If you have ever experienced vertigo, you will know just how unsettling it can be. One minute you are rolling over in bed, looking up at a shelf or bending down to pick something up, and suddenly it feels like the room is spinning.

For many people, this type of vertigo is caused by a common condition called Benign Paroxysmal Positional Vertigo, or BPPV. Despite the long name, BPPV is usually quite straightforward to treat. One of the most commonly used treatments is called the Epley manoeuvre.

If your audiologist, physiotherapist, vestibular therapist or doctor has recommended an Epley manoeuvre, you might be wondering what actually happens and, more importantly, what it feels like.

What is the Epley manoeuvre?

The Epley manoeuvre is a series of carefully guided head and body movements to treat BPPV. The aim of the Epley manoeuvre is to use gravity and a series of specific head positions to guide the loose crystals out of the affected balance canal and back to where they are less likely to cause problems.

What happens during the manoeuvre?

The Epley manoeuvre is usually performed by a trained healthcare professional after they have assessed your symptoms and identified which ear and balance canal are involved.

You will generally start sitting upright on an examination bed.

Your clinician will then turn your head to one side and help you lie back into a position that may trigger your vertigo. You may be supported throughout the movement, and your head may be positioned slightly backwards.

You will normally stay in each position for a short period before being carefully moved into the next position.

The exact sequence can vary depending on which ear is affected and the particular type of BPPV you have. In some cases, the clinician may repeat the manoeuvre more than once.

Although the treatment itself can be quite quick, your clinician will explain what is happening as they go and make sure you feel safe and supported.

So, what does the Epley manoeuvre feel like?

The honest answer is that it can feel a little strange.

Because the manoeuvre involves moving your head into positions that may trigger your BPPV, it is common to experience a short burst of vertigo during the treatment. The spinning sensation can be intense, but it usually lasts only a short time.

Some people feel nauseous during the manoeuvre, particularly if their vertigo has been strong. Others may feel sweaty, unsteady or slightly anxious while waiting for the spinning to settle.

Your clinician will usually pause in each position to allow the vertigo and eye movements to settle before moving on.

What might you feel afterwards?

After the Epley manoeuvre, some people feel almost immediate relief. They may notice that rolling over in bed, looking up or getting out of bed no longer causes the room to spin.

For others, improvement may take a little longer.

It is also quite common to feel slightly “off”, light-headed or unsteady for the rest of the day. This does not always mean the treatment has failed. Your balance system may simply need a little time to settle after the vertigo.

Some people need the manoeuvre repeated during the same appointment or at a follow-up visit. BPPV can also occasionally return in the future, even after successful treatment.

Is the Epley manoeuvre uncomfortable?

For most people, the Epley manoeuvre is not painful.

The main discomfort usually comes from the temporary sensation of spinning or nausea. The head and body movements themselves should be gentle and controlled.

If you have neck, back, shoulder or other mobility problems, it is important to tell your clinician before the manoeuvre begins. The positions may need to be modified to make the procedure safer and more comfortable.

You should also let your clinician know if you feel extremely unwell, anxious or unable to tolerate a particular position.

Should you try the Epley manoeuvre at home?

You may find plenty of videos and instructions online showing how to perform the Epley manoeuvre yourself. However, it is usually best to first have your vertigo properly assessed.

Not all dizziness or vertigo is caused by BPPV, and even when BPPV is the cause, the correct manoeuvre depends on which ear and balance canal are affected.

Using the wrong treatment may simply be ineffective, and in some situations it could make you feel more dizzy.

An audiologist or other trained vestibular clinician can assess your symptoms, perform positional testing and determine whether the Epley manoeuvre is appropriate for you.