Still Dizzy? Why Vertigo Won't Stop and Medically Approved Epley Maneuver Steps

If you're still dizzy days—or even weeks—after your first episode of vertigo, you're not alone. Many people are surprised when the spinning sensation doesn't go away quickly. The good news is that one of the most common causes of ongoing vertigo is Benign Paroxysmal Positional Vertigo (BPPV), and it can often be treated effectively with a simple technique called the Epley maneuver.

Let's break down why vertigo may not stop, when to take it seriously, and how the Epley maneuver works.

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Why Your Vertigo Won't Stop

Vertigo isn't a disease itself. It's a symptom. The spinning feeling usually comes from a problem in the inner ear or, less commonly, the brain.

The Most Common Cause: BPPV

BPPV happens when tiny calcium crystals (called otoconia) become dislodged and move into the wrong part of your inner ear. These crystals interfere with your balance system, sending false signals to your brain that make you feel like the room is spinning.

Common signs of BPPV:

• Brief episodes of spinning (usually less than 1 minute)
• Dizziness triggered by:
  • Rolling over in bed
  • Looking up
  • Bending down
• Nausea (sometimes)
• Feeling off-balance between episodes

BPPV does not cause:

• Ongoing severe headache
• Weakness on one side of the body
• Slurred speech
• Double vision
• Fainting

If you're experiencing those symptoms, seek urgent medical care immediately.

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Why BPPV Can Linger

Even though BPPV is considered "benign," it can persist for several reasons:

• The crystals have not moved back into place.
• The wrong ear is being treated.
• The maneuver was not done correctly.
• You have a different type of vertigo (such as vestibular neuritis or Ménière's disease).
• Rarely, there is a neurological cause.

BPPV can also recur. Some people experience repeat episodes months or years later.

If your symptoms sound familiar but you're not sure if it's actually BPPV causing your dizziness, you can take a free online assessment using this Benign Paroxysmal Positional Vertigo (BPPV) symptom checker to help guide your next steps.

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The Epley Maneuver: A Proven Treatment for BPPV

The Epley maneuver is a medically approved repositioning technique designed to move those misplaced calcium crystals back where they belong.

It is:

• Recommended by ear, nose, and throat specialists
• Backed by clinical research
• Often effective after one or a few attempts
• Non-invasive
• Medication-free

Studies show the Epley maneuver resolves symptoms in most people after one to three treatments.

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Before You Try the Epley Maneuver

Do not attempt the Epley maneuver without medical guidance if you have:

• Neck or spine problems
• Severe back issues
• Blood vessel problems
• Recent neck injury or surgery
• Uncontrolled heart disease

If you are unsure, speak to a doctor first.

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Step-by-Step: Medically Approved Epley Maneuver (Right Ear Example)

These instructions assume your right ear is affected. If your left ear is the problem, reverse the directions.

It's best to have someone with you the first time.

Step 1: Start Sitting Upright

• Sit on a bed.
• Turn your head 45 degrees to the right.
• Keep your eyes open.

Step 2: Lie Back Quickly

• Keeping your head turned, lie back so your shoulders are on the pillow.
• Your head should hang slightly backward.
• Wait 30–60 seconds.
• You may feel spinning. This is expected.

Step 3: Turn Head to the Opposite Side

• Without lifting your head, turn it 90 degrees to the left.
• Wait another 30–60 seconds.

Step 4: Roll Onto Your Side

• Turn your body onto your left side.
• Your nose should point toward the floor.
• Wait 30–60 seconds.

Step 5: Sit Back Up

• Slowly return to a seated position.
• Sit quietly for a few minutes.

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After the Epley Maneuver

Many doctors no longer require strict post-maneuver restrictions, but you may be advised to:

• Avoid lying flat for the rest of the day.
• Sleep slightly elevated the first night.
• Avoid sudden head movements.

You can repeat the Epley maneuver up to three times in a day if symptoms continue.

If vertigo persists after several days, consult a doctor.

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When the Epley Maneuver Doesn't Work

If your dizziness continues despite correctly performing the Epley maneuver, possible reasons include:

• The wrong canal is affected (posterior vs. horizontal canal BPPV).
• It's not BPPV.
• Crystals moved but returned.
• You need a different repositioning maneuver.

A healthcare provider can:

• Perform the Dix-Hallpike test to confirm diagnosis.
• Identify which ear is involved.
• Perform a supervised canalith repositioning procedure.
• Refer you for vestibular rehabilitation therapy.

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Other Causes of Persistent Vertigo

If it's not BPPV, possible causes include:

Vestibular Neuritis

• Viral inflammation of the balance nerve
• Sudden severe vertigo lasting days
• May take weeks to fully improve

Ménière's Disease

• Vertigo lasting 20 minutes to hours
• Ringing in the ears
• Hearing loss
• Ear fullness

Migraine-Associated Vertigo

• May occur with or without headache
• Light and sound sensitivity

Stroke (Rare but Serious)

Seek emergency care if vertigo occurs with:

• Sudden weakness
• Facial drooping
• Trouble speaking
• Severe headache
• Difficulty walking

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Why You Shouldn't Ignore Persistent Vertigo

While BPPV is common and treatable, ongoing vertigo increases the risk of:

• Falls
• Injuries
• Anxiety about movement
• Avoidance of daily activities

Getting the right diagnosis matters.

Before your doctor visit, it may help to use this free Benign Paroxysmal Positional Vertigo (BPPV) symptom checker to better understand your symptoms and prepare informed questions for your healthcare provider.

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When to Speak to a Doctor

You should speak to a doctor if:

• Vertigo lasts longer than a few weeks.
• The Epley maneuver does not improve symptoms.
• You have hearing loss.
• You have repeated episodes.
• You are unsure which ear is affected.
• You have risk factors for stroke (high blood pressure, diabetes, smoking).

Seek emergency care immediately if vertigo is accompanied by:

• Chest pain
• Severe headache
• Weakness or numbness
• Trouble speaking
• Loss of coordination

Even though most vertigo is not life-threatening, it's important not to ignore warning signs.

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The Bottom Line

If you're still dizzy, BPPV is one of the most likely causes—and the Epley maneuver is a proven, safe, and effective treatment when done correctly.

Most people experience significant relief after proper repositioning of the inner ear crystals. However, persistent or unusual symptoms deserve medical evaluation.

You don't have to live with spinning.

Start by understanding your symptoms, consider trying the Epley maneuver if appropriate, and speak to a doctor about anything that feels severe, unusual, or potentially serious. Your balance—and your safety—are worth it.