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Vertigo (BPPV) Post Treatment Instructions

Post-Treatment Instructions for Patients After
In-Office Epley or Semont Maneuvers

After either of these maneuvers, you should be prepared to follow the instructions below, which are aimed at reducing the chance that debris might fall back into the sensitive back part of the ear.

  1. Wait for 10 minutes after the maneuver is performed before going home. This is to avoid "quick spins", or brief bursts of vertigo as debris repositions itself immediately after the maneuver. Don't drive yourself home.
  2. Sleep semi-recumbent for one night. This means sleep with your head halfway between being flat and upright (a 45 degree angle). This is most easily done by using a recliner chair or by using pillows arranged on a couch.
  3. During the day, try to keep your head vertical. You must not go to the hairdresser or dentist, or engage in exercise that requires head movement. When men shave under their chins, they should bend their bodies forward in order to keep their head vertical. If eye drops are required, try to put them in without tilting the head back. Shampoo only under the shower.
  4. For at least one week, avoid provoking head positions that might bring BPPV on again:
    • Use two pillows when you sleep
    • Avoid sleeping on the "bad" side
    • Don't turn your head far up or far down

  5. Be careful to avoid the head-extended position, in which you are lying on your back, especially with your head turned toward the affected side. This means that you should be cautious at the beauty parlor, dentist's office, and while undergoing minor surgery. Try to stay as upright as possible. Exercises for low-back pain should be stopped for one week. No sit-ups should be done for at least one week and no "crawl" swimming (Breast stroke is permitted). Also avoid far head-forward positions that might occur in certain exercises (for example, touching the toes).

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