. Hilton MP, Pinder DK. The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo. Cochrane Database of Systematic Reviews. 2014.

Answered by Dr. Manan Patel, PT, DPT, TPSDoctor of Physical Therapy, Certified Vestibular Specialist and one of the few certified Therapeutic Pain Specialists in North Atlanta, with 15+ years of outpatient care. About Dr. Patel

This answer is general education, not a diagnosis or a substitute for an examination. If you have new or worsening symptoms, contact your doctor. Call 911 for sudden severe dizziness with trouble speaking, weakness, numbness, double vision or a severe headache.