The Canalith Repositioning Procedure, commonly known as CRP or the Epley Maneuver, is a simple and highly effective treatment for Benign Paroxysmal Positional Vertigo (BPPV). This form of vertigo occurs when small calcium carbonate crystals, known as otoconia, become dislodged and move into one of the semicircular canals of the inner ear. These misplaced crystals interfere with normal balance signals and cause sudden spinning sensations when the head is moved in certain directions.
CRP involves a specific sequence of gentle head and body movements performed by a trained clinician. The purpose of these movements is to guide the displaced crystals back to the utricle, the correct chamber of the inner ear where they no longer cause dizziness. The procedure is noninvasive, safe, and can provide immediate relief for most patients.
During the procedure, your clinician will guide you through a series of carefully timed head and body positions. Each position allows gravity to move the misplaced crystals through the semicircular canal and into a stable area where they can no longer trigger vertigo. The maneuver typically lasts about ten to fifteen minutes. Most patients experience improvement immediately or within a day or two.
CRP does not require medication or surgery. Instead, it relies on the natural effect of gravity and the precision of controlled head movements. This makes it one of the most successful and well-tolerated treatments for vertigo caused by BPPV.
Each step is performed gently and precisely to reposition the crystals. The clinician monitors your symptoms and eye movements throughout the procedure to ensure that the maneuver is effective.
CRP has been shown in multiple clinical studies to be highly effective in resolving BPPV symptoms. Approximately 80 to 90 percent of patients experience complete relief after one or two sessions. In some cases, a repeat procedure may be required if symptoms recur. Because it addresses the mechanical cause of vertigo, CRP provides faster and more lasting results than medication alone.
The procedure is endorsed by the American Academy of Otolaryngology–Head and Neck Surgery as the first-line treatment for BPPV.
Most patients can return to normal activities immediately after the procedure. However, a few precautions help improve outcomes and reduce the chance of recurrence:
If dizziness persists or recurs, your clinician may recommend Vestibular Rehabilitation Therapy (VRT) to help retrain your balance system and restore full stability.
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Although CRP is very safe, it is not appropriate for every patient. The procedure may not be recommended for individuals with:
Your NeuroEquilibrium clinician will evaluate your medical history and physical condition to determine if CRP is suitable for you. If not, alternative vertigo treatments may be discussed.
The Canalith Repositioning Procedure (CRP) is a non-surgical treatment used to relieve dizziness caused by Benign Paroxysmal Positional Vertigo (BPPV). In BPPV, tiny calcium crystals inside the inner ear move into areas where they disrupt balance signals, leading to spinning sensations when the head changes position.
At NeuroEquilibrium, the CRP is performed by trained vestibular specialists using gentle, controlled head and body movements. These movements guide the displaced crystals back to their correct chamber in the inner ear, restoring balance and relieving vertigo symptoms safely and effectively.
CRP treatment for BPPV is a brief, outpatient procedure designed to correct the mechanical cause of vertigo. During the session, a NeuroEquilibrium clinician moves the patient’s head through a specific series of positions that allow gravity to move the displaced otoconia (ear crystals) back into the utricle.
Most patients experience significant improvement after one or two sessions. The procedure requires no medication or anesthesia, and recovery is almost immediate. It is considered the gold-standard, first-line treatment for BPPV worldwide.
The CRP is performed under professional supervision to ensure precision and comfort. At NeuroEquilibrium, the clinician begins with the patient sitting upright and turns the head about 45 degrees toward the affected ear. The patient is then guided through a series of positions—lying back with the head tilted, turning to the opposite side, rolling onto the shoulder, and finally sitting upright again.
Each step allows gravity to move the dislodged crystals through the semicircular canal and into a safe location. The process typically takes 10 to 15 minutes, and patients may be advised to avoid lying flat or sudden head movements for the next 24 hours.
A “red flag” in vertigo refers to warning signs that suggest a more serious underlying condition rather than a simple inner-ear problem like BPPV. At NeuroEquilibrium, patients are screened for these symptoms before treatment.
Red flags include sudden severe headache, double vision, difficulty speaking, limb weakness, numbness, loss of coordination, or hearing loss in one ear. These may indicate neurological or vascular causes of vertigo, such as stroke or brainstem disorders.
If any of these symptoms are present, immediate medical evaluation and diagnostic testing are recommended before performing the Canalith Repositioning Procedure.
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