Repositioning Maneuvers

Benign Paroxysmal Positional Vertigo (BPPV) is one of the leading causes of vertigo among U.S. patients; repositioning maneuvers fortunately make the condition very easy to treat in most people. Repositioning maneuvers take only five to ten minutes and successfully treat BPPV in 85 percent of patients in just a few treatments.


BPPV occurs when tiny particles of calcium (canaliths) detach from the otolithic membrane in the inner ear’s utricle and move into the fluid-filled semicircular canals. When patients’ head movements cause these particles to shift, it results in symptoms like dizziness.

When a balance specialist begins a treatment plan for a patient, repositioning maneuvers are typically the first step in providing relief from vertigo. These medically developed exercises extract the canaliths from the fluid in your semicircular canals and move them back into the utricle, where they re-adhere to the otolithic membrane.

Types of Repositioning Maneuvers

Balance specialists use a few types of repositioning movements to treat patients with BPPV. Each uses slightly different movements and angles to move the calcium deposits from your inner ear canals. Known repositioning maneuvers include:

  • Canalith Repositioning Procedure (CRP) or Epley maneuver
  • Semont-Liberatory maneuver
  • Half somersault maneuver or Foster maneuver

After your BPPV diagnosis, your physician or balance specialist will work with you to develop a treatment plan. The repositioning maneuvers that your physician recommends will depend of individual case of BPPV.

While there are many videos available online that show the patterns and head movements of some of these maneuvers, it is important not to self-treat. Especially not before you’ve discussed a treatment plan with your doctor. These videos assume problems originate from one canal, but it will make matters worse if that is not the case. Treatment is most effective when done with the guidance of a professional.

Your doctor will give you clear instructions and help you learn and understand the techniques of your repositioning maneuvers. Some patients need the help of a balance doctor to perform their repositioning maneuvers each time, while other patients who feel comfortable with the process can usually perform the procedures at home.