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.

91 Responses

  1. Joe

    I had the vertigo feeling for almost 4 months until I decided to go see the ENT. I have been diagnosed with BPPV but feeling better now after performing the exercise recommended by my physio. However, I still feel lightheaded now, eyes get tired easily and sometime feel tension around my eyes. Is it normal?

  2. The Virtigo Fix

    I would like to share my experience with everyone so they can beat this horrendous feeling today.

    I’m currently at the end of my vertigo, self-diagnosed myself and performing many maneuvers, not just the Epley maneuver. What a lot of doctors and folks don’t tell you is, there’s two different BPPV Canal’s. One is the Semi circle canal, and the other is a horizontal canal. The Otoconia Crystal can be in either one of these canals. If the Crystal does not leave the horizontal or the semicircle canal, you will experience vertigo,nausea,dizziness and possibly vomiting and it most likely will never go away.

    The calcium carbonate crystal does not dissolve in the Semi circle canal, the only way it dissolves is if you rerouted it to the Utricle where there is what’s called “Dark Cells”, these dark cells dissolve the Otoconia Crystal. There’s another theory that the crystal can retach itself in the Utricle.

    Having said all of that, many maneuvers are explained and shown incorrectly.

    The Epley maneuver for instance, the correct way is to start out with your head turned at a 45 degree angle and chin tuck towards your sternum, then very quickly go to the side the back of your head is facing. For your “right” ear, you would turn your head left 45 and lie down to your right. Then you will keep your chin tucked to your sternum for no less the 60sec, I prefer 3 minutes or until the dizziness completely stops, Then “very very” quickly go up and left to the other side with your nose facing down in the bed or floor at a 45 degree angle with your chin tucked. Wait 60 seconds to 3 minutes, then come back up right with your chin still tucked and then you can relax and straighten your head out. If you do not do this within one second by saying one Mississippi and your nose is touching tge other side, the Otoconia Crystal will start to go back where it came from.

    I learned this the hard way with feeling even worse after performing the Epley maneuver. What you do not want to do is three steps where you go down to your right, come up in the middle stop, and then go to your left, That will NOT work like they tell you, many doctors have said to do it this way and it is incorrect!

    If I can leave you with anything, it would be to perform each maneuver very quickly, do not take your time or the crystal will start to go backwards. You almost have to make yourself dizzy at the rate of speed you go. A prime example would be a cup sitting on a table underneath a paper towel, if you pull the paper towel slowly, the cup will move and fall over, but if you pull it quickly, the cup remains stationary. You want the crystal to remain stationary until you get to the other side of the maneuver. Basically the crystal gets to the top of the rainbow with step 1 of laying down at a 45 and then when you get all the way up over to the left side it starts to come down the other side of the rainbow. If you do this too slow, it will start to go back down where it came from. Which you already know is nausea,dizziness,vomiting ect.

    I’m going to leave you with each maneuver and explain what they do.

    When doing these maneuvers, whichever side your eye is twitching, that is the inner ear side the crystal is on.

    *Maintain each position 3mins, or until the spinning/dizziness stops.


    1) Deep Head Hanging

    2) Half Somersault Maneuver

    3) Epley maneuver (Sideways one)

    4) Epley maneuver (Lying on back)

    5) Semont maneuver (liberatory” maneuver)

    6) Lempert BBQ Maneuver

    Horizontal Kanaal BPPD Maneuvers

    1) Gufoni Maneuver

    Vorg Exercise

    This is an exercise that aligns your eyes where you put a index card in front of you or your hand and you turn your head side-to-side with your eyes focused on your hand or the index card, you do this for 30 seconds.

    This maneuver helps you cope and recover after the Maneuvers have been completed.

  3. Norton Leger

    Has anyone tried the VOR Exercises ??

    Sounds like this might work

  4. Zeke

    Has anyone tried the VOR Exercises ??

    Sounds like this might work

  5. Sheens

    Hi, i had vertigo for the first time 27 years ago. I got it in the middle of the night, thought I was having a stroke. Didn’t get it again until 2013 but it was only when i lay in bed for a couple of seconds. I had this for 6 monthd. Last December i woke up feeling strange, turned over in bed, got violently sick and room spinning. This was a mugraine vertigo. In July this year I turned in bed and room spinning, had it for 8 days then just lightheaded. On Tuesday 23rd October I got intense spinning again. Have had it for 8 days. Spinning has stopped but feel quite dizzy sometimes (no spinning just lightheaded) i take Serc 16 tabs 3 times daily. They take ages to work but i dont think I could do any head maneuvres in case I got so dizxy.

  6. Liz W

    I had my first BPPV attack in May 2017, like everyone just woke up in bed turned over and wham! Nurse practitioner gave me stemetil even though I fortunately had no nausea but I felt very ‘off’. Tried Epley myself a couple of times while waiting for ENT appointment and gradually it settled. I was though horrible in supermarkets, corridors and busy crowds and that was new along with the residual lightheaded feeling. Didn’t get ENT appt until October 2017 when they started me on rehab exercises which really helped.

    I was doing ok until a bad head cold over Christmas brought on a more minor attack which the audiologist did Epley for and continued with rehab progression exercises. Most of t his year it’s not been bad although residual feelings of being a bit spacey or just feeling off balance would come and go especially when I was stressed. I’ve been told stress does make it feel worse and also I’m apparently very visually dependent so it affects me more.

    Had a check up last Friday and all fine – didn’t even get my eyes opened on Sunday morning and I could feel it strongly. No idea why it came back other than stress and also my ears have been feeling quite full and I’ve got a bit of a blocked nose. So back for Epley yesterday and it was probably the first time they’ve seen me in such an acute phase. Felt great afterwards but this morning work with headache and sore neck (from sleeping half upright I think) and the residual dizziness is there when I turn my head. Too early to try sleeping on my right side and I’m terrified of provoking it again.

    They suggested I might need an MRI as I’ve had 2-3 episodes over the last 18 months but I see a lot of people getting fairly frequent recurrence. It’s horrible and really knocks your confidence too.

  7. Dave

    Has anyone tried medicinal marijuana? I am going on 5 months of we all called “just not right” I have good days and bad days, but the bad days are really bad. Quality of life is not good and I wonder if weed would help….

  8. Margaret Clare

    I’ve still got residual dizziness eight months now after the Epley manouevres. I wonder if it will ever go away. Some days are better than others [as many say]. It’s depressing when you get a few good days and start to hope this is it fading, but then wham and you have a rotten day. I’ve found atmospheric pressure doesn’t help – so very humid days make it worse.
    You have to power your way through this – I found doing stuff, even though you think it won’t, was much better than sitting doing not much, which made it awful. I’m mad about my garden and nothing was going to stop me planting up stuff, so I did and found that I could do a lot of things in that scenario that would have been more worrying indoors. I have had tinnitus since 2013 and have learned to ignore that [although of course, here it comes now I’ve typed that … :¬) lol]. You have to try and think ‘I’m going to live my life despite this – it is not true vertigo – you won’t fall over – it’s just the feeling, so keep yourself safe and get on with things. Don’t LET it overcome you. I know this is a hard call, but what else can you do really? My consultant said it would ‘just go away and suddenly I’d realise it wasn’t there’ hmm …. I think my anxiety is so locked into it, I don’t know if that’s going to happen, that’s why I’m just pressing on. Good luck everyone!

  9. Felicia Pillitteri

    I’ve had the Epley done twice. Still feel dizzy with extreme nauseousness when i move. I believe if I don’t move my neck I am happier. I have stated that i have a lot of pressure in my head. Is there anyone who can shed some light

  10. Felicia Pillitteri

    Ive had Epley done twice. Still feel dizzy and extreme nauseousness when i move i brlieve if i dont move my neck i am happier

  11. Elena

    Hi everyone, what a horrible condition bppv is! I’ve had my third episode 2.5 weeks ago. The first one was a year and a half ago. Each time it happened when I rolled over in bed to my right side, though audiologist at the ENTs office claims that my left ear is affected. Not sure what that is about. The first time, it only lasted about an hour, the second time it was about 24 hours with residual wobbly/standing on the rocking boat feeling for another 24hours. This time, I am still terrified to lie on my right side from the fear of provoking it. I have been sleeping on my back for over 2 weeks. I have never had Epley and refused it this time after merely Dix Hallpike testing horrified me as it provoked the spinning. I had a horrible migraine pain yesterday (2 weeks after the acute vertigo attack) and vomitted 4 times. My stomach feels a bit better today and I don’t have the migraine pain, but the wobbles are still here. It’s horrifying and so depressing to deal with this especially because I have a young family to look after (2.5 and a 4 year old), not to mention the strain that it puts on my husband. I am wondering how likely is this to get worse with time and if there is any hope for those of us who simply can not go through Epley or any maneuver which would provoke the spinning. I feel so hopeless and helpless, and holding on only for my children.

  12. Patsy

    I started getting BPPV 2 days ago- feeling nauseous and horrible head spins anytime I moved my head a certain way. Eventually I realised it only happened if I turned my head to the right- so my right ear was wrong not my left. I looked up the manoeuvre and asked my man to help me do it and it’s all gone now. Instant relief!

    It’s brave to attempt the manoeuvre because it causes a huge head spin- instead of moving your head to make the spinning stop you must grit your teeth and bare it. (Also I held each position for 1 minute to make sure the small crystals didn’t go back the wrong way etc)
    I found I knew it was working because even when I turned my head the other way into the second position, the spinning was lesser but still there. Eventually it stopped completely and even though I still feel a bit nauseous and off balance it’s all gone. I sat upright for about 15 minutes and then tried it again- I got dizzy but didn’t have a head spin, so I knew it had worked.

    It will take a long time for my brain to adjust I think because even though I was spinning for 2 days my brain would have gotten used to the sensation. So even though I feel fine I keep swerving and banging into things (like I’ve woken up from a big night out and I’m still drunk haha)

    Sites like this really helped me understand what to expect and gave me hope that I could make it all go away, which is why I’m sharing what I did

    Hope someone finds this useful, I can’t imagine having to live like that- it’s impossible to do anything!

  13. Inam

    Bvvp started two weeks ago the dizziness not lasting beyond half a minute. Not much bother except the fear of falling and injuring oneself. Yesterday an ENT did the Epley manoeuvre on me causing instant relief. However,the next morning,the dizziness reappeared along with nausea which was not present earlier. A stemetil tablet has stabilised me somewhat but the fear of a recurrence bothers me once the effects of the tablet wears off.

  14. Charlotte

    This is my third time having a vertigo attack and it has been the worst so far. This one happened after having a deep tissue massage. I got off the table and everything started spinning. I ran to the bathroom and power puked all over their bathroom…oops. That was a week ago. I tried the Epley maneuver a few times in the past week and seem to be better except for now I feel “off” as some of you have described on here. It’s like my brain needs to catch up with what I’m seeing…it’s hard to describe but kind of like I’m in the first stages of being drunk? I just want it to go away so I can get back to my life. Thank you all for sharing…makes me feel like I’m not alone in my misery.

  15. Adriene DeVita

    Can you fly after Epley manuver? My doctor said to wait 2 weeks, but have booked flight over a month ago. Anyone try to fly three days after Epley?

  16. eileen

    I was treated 29 years ago (3 months pregnant)when i first experienced the vertigo..They had no real name for it and the Dr. told me it was all experimental…the treatments. He did the flinging you to one side..then the other..but told me to sleep sitting up for 4 nights. Very difficult but I swear by this after any treatment.! I had no issues for years then in March 2018 started up again. Had Epley and felt greatbut now..again in we go again…Did my own Epley at home..made it 10 times worse.but slept sitting up…feeling better but not perfect after one night. Maybe this might help someone?

  17. Chelsea

    Hello! Thank you, everyone, for sharing your experiences with BPPV. They’ve really helped me put things into perspective because this condition is so terrifying!

    I want to include my experience with BPPV for reference to others as well. I had my first bout on July 7, 2018; I woke up at 4 am and turned my head towards my husband and suddenly everything was spinning uncontrollably and had to vomit. I stumbled to the bathroom, in total fear, and didn’t have the confident that I would make it there at all. After that, I tried turning my head again and the spinning came back. I was so scared so I went to the ER. The doctors did the Epley and the spinning would happen again and I needed to vomit so I don’t think it was successful. I didn’t move my head much after that, but I could feel that turning my head left or right would trigger the spinning sensation again. I went to two ENT doctors, the first one didn’t do much for me except give me anti-dizziness medicine and said I need to wait it out. The second one took video recordings of my eye movements and said I had horizontal BPPV because the spinning occurred when I moved my head both sides. The nurses there taught me to do the BBQ roll and that made me feel much better.

    But now I believe I have residual dizziness, and it’s really bad when I’m sitting still or laying down flat and looking straight up. I constantly feel like I’m on a boat or a ride at the amusement park (which I don’t think I’ll ever go on anymore…) Going to work has been difficult as I can’t concentrate at all in meetings or at my desk when I’m sitting down and not moving. I’m hoping it’ll go away soon but it makes me feel completely helpless.

    It’s horrible living like this. I hope everyone with it feels better soon!

  18. barbara latulippe

    It feels sad that alot of doctors prescribe the anxiety meds, but it sometimes almost feels like a stroke and my bloodpressure shoots thru the roof. The one thing that has been a godsent to me is the Omnimax
    Took me 3 visits but very precise and it kept my vertigo at bay until my new ENT did the epley manouver and brought it all back on. He is also advocating these are not ear related by vestibular migrane. It’s terrible living like this.

  19. Bianca

    Almost 7 years ago i when i go this type of vertigo for the first time. I had no idea what was going on and it scared me. I went to the hospital and they gave me morphine which didn’t help at all. The after effects last almost two weeks. I did go to PT and had the epley maneuver done to me but nothing happened so i did not go again. Like i said that was 7 year ago and until a few weeks ago i would randomly turned my head while laying down and get dizzy. It would only last for a few seconds but i would be left with a headache and feeling “off” for a few days. Just had the epley maneuver done twice this week and only got a little dizzy and was able to drive myself home after a few minutes. The last time i went was yesterday, and i was ok to drive afterwards, but later last night i laid on my back and had my head turned the wrong way and got dizzy which lasted a few minutes. Today i dont feel dizzy at all just “off” and a headache. My doctor wants me to keep doing the epley maneuver once a week, but not sure for how long.

  20. Audrey

    Got vertigo end Feb. Had epley on april 20 and april 27 – got severely dizzy and nauseated from epley right away and still have that. ENT now blaming it on anxiety – yes I am anxious, afriad to lie flat and turn in bed so sleep on a few pillow and won’t let myself turn in bed. But am dizzy all the time when before epley I wasn’t. I am getting scared. Any advice?

  21. Nick

    I looked down and then it happened. Bam! The world was moving back and forth and up and down but I was standing still. I did all I could to get to a chair that was a few feet in front of me. I started vomiting uncontrollably . Someone called the ambulance. Blood pressure was through the roof. Took every test possible . Nothing. 3 hours later I felt well enough to be discharged . I did Epley the next day. It’s almost 6 weeks later and I’m not the same person. Dizzy all the time. Some days better some days worse. Ear ringing all the time. It’s bad. It sucks and there’s not a damn thing anyone can do about it. When I get older if it still is happening I may elect labrynth removal surgery even if I lose hearing in that ear. Very sad indeed .

  22. Perry

    I’m reporting back to say that the dizziness is completely gone today, Wednesday morning – so about 2.5 days after Epley manuever. Pretty amazing actually . . .

  23. Ramona

    I have had bouts with Vertigo for over 24 years. I prefer the Brandt-Daroff Exercises. The last time I had such severe spinning I was reassured that it would go away with these exercises. They did but I was still extremely dizzy even after the spinning stopped. I went so far as to see a neurologist and was told to keep doing the exercises. It took time but it went away. I have had episodes of vertigo that were not as severe. I had one starting on 5-18-2018. It came on suddenly and I was nauseous and it was miserable. But I started the Brandt-Daroff and by the evening was feeling so much better.

  24. Perry

    I’ve had the vertigo thang about a week and a half ago. I read where it can come from stress and anxiety, which makes sense as I was working on a difficult project away from home. Just tried Epley last night and it seems to have gone away this morning. But like others, I just feel a little off with my balance. Not a huge deal, don’t think I’ll fall down or anything, but like I maybe had a couple beers or something balance-wise. I tried some of my typical balance exercises and I couldn’t stand on one foot very long. I will continue to do these exercises several times a day to retrain my brain and see if I get better. I’ll report back.

  25. Brian

    Like many of you…. I allowed stones to get used to being in my ear for a while. Although, I should have sought professional medical treatment sooner, I didn’t. After receiving the Epily maneuver yesterday morning, I am left with what most of you say is, like being on a boat with severe unsteadiness. I was ashored that it usually subsided within a few days, if not within 2 weeks on its own. It all depends on how much you choose to move your head around. I was warned that within the first 24-48 hours, don’t be tempted to move excessively. You can redeposit the stones back in areas of the ear these stones have no place being, and be right back where you started.

  26. Pamela

    Glad to read all these comments on this vertigo. I went to a Neurologist who suggested therapy, which I did. That didn’t work. It’s going on almost an entire year now. Well, it will be in July. It happened in July 2017. The therapy was awful. It brought on the dizziness. Talking about a spinning room and feeling like I would fall off their table. I did this 3 times and could no longer take it. I asked the Neurologist if it would go back on its own…she said yes. But today, it is pretty much the same. Some days are worst than others.

  27. Millie

    Hello so I’ve been suffering really bad with vertigo to the point I can’t do anything with my life, I did the epley maneuver yesterday and feel quite dizzy today a very unsteady dizziness is this normal?

  28. victoria budden

    I had the Epley maneuver done in July 2016 after suffering 6 weeks of horrendous dizziness, but I still find it uncomfortable to lay in bed sometimes and am caught occasionally when out and about. It seems to have left me with a residual dizziness that has stayed with me, but is manageable.

  29. Jess

    Had an attack of vertigo after rolling over in bed one night. Went to see my GP who diagnosed BPPV. She said it would burn itself out. It took two weeks to recover but every now and then I will feel dizzy, unsteady, like I’m on a ship. It’s so horrible….. never been the same since. It gets particularly bad when I’m tired. Wishing you all relief.

  30. dean

    hi ive had this problem myself had it for about 2 months now not to the extent of some people but it couldnt come at a worse time. my partner has a slipped disc in her back and is bed bound, plus I have to hand in my final work for uni which means i have to sit at my desk all day on my pc. doesnt sound bad sitting but even then i feel dizzy. after 2 months of waiting i finally had the vertigo reset at my doctors yesterday which seemed to help when i left the doctors but after about 15 minutes of walking the syptoms came back. i felt abit better when i got in the house, took the doctors advice of using 4 to 5 pillows to sleep with under my head but woke up about 4am this morning feeling very sick. this morning i work up about 9am and i feel more dizzy than i have over the last 2 months…not sure what is going on.

  31. Greg Pohlmann

    I’m a first timer having vertigo which started about a week ago. I just had the epley maneuver this past Wednesday. Going back to therapist this coming Monday to see if I am clear of dizziness. Treatment has helped along with using a neck brace to keep my head upright and still after epley. I also feel light headed and not with normal balance. Glad to know these symptoms are often normal after having the epley maneuver. Would not wish this condition on anyone. Being a senior golfer, I now have a greater appreciation of what Jason Day went through having this problem on the course while playing on the PGA tour. Ugh!

  32. Cindy

    So reassuring to read some of your comments. I got vertigo two weeks ago – out of nowhere. Saw ENT, had a wax build up I was not aware of and he started me on Epley. After 5 days of that the BPPV went away but now I have what seems like “residual” lightheadedness and just feeling off. Balance now has become an issue as well. I’ve been so scared something worse is happening but after reading here apparently this is what happens. Just want my life back and the “off/lighthead” feeling to go away and regain balance. Good luck to all of you – it is horrible. Having kids was much easier to cope with that this!!!!

  33. Mary

    I have had two episodes of vertigo, the worst feeling ever. It has taken me many months after the initial spinning (which occurred by turning my head in bed). I feel “off” and hate this feeling. Epley helps but still have an unsettled feeling. Definitely the most miserable thing. Can’t exercise at the gym or take classes bc of fear it will come back. Ugh.

  34. Janet Thorup

    I too had an onset of Vertigo for the first time last week, I was petrified! I was sick to my stomach and could not stand. I went to E.R. they gave me pills to take home and assured me it was Vertigo. 5 days later I had another postcode. I did the half somersault maneuver and it helped so much. I am still experiencing light headiness and feeling scared to go out just in case it happens again. I did go to an ear nose and throat specialist and he concurred that it was vertigo and that my ears looked fine. I never knew how terrifying vertigo was, but I certainly have a new found compassion for people that suffer with this condition.

  35. Rebecca

    Hi I’ve bin suffering with this vertigo & dizziness and feeling off balance since January 2016 I’ve bin through a lot had a grommet in my left here symptoms went for a month then came back. Had a balance test they said my particles were out of place in left ear and I have poor eye tracking I’ve had the Epley Maneuver done Several times and it does help but I’m still not right I just feel like I’m going to fall over and the floor feels like it’s moving I do get ear ache too it’s bin over 2 years of this and it’s ruining my life I can’t work anymore because of it as I was a cleaner and hoovering triggered it off worse. I struggle going in shops as makes me feel worse I have to walk straight back out I went to have another Epley Maneuver done Monday and he said my left eye was twitching still so having this treatment done every month why isn’t my particles going back right I don’t understand.

  36. Rebecca C

    On 2/15/18 I experienced a rapid onset, severe vertigo attack. I couldn’t stop vomiting and 911 was called. I stayed hospitalized for several days during which time the Epley maneuver was done several times. It finally worked and the spinning stopped on day 4. It is now 2/27/18 and I am still lightheaded, dizzy, and off balance. I’m grateful to learn that this is just residual effects of the crystals moving but I can’t wait for it to be over.

  37. Susan

    I had 2 very short duration vertigo incidents 5 weeks ago and still feel off. It’s hard to describe because it’s not quite dizzy, but kind of lightheaded and buzzy. Almost like a caffeine buzz or when your blood sugar is dropping. Sometimes sudden movements intensifies it. It sounds like it’s not unusual, but the duration is bothersome.

  38. Flores

    I have had vertigo for about a week and bed spinning nauseous father went to the doctor and compactor corrector helps so much, but I still feel light headedness. When does it go away? The spinning is done. The dizziness is gone. I just feel light. Headed still.

  39. Gail Goldberg

    I have been suffering with the after effects of a vertigo episode almost 5 months ago! I have gone to Urgent Care, seen my Primary Care Physician, seen a neurologist and an ENT, who prescribed vestibular therapy. I am only slightly better. I now have an appointment to see an ear specialist at the House Clinic that specializes in ear problems…I pray they can help me.

  40. Dino

    Hi Chiratla, I had a vertigo also and had the Epley maneuver. It’s been 4 days now yet I’m still dizzy and light headed but the vertigo is gone. This is my 3rd episode within the past 10 years. The residual dizziness usually goes away after a few weeks. However, residual dizziness on my first episode lasted longer but the second took about 3 weeks.

  41. chiratla

    Hi Ann,

    Am also in the same boat as you were. Got a vertigo attack on Dec 26th and after 3 days i did the Epley. It stopped immediately. But the residual dizziness is still bothering me.

    Are you able to get back to normal now? From what i read online i heard that after 2-3 weeks you should be able to get rid of the residual dizziness as well. However am still feeling off balanced.

    Can someone suggest on this please?

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