Semont Maneuver for Vertigo: Step by Step Guide

Vertigo is a condition characterized by sudden spells of nausea, dizziness, motion sickness, vomiting, & sometimes, headaches of migraine intensity. Vertigo isn’t a disorder in itself, rather always a symptom of some underlying condition, whether diagnosed or undiagnosed. Although Vertigo isn’t a fatal or dangerous condition in itself, it can cause a lot of problems for people who experience it. The dizziness & spinning sensation that occurs along with Vertigo can make life very difficult indeed for patients, as it stops them from performing various day-to-day activities.


Vertigo is of two types:

  • Central Vertigo: Central Vertigo is caused by problems in the brain, which affects how the brain transmits & interprets information regarding the body’s balance signals. Any issues with processing this information can lead to Vertigo attacks, disbalance, & bouts of dizziness.
  • Peripheral Vertigo: Peripheral Vertigo is caused by problems in the inner ear. The inner ear houses the body’s vestibular system, which is responsible for maintaining the balance of the body. The vestibular system involves the ears, the eyes, & the brain working together in perfect tandem to maintain the body’s position in space.

When the inner ear’s functioning is disrupted by infections, or any viral illnesses, the inner ear can’t send appropriate balance signals to the brain, thus causing problems with the body’s balance & posture. BPPV Vertigo is one of the most common types of peripheral vertigo, and affects about 80% of all people with vertigo.

BPPV Vertigo occurs when tiny calcium crystals called canaliths get displaced from their original position & get deposited in the semicircular canal of the inner ear. These calcium crystals are sensitive to any motion stimulus, & thus they cause problems with the body’s balance in the semicircular canal whenever the patient moves their head.  BPPV Vertigo treatment involves BPPV maneuvers that can move these calcium crystals from the semicircular canal to their original position.  These maneuvers include a lot of well-known Vertigo exercises; the Epley Maneuver, the Semont-Maneuver, the Brandt-Daroff exercises, & the Semont-Foster maneuver.

All of these Vertigo exercises are helpful for BPPV Vertigo treatment in varying degrees, & need to be performed the recommended number of times for effective results.

In this article, we’ll discuss the Semont Maneuver for BPPV Vertigo treatment, & also give you a detailed step-by-step guide to perform it.

What is the Semont maneuver for BPPV Vertigo treatment?

 Named after its inventor, Dr. Alain Semont, the Semont maneuver is a posterior canal maneuver designed to displace the calcium crystals back to their original position.

Their goal is to promote the motion of canaliths from the more sensitive posterior canal location, back to their original position in the less sensitive zones of the ear. The Semont maneuver for Vertigo takes about 15 minutes to perform, & works by dislodging the calcium crystals from the cupula into the vestibule where they originally reside. It is usually easy to perform, & is best done under the supervision of a trained physiotherapist or Vertigo specialist.

How to perform the Semont Maneuver for BPPV Vertigo treatment? 

To perform the Semont Maneuver, follow the instructions given below. Note that these instructions are to perform the Semont maneuver from the left ear & side.

  • Sit on the edge of the bed, & turn your head 45 degrees to the right.
  • Next, quickly lie down on your left side, & hold this position for 30 seconds.
  • Now, quickly move & lie down on the opposite end of the bed, without changing the direction of your head. Keep your head at a 45 degree angle while looking at the floor. Hold this position for at least 30 seconds.
  • Return to your original position slowly, & wait for some time to let the dizziness pass.
  • Next, repeat these steps on the right ear & side.

Perform the maneuver at least thrice everyday, until you notice no Vertigo symptoms in a period of 24 hours.


Precautions to take with Semont Maneuver for BPPV: 

Like with every other BPPV maneuver, the Semont Maneuver for BPPV Vertigo can trigger dizziness & bouts of vertigo with the constant & quick head movements. Hence, it’s advisable to always bring along someone to drive you back home whenever you’re going for one of your Vertigo exercise sessions.  You should also take care to not indulge in any activities that require you to stand up or concentrate for long periods, immediately after performing the Semont maneuver.

In addition to the above, BPPV patients should also abide by the following set of instructions to avoid dislodging the calcium crystals into the semicircular canal.

  • Sleeping semi-recumbent throughout the night. In layman terms, it means that patients should sleep with their head halfway between being flat & upright at a 45 degrees angle. This can easily be done with the help of a recliner chair, or by placing several pillows behind your head. Patients should also try their best to keep their head in a vertical position throughout the day, & avoid visits to the dentist & the hairdresser for a couple of days right after the procedure. Patients must also not perform any exercises which require any amount of head movement for a few days immediately after performing the Semont maneuver for BPPV Vertigo treatment.
  • Patients must also avoid moving their heads in any positions that can trigger bouts of BPPV Vertigo. Some precautions to this end may involve sleeping with pillows under your head, avoiding sleeping on the ‘bad’ side of your Vertigo symptoms, & avoiding turning your head far up or down. Any exercises for low back-pain should be avoided for at least a week, along with sit-ups & ‘crawl’ swimming.
  • Patients must also not start the Brandt-Daroff maneuver immediately after the Semont Maneuver, or 2 days after it. Patients should also avoid any exercises that include far head-forward positions, for eg., touching your toes.

To check the effectiveness of the Semont Maneuver for BPPV Vertigo treatment, try putting yourself in Vertigo inducing positions after one week of performing the Semont Maneuver. You should ideally not feel any dizziness or any other Vertigo symptoms when you do this. If this is the case, then consider the Semont Maneuver successful. However, if you still experience dizziness or any other Vertigo symptoms, you should consult your doctor & book another appointment, or start another BPPV maneuver depending on your particular condition & diagnosis.


Success rate for the Semont Maneuver for BPPV Vertigo treatment:

All things considered, the Semont Maneuver for BPPV Vertigo treatment is considered upto 90% effective. It is however, not as popular as the Epley Maneuver, & so is usually the second option after the former doesn’t work on the patient.