Feeling Dizzy? Experts Share How To Tell Which Ear Is Causing Vertigo, Plus the Move That Treats It

We’ve all experienced dizziness after riding a rollercoaster or spinning around in circles with the grandkids. That off-balance feeling can be fun in small doses, but if it occurs randomly, it may indicate benign paroxysmal positional vertigo (BPPV). Here we explain why BPPV occurs, how to tell which ear is causing vertigo and how to treat it.

What is BPPV?

BPPV is a common cause of vertigo. About 20% of people who see a doctor for dizziness are diagnosed with the condition. Anyone can experience BPPV , but it usually affects older adults, specifically those 50 and older .

Ayelet Hamburger, AuD, CCA-A, a clinical audiologist at Rush University Medical Center, says BPPV has unique characteristics that differentiate it from other types of vertigo. “BPPV most commonly occurs in the morning and is triggered by certain head movements” such as tipping your head up and down, sitting up from lying down or turning over in bed. The dizziness BPPV causes is also short-lived. Hamburger says it typically improves within a minute.

How what’s going in your inner ear can cause vertigo

“Inside everyone’s ears are hearing and balance organs,” explains Virginia Wise, AuD , Director of Audiology at The Centers for Advanced ENT Care - Central ENT Consultants. “Three semicircular canals are the parts of the inner ear primarily responsible for detecting motion. Each canal faces a different direction, so your body can sense up and down, side to side and rotational [movements].”

“There are lots of little nerve endings in those canals, and they all have calcium carbonate crystals stuck on top of them,” she adds. “Gravity weighs [the crystals] down when you move, so your brain knows which way your body is going.”

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“Sometimes, those little crystals come unstuck and float around,” Wise explains. “So when you move, they do, too. Unfortunately, your brain can’t tell the difference between floating crystals and real spinning, so you experience vertigo.”

Wise encourages you to visit your doctor or a vestibular-trained audiologist if you often feel dizzy, since more serious issues like high blood pressure , diabetes and head injuries can also cause vertigo.

How to tell which ear is causing vertigo

Now you’re probably wondering how to tell which ear is responsible. Happily, two easy techniques can help:

1. The roll test

“Often, patients describe their BPPV as happening when they roll over in bed,” Wise says. “That’s because BPPV happens in the canal that senses torsional, or rotational movement. If the dizziness occurs when you roll to the left, chances are your left ear is affected.” And if it happens when you roll right, it’s likely your right ear.

2. 'Stepping Fukuda' (or the Unterberger test)

For this test, Wise says to stand in an open area, away from obstacles with your eyes closed. Once you’re in position, “march in place for approximately 30 seconds or 100 steps. Your body will naturally turn toward the affected ear.”

Can’t tell which ear is causing vertigo? When to see a doctor

If these tests don’t provide enough information, make an appointment with an ear, nose and throat doctor (ENT) or a vestibular-trained audiologist. Hamburger says these professionals can “perform a maneuver called the Dix-Hallpike . During this test, the provider looks for specific eye movements, which gives them information about which ear and which balance canal is affected.”

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How to treat vertigo with the Epley Maneuver

BPPV treatment often uses what’s known as the Epley Maneuver. “The Epley Maneuver is a series of movements designed to move the loose calcium crystals ‘upstream’ where they get trapped and reabsorbed by the body,” Wise explains.

“Because it requires a patient’s head to be held at certain angles, it ideally should be done under the care of a professional,” Wise adds. “Audiologists, ENT physicians and vestibular physical therapists are all qualified to perform the maneuver.”

If you’d like to try the Epley Maneuver yourself at home, make sure you have a qualified professional demonstrate it first.

Performing the Epley Maneuver: Video and guide

1. Sit on your bed and turn your head 45 degrees toward the ear causing vertigo.
2. Quickly lie down on your back, with your head slightly off the edge of the bed while holding the same position. (It’s normal for vertigo symptoms to worsen at this time).
3. Slowly turn your head 90 degrees to the opposite side.
4. Rotate the rest of your body so it’s aligned with your head.
5. Remain on your side for a few minutes.
6. Sit back up.

Note: “Use caution when performing the Epley maneuver at home,” Hamburger says. “Doing it incorrectly can cause the calcium crystals (called otoconia) to move into a different balance canal, which can worsen your vertigo and make it more difficult to treat.”

This video illustrates each step of the Epley Maneuver:

For more on managing dizziness:

Experts Reveal How to Get Rid of Dizziness Using Home Remedies

Can Dehydration Cause Dizziness? What Doctors Say About Signs and Symptoms

These Vertigo Exercises Stop Dizziness in Minutes

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan .