Benign paroxysmal positional vertigo (BPPV) is a common form of vertigo caused by inner ear issues. The Semont maneuver is an effective BPPV treatment performed under the guidance of a medical professional. Learn what it is and what to expect during your office visit.
The Semont maneuver, also known as the liberatory Semont maneuver or the Semont-Toupet maneuver, is a series of movements designed to treat benign paroxysmal positional vertigo (BPPV). It requires putting your head in specific positions to realign otoconia (also known as canaliths), which are tiny calcium carbonate crystals in your inner ear that help you maintain balance and spatial awareness. This maneuver should always be performed under the supervision of a medical professional to ensure safety and effectiveness.
BPPV is a common type of vertigo that happens when naturally occurring calcium carbonate crystals in your inner ear (known as otoconia or canaliths) are dislodged. When this happens, it causes a disruption in the signals sent to your brain about your body’s position in space. While there often isn’t a clear reason why the crystals get dislodged, some common causes of BPPV include:
● Head trauma
● Changes in head position (e.g., lying down)
● High-intensity physical activity
● Ear infections or other diseases
● Aging
Symptoms of BPPV can include:
● Vertigo (a spinning sensation)
● Nausea
● Blurred vision
● Loss of balance
The good news: BPPV is common, usually short-lived and highly treatable with procedures like the Semont maneuver.
While BPPV and hearing loss are not directly linked, some research has shown that the risk of BPPV may be greater in patients with sudden hearing loss.1
Naturally, you may be wondering, “Can BPPV cause hearing loss?” The short answer: No. However, it’s not uncommon for BPPV and hearing loss to occur together, since they are both linked to problems in the inner ear. The anatomy of your inner ear is tightly packed and complex, so one issue can often be tied to others. For example, head trauma can damage ear structures, leading to both BPPV and hearing loss.
If you’re experiencing symptoms of hearing loss or vertigo, consult a medical professional to rule out potential related issues.
The Semont maneuver is a common and effective maneuver to get rid of vertigo — but it is specifically for BPPV. The strategic timing and changes in head position are designed to reposition the otoconia of your inner ear to restore your body’s sense of balance and spatial awareness. Other causes of vertigo, like labyrinthitis or Meniere’s disease, are not related to the otoconia of your inner ear. In those cases, your doctor will use treatments other than benign postural vertigo maneuvers.
In some instances, your doctor may recommend the Semont-plus maneuver to relieve your vertigo symptoms. This procedure uses the support of your arm to tilt your body further than in the traditional Semont maneuver. This moves the otoconia in your inner ear more efficiently.
Research has shown that the Semont-plus maneuver may be more effective than the traditional Semont maneuver when performed repeatedly over time, reducing the time to relieve vertigo symptoms by about 50%.2
The Epley procedure is another common treatment for BPPV. Similar to the Semont maneuver, the Epley procedure requires placing your head in specific positions to move the crystals in your inner ears.
So, what is the difference between Epley and Semont maneuvers? Unlike the Semont maneuver — which requires you to sit up and switch sides in the middle of the procedure — the patient lays flat on the bed or table and does not lie on their side during the Epley maneuver.
Research has shown that both are effective for treating BPPV,3 so your doctor’s recommendation may depend on which ear is affected and the exact position of the crystals in your inner ear.
When you perform the Semont maneuver, your doctor will walk you through each step. Here’s what to expect.
Semont maneuver (left ear):
Semont maneuver (right ear):
After performing the Semont maneuver, avoid activities that could trigger vertigo symptoms, such as intense exercise or sleeping on your side.
The Semont-plus maneuver follows a similar procedure, with a few extra steps and small differences. Here is the process your doctor will guide you through:
The Semont maneuver should always be performed under the supervision of a professional. Done incorrectly, the procedure could exacerbate vertigo symptoms—including dizziness, nausea and unsteadiness — as well as existing neck or back problems.
Once you have learned the procedure, you and your doctor can discuss a plan to safely do the Semont maneuver at home, as you may need to do the procedure repeatedly to ease symptoms.
*Miracle-Ear locations do not perform or provide instruction for the Semont maneuver.
1 Lee, Sang-Yeon, et al. “Increased Risk of Benign Paroxysmal Positional Vertigo in Patients with a History of Sudden Sensory Neural Hearing Loss.” Otology & Neurotology, vol. 40, no. 2, Feb. 2019, pp. e135–e141, https://doi.org/10.1097/mao.0000000000002084. Accessed 12 May 2025.
2 Strupp, Michael, et al. “BPPV: Comparison of the SémontPLUS with the Sémont Maneuver: A Prospective Randomized Trial.” Frontiers in Neurology, vol. 12, 14 Apr. 2021, https://doi.org/10.3389/fneur.2021.652573.
3 Kinne, Bonni Lynn, et al. “Semont maneuver vs. epley maneuver for canalithiasis of the posterior semicircular canal: A systematic review.” Physical Therapy Reviews, vol. 21, no. 2, 3 Mar. 2016, pp. 102–108, https://doi.org/10.1080/10833196.2016.1228511.
4 Alashram, Anas R. “Semont Maneuver for Posterior Canal Benign Paroxysmal Positional Vertigo: A Systematic Review of Randomized Controlled Trials.” European Archives of Oto-Rhino-Laryngology/European Archives of Oto-Rhino-Laryngology and Head & Neck, 26 Mar. 2024, https://doi.org/10.1007/s00405-024-08586-0. Accessed 12 May 2025.
