Date Updated: 08/28/2020


The canalith repositioning procedure can help relieve benign paroxysmal positional vertigo (BPPV). BPPV is a condition in which you have brief, but intense, episodes of dizziness and vertigo that occur when you move your head. Vertigo usually comes from a problem with the part of the inner ear responsible for balance. BPPV occurs when tiny canalith particles (otoconia) in one part of your inner ear break loose and fall into the semicircular canals of your inner ear.

The canalith repositioning procedure can move these particles to a part of your ear where they won't cause dizziness. The procedure involves several simple head maneuvers. It can be done in your doctor's office. The procedure is usually effective and relieves vertigo in about 80% of people after one or two treatments. But the problem may recur.

Why it's done

The canalith repositioning procedure is performed to relieve symptoms of BPPV. The procedure moves the particles causing symptoms from the fluid-filled semicircular canals of your inner ear to an area where they won't cause problems. They move to a tiny baglike open area that houses one of the other structures in your ear. Once there, these particles won't cause vertigo and will likely dissolve or be reabsorbed by bodily fluids in your ear.


The canalith repositioning procedure has certain risks, such as:

  • Neck or back injury
  • Movement of the particles to an unintended location which could continue to cause vertigo
  • Side effects, including feelings of nausea, dizziness and lightheadedness

Make sure you tell your doctor about any medical conditions you have, such as a neck or back condition, or advanced rheumatoid arthritis, before beginning the procedure. You may need to delay having the procedure.

How you prepare

There are no special preparations for the canalith repositioning procedure. Wear clothing that will allow you to move freely through each of the maneuvers.

What you can expect

During the procedure

The canalith repositioning procedure involves holding four positions for about 30 seconds each, or as long as you have symptoms while you hold that position. You'll generally stay in each position an extra 30 seconds after your symptoms have stopped. Your doctor will watch your eyes for abnormal movements during the procedure. The procedure may be repeated three or more times within a treatment session.

The canalith repositioning procedure includes these steps:

  1. First you move from a sitting to a reclining position with your head turned to the affected side by 45 degrees. Your doctor will help extend your head over the edge of the table at a slight angle.
  2. With your head still extended over the edge of the table, you'll be prompted to turn your head slowly away from the affected side by about 90 degrees.
  3. Roll onto your side. Your head should be slightly angled while you look down at the floor.
  4. Finally, you return carefully to a sitting position with your head tilted down and returned to the center position. You'll likely need to sit still for about 20 minutes.

After the procedure

After the procedure, follow your doctor's instructions. Your doctor will likely teach you how to perform the procedure yourself so that you can do it at home if needed. You may need to perform these exercises for several days before your symptoms go away.


Nearly 80% of people who undergo the procedure experience relief. But if your symptoms return, your doctor can repeat the canalith repositioning procedure. The procedure may need to be repeated several times to relieve your symptoms. Talk to your doctor if your symptoms don't improve.

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