What is the Semont maneuver?

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.

Semont maneuver for BPPV

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.

Semont-plus maneuver

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

Semont maneuver vs. Epley procedure

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.

How to do the Semont maneuver

When you perform the Semont maneuver, your doctor will walk you through each step. Here’s what to expect.

Semont maneuver (left ear):

1. Sit on a bed or table with your legs hanging over the edge.
2. Turn your head 45 degrees to the right.
3. Lie down quickly on your left side, keeping your head turned 45 degrees.
4. Remain in this position for one minute.
5. Without moving your head, quickly move to lie down on your right side.
6. Remain in this position for one minute.
7. Slowly return to a sitting position, keeping your level for several minutes.

Semont maneuver (right ear):

1. Sit on a bed or table with your legs hanging over the edge.
2. Turn your head 45 degrees to the left.
3. Lie down quickly on your right side, keeping your head turned 45 degrees.
4. Remain in this position for one minute.
5. Without moving your head, quickly move to lie down on your left side.
6. Remain in this position for one minute.
7. Slowly return to a sitting position, keeping your level for several minutes.

After performing the Semont maneuver, avoid activities that could trigger vertigo symptoms, such as intense exercise or sleeping on your side.

How to do the Semont-plus maneuver

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:

1. Sit on a bed or table with your legs hanging over the edge.
2. Turn your head 45 degrees to the opposite side of your affected ear.
3. Extend the arm on the same side as your affected ear straight out to your side.
4. Quickly lie down on the side to which your arm is extended until your head is tilted downward at a 60-degree angle. Keep your head turned at 45 degrees through the movement.
5. Remain in this position for one minute.
6. Quickly switch sides to lie on the opposite side, allowing your head to rest on the table. Keep your head still through the movement.
7. Remain in this position for one minute.
8. Slowly return to a sitting position, keeping your head level for several minutes.

Is it safe to do the Semont maneuver at home?

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.