The Epley maneuver worked – why do I still feel dizzy?

A person with BPPV who was treated in Greece asked: “After the treatment maneuver I felt much better. However, I now feel,…off balance? Why? How long with this last? Should I keep trying the Epley treatment?”

This is a common question and has an interesting, if theoretical, answer. It seems that some people can tell when they have BPPV just by the way they feel, even if they don’t experience vertigo at that moment. They just feel off, like something isn’t right. It is almost as if they can feel the particles sitting in the posterior semi-circular canal. This feeling goes away after they get used to the particles being in the canal. These people still experience spinning vertigo when they lay down or move in such a way as to stimulate BPPV. Interestingly, when they undergo treatment for BPPV with the maneuver and the particles are suddenly gone they again feel odd. Some describe a sense of being off balance, or even lightheadedness. It seems as if they miss the particles after having become used to them. Again this feeling goes away after about 1-2 weeks and you return to normal. There is no need to continue repeating the treatment maneuver at this point unless you are still experiencing spinning vertigo.

This whole sequence of events can be prevented by rapidly undergoing treatment before your brain has had a chance to become accustomed to the presence of the particles in the ear canals.

As always it is important to consult your own physician about your specific symptoms, especially if they change or do not fit with your usual experience or expectations.

25 Responses

  1. Bonnie landfair

    I’m going through the same thing, however, my doctor
    ordered Vestibular Therapy to help with my balance issues. I start next week! I just feel horrible at times, like I’m on a boat, and fatigued. Can’t wait to feel normal again.

  2. Clearwater Clinical

    Post maneuver “off balance” feeling is common and does not mean the Epley did not work. If you have recurrent spinning then you might seek another maneuver. Home treatments like the DizzyFIX are alternatives. You might like to discuss with your own physician.

  3. jen

    Hoping for some insight. I awoke with spinning vertigo August 7th. I then experienced positional vertigo for the next month and a half. At that time I went to physic for the Epley maneuveur. During the maneuver I experienced strong spinning at the final stage. The problem is, since then (2 weeks ago now) I feel terrible. I have constant nausea, dizziness, and feel ‘woozy’. I feel as though I am completely out of sorts and sometimes have difficulty focusing in on things with my eyes because I my heads feel like it’s full of water and wavy. Does this mean the Epley was unsuccessful? This is worse than the positional spinning unfortunately. Thanks

  4. Bonnie Landfair

    I was cleaning in my bathroom and leaned up and hit my head on the left side front forhead.on the edge of my marble bathroom cabinet, wow it hurted for a minute ….a week later i had my first attack of Vertigo. Went to my ear dr. and he did the epiley maneuver, i felt much better, however i’m having some off balance and light headedness which my dr. said would go away after a couple of days. He gave me some exercises to do at home, can’t wait to get back to normal. By the way, he told me i hit my head a lot harder than I expected….called a light concussion!

  5. Clearwater Clinical

    Thanks for your comments.

    If you don’t feel well then don’t drive. Talk to your own doctor about your safety to drive. With that said,.. most people don’t get spinning dizziness with BPPV. Also it is quite normal to have a “weird” feeling after doing the Epley maneuver. See this blog link: Why am I still dizzy?

    If you need to do another maneuver you may find a home device helpful to ensure you get the maneuver correct.

  6. nicky

    I had epily manoeuvre done a few days ago and its been successfull although my eyes head feel very weird my question is is this safe too drive like this only I’m due too go back too work in a couple of days ?

  7. Clearwater Clinical

    Thanks for your comments. There is a great deal of discussion around post maneuver precautions but there is little evidence. The most recent guidelines do not suggest anything in particular except being safe (no ladders or roofing etc).

    We wrote a blog post here about the subject.

  8. Carole

    I had the eply done this morning by my ear doctor . I know I will feel off for a while after this maneuver .. my question is … how long do I need to stay “upright” ? Can I bend over to put on shoes .. in other words, should I just go about my Normal day things ? Thank you for any feedback you can give me in this matter 😉

  9. Clearwater Clinical

    Thanks for your qustions.

    Usually BPPV is associated with spinning but people describe this differently. Some people call it a wave, others light headed so it is difficult to rely entirely on the description.

    If you have BPPV then yes you should get and Epley maneuver or use a home treatment device ( which can help you do the approved maneuver.

    Stress makes all forms of vertigo worse but it does not cause vertigo.

    Yes – try to keep as active (and safe) as possible. Keeping active improves your vestibular function.

  10. Carol Hilliard

    I have only just started experiencing BPPV symtoms about 2 months ago – could it be an ear infection and not Bppv

  11. Luisa P


    I would like to know if it is possible to have positional vertigo without the spinning. My neurotologist sent me home with a sheet of the brant dorrof maneuver to do at home. I have been doing it for almost 2 weeks and I thought I was getting better since the dizziness went away and I only had the rocking sensation( when actually not moving) left but the last 3 days I have been feeling as dizzy as the fist day I got it 2 months ago, Plus the boat sensation like if I am in a bout. He never performed the EPLEY nor he mention it to me. Should I just go with a certify therapist to perform it on me? I wonder if instead I have vestibular migraines since the dizziness started during a stressful time of my life worrying about a breast lump that turned out to be benign? I come up with this thoughts because during this waiting stressful time I had some pressure on my forehead and some couldn’t sleep or relax much. I had hearing test that came back normal (does that exclude labyrinthitis or was it healing by the time I got the test which was a month after all this started?) I do have the herpes virus and I read that it can cause problems to the ears. I am trying to stay away from the Internet since I read that some people stay like this forever or for many years and I am doing my best to recover since I have a 2 year old and I wonderful husband to live a normal life for plus I have dreams of continuing my career and being as active as before, will it take physical therapy? I don’t know? I have a “lazy eye” as the doctor said but… Could this be making me dizzy by perceiving the images in the wrong way and sending the wrong signal to the brain? I have heard of people having to retrain their eyes and wearing prism glasses. Please I need to insight. Thank yoj

  12. Clearwater Clinical

    Possibly. The DizzyFIX works only for BPPV. You should get a diagnosis from your physician first. BPPV is characterized by spinning dizziness which comes on only in certain positions and lasts only for seconds.

  13. Clearwater Clinical

    Hard to say why so severe. Some people get conversion from posterior to horizontal canal BPPV which can be very severe vertigo indeed. Usually it is quite short lived and goes away spontaneously – so that could explain it, but it is very hard to comment without seeing your eyes during the treatment.

  14. Clearwater Clinical

    Sometimes the treatment can be as bad as the episodes (usually during active periods) however usually this is the last episode. Normally you don’t have any more spins after successful treatment. Success is 88% with DizzyFIX. Most people do feel a bit “wonky” for a while after.

  15. Alex

    I had Epley a few weeks ago by experienced therapist. I had very intense vertigo during procedure and couldn’t walk unaided immediately after. It was 24 hours before I could walk to the toilet at home. i had 2 spontaneous spins during that 24 hrs. A bit wonky for next few days. Is this unusual?.

  16. Alex

    I’m 69 and I’ve had BPPV for a long time and have had the Semont and Epley done successfully a number of times. 3 weeks ago, I went to my therapist with some vertigo symptoms and we identified the left ear as the problem. In the first and second positions of the Epley, I had the most intense and scary vertigo ever. We did it twice. But afterwards, I felt completely drunk and couldn’t walk unassisted. It took a full 24 hours before i could walk around the house. During that 24 hours I had 3 spontaneous ‘spins’ lasting about 10 seconds each. I have never had such severe after effects before from the Epley. My therapist said I had a LOT of particles which shifted. I feel OK now, just a bit of occasional unsteadiness. Why the severity?

  17. cathy

    I just had the Eply manuver done for a severe bout of BVP(I later found out that is what it was and that I have had less severe attacks in the past ,and that my brain has been compensating for this all along without me knowing what was wrong with me). After a couple of years of not feeling right (off balance,foggy and difficulty focusing my eyes when reading or watching TV), I finally feel normal again,except for the light headedness while sitting or lying down, which I am confident will resolve in a couple of weeks. The feeling of falling when I am sitting still or lying down can be managed by moving a lot.t I have read that after years of being out of balance, my brain is readjusting itself. I have heard this takes a couple of weeks. I am especially ecstatic that I can read again without squinting and feeling like my eyes were always so tired, I just could not keep them open. I think my brain was constantly adjusting to the imbalance in my ears and my eyes were constantly trying to adjust to the imbalance. Needless to say my eyes and head always felt exhausted. This problem has completely disappeared , my eyes are not squinty and fatigued anymore! This is nothing short of a miracle!

  18. gloria

    I am off balance and have to hold on to things to keep balance doctors said I had ear infectionand I’m a bit dizzy can this product work for me?

  19. Clearwater Clinical

    Thanks for the question. Yes you are right that post maneuver disequilibrium is quite common, meaning that aften after a maneuver you can feel “off”. This usually goes away. The best way to speed the process is to keep up with some activity (but be careful – as in don’t climb ladders).

    However, if you are experiencing unusal, new or severe symptoms then you should certainly seek the advise of your own physician. Sometimes you can have more than one cause of vertigo and sometimes following a maneuver you can get horizontal canal BPPV which is similar to regular BPPV but more intense and usually self limited (meaning you don’t need treatment) but is easily treated with a “log roll” maneuver.

    Given all the above, it is common to have symptoms of “off balance” following a BPPV treatment and usually it goes away – day by day.

    Good luck.

  20. Gene r

    Experiencing BVVP for 6weeks went yesterday and had treatment maneuver I was little dizzy right after but got better as day went on woke up this morning and now am very dizzy and “off” feel like I am walking on the deck of a ship. I read that is normal sometimes and should go in a week or two. Problem is I am non functional and don’t think I can wait a week. Should I alert my doctor or is she just going to tell me to wait also. Help!

  21. leisure

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    I’ll definitely digg it and personally recommend to my friends. I’m confident they will be benefited from this website.

  22. Clearwater Clinical

    No it is, in my opinion, not necessary. See this blog posting for details.

  23. Kristen Mayo

    Is it necessary to keep your head upright for 48 hours after an Epley maneuver? The PT that performed the procedure told me to not bend over, etc. for the day. Do I really need to sleep upright?

  24. Clearwater Clinical

    Hmm, that is a really tough question. BPPV can act in a variety of ways depending on the person and the situation. If you have BPPV usually you get spinning dizziness when moving in certain ways. Usually if you move quickly it is worse. When BPPV is going away you may just get some light sensations. The best way to get a diagnosis is to see an ENT specialist who can look in your eyes when they perform a special maneuver called the Dix-Hallpike Maneuver, they look for something called Nystagmus (click the link and watch the video to see what it looks like). You can usually determine which side you have BPPV by trying both sides and seeing which side makes you dizzy. As you indicate it is not always perfectly clear.

    Good luck.

  25. Dianne Trinder

    I have been experiencing BPPV symptoms for several weeks now. I purchased the dizzy fix to help but it does not seem to be helping much. Whenever I would do the procedure I really did not experience that much dizziness. I mostly feel light headed, nausea with some dizziness if I moved quickly. I have been using the dizzy fix now for almost 2 weeks now because I was not sure what side it was. Do I have BPPV?

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