When you move your head or change positions do you feel dizzy and off balance? You could be experiencing benign paroxysmal positional vertigo (BPPV). The spinning sensations of BPPV can hamper your ability to move normally, greatly disrupting your quality of life.

The Semont maneuver is one way treat BPPV.

To understand the Semont maneuver, you need some understanding of benign paroxysmal positional vertigo (BPPV).


When tiny calcium crystals — called canaliths — in the vestibular system in your inner ear move to an area where they do not belong, they can interact with nerves that send communications about eye and head position to your brain.

When your vestibular nerves and your canaliths interact, you feel a spinning sensation and dizziness. This is BPPV.

The Semont maneuver

The Semont maneuver is a simple procedure that treats BPPV by repositioning the canaliths to help eliminate the vertigo.

The Semont maneuver involves moving the patient rapidly from lying on one side to lying on the other. It’s often performed by a physical therapist (PT) after they determine which vestibular system — right or left — is being affected by BBV. Here’s how it works:

  1. The PT will sit you on the edge of a treatment table with your legs hanging over the side.
  2. The PT will turn your head about 45 degrees away from the side affected by BPPV.
  3. The PT will quickly move you to a lying down position on the affected side. You are now looking at the ceiling. If you experience dizziness, you will stay in that position until it passes.
  4. Once the dizziness passes, the PT will move you back to the sitting position and then quickly onto your other side. You are now looking at the floor. If you experience vertigo, you will stay in that position until it passes.
  5. Once the vertigo passes, the PT will move you back to the sitting position

If the procedure was successful, in a day or two your dizziness and vertigo should be gone. If not, the PT might try the Semont maneuver again or try a very similar exercise known as the Epley maneuver.

Once you’ve completed the Semont maneuver, which typically takes about 15 minutes, you might have a few brief vertigo episodes as the canaliths reposition themselves, so it is recommended that you wait 10 or 15 minutes before heading home from the PT’s office. It’s also recommended that you do not drive yourself home.

Other post-maneuver suggestions include:

  • Stay upright for the next few hours.
  • Sleep on your back with extra pillows to keep close to upright (about 45 degrees) throughout the night. Do not turn your head toward the affected side.
  • Do not go to the dentist or hairdresser.
  • Avoid exercise requiring head movements including situps, toe touches, and freestyle swimming.

After one week, carefully put yourself into the position that typically makes you dizzy, and then report the results to the PT who performed the Semont maneuver and your doctor.

If you experience vertigo and dizziness, talk to your doctor about your symptoms. They might use the Dix-Hallpike test to confirm a diagnosis of paroxysmal positional vertigo (BPPV). Once it’s diagnosed, your doctor or a physical therapist might use the Semont maneuver — or the similar Epley maneuver — to reposition your canaliths in the vestibular system in your inner ear to relieve you of your BPPV.