Benign Paroxysmal Positional Vertigo — BPPV — is the most common cause of vertigo, causing sudden and intense episodes of dizziness triggered by specific head movements. It can be a frightening and debilitating condition, but the good news is that it responds extremely well to treatment.
At Sloane Square Chiropractors in Chelsea, we are experienced in the assessment and treatment of BPPV using the Epley Manoeuvre — a highly effective, non-invasive technique that resolves symptoms in the majority of patients, often within just one to three sessions.
What Is BPPV?
BPPV occurs when tiny calcium carbonate crystals — known as otoconia or canaliths — become dislodged from their correct position in the inner ear and migrate into the semicircular canals. These canals are responsible for detecting rotational head movements. When the displaced crystals move within the canals, they send false signals to the brain, causing an intense sensation of spinning (vertigo).
Symptoms of BPPV
- Sudden, intense episodes of dizziness or spinning lasting seconds to minutes
- Symptoms triggered by specific head movements — rolling over in bed, looking up, bending forward
- Nausea, sometimes vomiting
- A feeling of unsteadiness between episodes
- Nystagmus (involuntary eye movements) during an episode
BPPV can affect any age group but is more common in those over 50. It can develop spontaneously, following a head injury or inner ear infection, or as a result of prolonged periods of inactivity.
The Epley Manoeuvre — How It Works
The Epley Manoeuvre is a series of four specific head and body positions performed in sequence. The manoeuvre uses gravity to guide the displaced crystals out of the semicircular canal and back to their correct location in the utricle, where they can no longer trigger vertigo.
The procedure takes approximately 10-15 minutes and is performed by your chiropractor at our Chelsea clinic. Most patients experience a brief intensification of dizziness during the manoeuvre — this is expected and confirms the crystals are moving. Symptoms typically resolve within 24-48 hours of treatment.
A 2014 Cochrane Review confirmed that the Epley Manoeuvre is a safe and highly effective treatment for posterior canal BPPV, with resolution rates of 80-90% after one to three treatments.
What to Expect at Your Appointment
- A detailed history of your symptoms including onset, triggers and duration
- The Dix-Hallpike test to confirm the diagnosis and identify the affected side and canal
- Administration of the Epley Manoeuvre
- Post-procedure advice on head positioning for the following 24-48 hours
- Follow-up plan — most patients require 1-3 treatments
Other Causes of Vertigo
Not all vertigo is caused by BPPV. Other causes include vestibular neuritis, labyrinthitis, Meniere’s disease and central causes such as cerebellar or brainstem lesions. A thorough clinical assessment allows us to differentiate BPPV from other causes of dizziness and refer appropriately where needed.
Why Choose Sloane Square Chiropractors?
- Over 50 years of combined clinical experience
- GCC-registered chiropractors
- Dominic Cheetham is an elected Examiner for the General Chiropractic Council
- Established in Chelsea since 2001
- Close working relationships with London’s leading medical specialists and consultants
- GP and consultant referrals welcomed — no referral required to self-refer
- Recognised by BUPA, AXA Health, Vitality, Aviva, WPA and Cigna
- Thorough, unhurried consultations
- 9a Wilbraham Place, Chelsea — minutes from Sloane Square tube
Health Insurance
We are recognised by all major UK health insurers. Please contact your insurer before your first appointment to confirm cover and obtain any required authorisation code.
- BUPA · AXA Health · Vitality · Aviva · WPA · Cigna
Frequently Asked Questions — BPPV & Vertigo
How quickly does the Epley Manoeuvre work?
Many patients experience significant improvement immediately after the first treatment or within 24-48 hours. A Cochrane Review found resolution rates of 80-90% after one to three treatments. Some patients require a further session if the crystals have not fully repositioned.
Is BPPV dangerous?
BPPV itself is not dangerous, but the dizziness it causes can increase the risk of falls — particularly in older patients. It is important to seek treatment promptly. If your symptoms include hearing loss, tinnitus, severe headache or neurological symptoms such as double vision or speech difficulty, you should seek urgent medical assessment as these may indicate a more serious cause of vertigo.
Can BPPV come back?
Yes — BPPV has a recurrence rate of approximately 30% in the first year. If symptoms return, further treatment with the Epley Manoeuvre is equally effective. We can also teach you a home version of the manoeuvre (the Brandt-Daroff exercises) for self-management if symptoms recur.
Book Your BPPV Consultation
Call 020 7730 3031 | 9a Wilbraham Place, Chelsea, London SW1X 9AE