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Dizziness (Including Vertigo)

The most common cause of vertigo, known as benign paroxysmal positional vertigo, usually can be treated with one visit to your chiropractor. Because the problem is caused by loose crystal particles floating in the inner ear canal, DC’s usually manoeuvre the head and upper body so that the particles fall out. Sometimes, however, the vertigo persists or recurs, and repeated treatments become necessary.

"It is important to stress that a cervical factor may be present in all forms of vertigo and dizziness... in no field is manipulation more effective than in the treatment of disturbances in equilibrium". Karl Lewit, MD, Neurologist. Read The Chiropractic Report on Vertigo in its entirety here.

HOME EPLEY MANEUVER - Caution: Refrain from this exercise if you have a current neck problem as it may cause further aggravation.

The Epley and/or Semont maneuvers as described above can be done at home (Radke et al, 1999; Furman and Hain, 2004). The exercise was developed by Portland, Oregon physician John Epley. We often recommend the home-Epley to our patients who have a clear diagnosis. This procedure seems to be even more effective than the in-office procedure, perhaps because it is repeated every night for a week.

Similar video instructions to the above diagram may be found here.

The procedure shown above is for the left ear. One stays in each of the supine (lying down) positions for 30 seconds, and in the sitting upright position (top) for 1 minute. Thus, once cycle takes 2 1/2 minutes. Typically 3 cycles are performed just prior to going to sleep. It is best to do them at night rather than in the morning or midday, as if one becomes dizzy following the exercises, then it can resolve while one is sleeping. The mirror image of this procedure is used for the right ear.

There are several problems with the "do it yourself" method. If the diagnosis of BPPV has not been confirmed, one may be attempting to treat another condition (such as a brain tumor or stroke) with positional exercises -- this is unlikely to be successful and may delay proper treatment. A second problem is that the home-Epley requires knowledge of the "bad" side. Sometimes this can be tricky to establish. Complications such as conversion to another canal (see below) can occur during the Epley maneuver, which are better handled in a doctor's office than at home. Finally, occasionally during the Epley maneuver neurological symptoms are provoked due to compression of the vertebral arteries. In our opinion, it is safer to have the first Epley performed in a doctors office where appropriate action can be taken in this eventuality.

Patients who can treat themselves feel more confident if it recurs “because they have learned how to manage their vertigo independently,” says principal researcher Dr. Andrea Radtke, a neurologist at Charite Campus Verchow Clinic in Berlin.

The study, published in the journal Neurology, involved 70 people, all of whom were about 60 years old. (Vertigo occurs nearly twice as often in women and in people older than 50.)

The group was split in half, with each group performing one of two treatments. Both techniques took less than two minutes and involved head and neck movements while sitting on a bed. Patients performed the movements three times a day until the vertigo stopped for at least 24 hours.

After one week, 95 per cent of people who did the “modified Epley” procedure had no more symptoms.

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