HealthInfo Canterbury
Exercises for benign paroxysmal positional vertigo (BPPV)
Whakangungu kehu
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.
- Hold each head position for at least 30 seconds.
- During the movements, you may experience some vertigo.
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:
- Sit on the edge of a bed and turn your head slightly to the left (approximately 45 degrees).
- While maintaining this head position, lie down quickly on your right side so that the back of your head is resting on the bed.
- Wait for 20 to 30 seconds or for any dizziness to go away.
- Sit up straight, and again wait for 20 to 30 seconds or for any dizziness to go away.
- Turn your head slightly to the right and repeat the sequence in the opposite direction.
- Continue as above for 10 minutes (five or more repetitions to each side). If possible, perform the exercises three times daily.
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.
SourcesReview key: HIVER-17706
