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Exercises for benign paroxysmal positional vertigo (BPPV)

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These exercises are recommended to help people with benign paroxysmal positional vertigo (BPPV). A doctor or specially trained physiotherapist will decide if they're suitable for you.

The Epley manoeuvre

Watch these videos about how to do the Epley manoeuvre.

If you think your vertigo is coming from a particular ear, try doing the Epley manoeuvre for that side. If that doesn't help, try doing the manoeuvre for the other side as sometimes in can be difficult to know which ear is causing the problem.

One correctly performed Epley manoeuvre has been shown to resolve positional vertigo in 75 to 80% of people with BPPV. It involves four separate head movements to move the calcium crystals that cause vertigo to a place where they no longer cause symptoms.

It may take a few hours for your symptoms to improve after an Epley manoeuvre, and it may be several days before you feel confident with moving more normally again. Sometimes you need to repeat the manoeuvre or use other manoeuvres to make your symptoms go away.

Tell your doctor if your symptoms have not improved after a few weeks. BPPV can reoccur in the future.

Brandt-Daroff exercises

Sometimes the Epley manoeuvre isn't successful or is unsuitable. For example, if you have neck or back problems. In those cases, your doctor may recommend Brandt-Daroff exercises.

Brandt-Daroff exercises are designed to break up the calcium crystals and unblock your ear canal.

You'll need to repeat the exercises three or four times a day for two days in a row. Your symptoms may improve for up to two weeks.

Your doctor will teach you how to the exercises. The following is a guide:

Watch this video about how to do Brandt-Daroff exercises.

For the exercises to be helpful, you must experience the symptoms of dizziness while doing them. You may realise the treatment has been effective if you stop having dizziness when doing the exercises.

In most cases, if you do the exercises regularly, the symptoms should go away over a period of several days.

Written by HealthInfo clinical advisers. Last reviewed August 2023.

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Review key: HIVER-17706