The Epley manoeuvre is a highly effective treatment for Benign Paroxysmal Positional Vertigo (BPPV), the most common cause of vertigo. (By way of explanation, the word benign means good i.e. not harmful; paroxysmal means sudden attack; positional means it only occurs on certain movements; and vertigo means to turn i.e. it is the illusion of movement.) It is often worse in the act of lying down, turning over in bed, getting up from a lying down position, or when looking up. BPPV is a disorder of the inner ear, and arises when a tiny crystal (you may hear this referred to as an otolith, or canalith) gets dislodged and falls into one of the semi-circular canals, which is normally just filled with fluid. The dislodged crystal then leads to abnormal messages being sent to the brain. People often wake up with BPPV, which suggests that the crystal is displaced during sleep. The vast majority of BPPV cases are when the crystal falls into the posterior canal (as opposed to the horizontal or anterior canals). The good news is that the Epley manoeuvre resolves most cases of BPPV. It is a simple procedure, but you will experience vertigo during the procedure. If you have BPPV and are considering having the Epley manoeuvre, please ring the osteopath who can explain the procedure and how to prepare for it.