Epley for Vertigo: Addressing the Root Cause with Upper Cervical Chiropractic at Lavender Family Chiropractic in Sarasota

Posted on6 February 2025,in

By Dr. Rusty Lavender, D.C. — upper cervical chiropractor, Lavender Family Chiropractic, Sarasota, FL. Reviewed and updated October 2026.

For the full picture of how we evaluate and address vertigo at our Sarasota office, see our guide to vertigo treatment in Sarasota.

Our complete guide to vertigo care in Sarasota covers the causes we see, the imaging we use, and what to expect at an evaluation.

Epley For Vertigo: Vertigo is a distressing condition that can severely impact daily life. The sensation of spinning, dizziness, imbalance, and nausea can make even the simplest tasks feel overwhelming. While many conventional treatments focus on symptom management, upper cervical chiropractic care at Lavender Family Chiropractic in Sarasota takes a different approach. Instead of merely addressing symptoms, our method seeks to resolve the root cause of vertigo for long-term relief.

For more information on how we help patients overcome vertigo, visit our website: Vertigo Treatment.

Epley For Vertigo-Understanding Vertigo and Its Underlying Causes

Vertigo is not a disease itself but rather a symptom of an underlying issue. It is commonly associated with conditions such as:

Benign Paroxysmal Positional Vertigo (BPPV): A condition where tiny calcium crystals in the inner ear become dislodged, affecting balance.
Meniere’s Disease: A disorder of the inner ear that leads to vertigo, ringing in the ears (tinnitus), and hearing loss.
Vestibular Migraines: A neurological condition that triggers vertigo episodes.
Cervicogenic Vertigo: Vertigo resulting from dysfunction in the cervical spine, particularly the upper cervical region.

Many treatments for vertigo focus on repositioning maneuvers, such as the Employ Maneuver (Epley Maneuver), which helps move displaced inner ear crystals back into place. While these techniques can be effective for some, they do not address deeper issues related to upper cervical misalignment, which may be the true root cause of persistent vertigo.

Upper Cervical Chiropractic: A Root Cause Approach

At Lavender Family Chiropractic, we specialize in upper cervical chiropractic care, which differs significantly from traditional chiropractic approaches. Instead of forceful adjustments involving cracking, twisting, or popping, upper cervical care uses gentle, precise techniques to restore proper alignment to the upper cervical spine.

How the Upper Cervical Spine Affects Vertigo

The upper cervical spine, which consists of the atlas (C1) and axis (C2) vertebrae, plays a crucial role in neurological function and balance. These vertebrae house the brainstem, which is responsible for coordinating signals between the brain and body, including those related to balance and spatial orientation.

When the atlas and axis become misaligned, they can create interference in the nervous system, affecting the vestibular system and leading to vertigo symptoms. This misalignment can stem from trauma (such as whiplash injuries), poor posture, or chronic stress on the neck.

3D CBCT Imaging: Precision Diagnosis for Effective Treatment

A key component of our approach at Lavender Family Chiropractic is the use of 3D Cone Beam Computed Tomography (CBCT) imaging. This state-of-the-art technology allows us to obtain highly detailed, three-dimensional images of the upper cervical spine. Unlike traditional X-rays, CBCT imaging provides a comprehensive view of spinal misalignments that may be contributing to vertigo.

By using CBCT imaging, we can accurately diagnose whether upper cervical misalignment is a factor in a patient’s vertigo symptoms. This precision enables us to tailor a treatment plan specifically designed to restore proper alignment and relieve neurological interference.

Gentle, Non-Invasive Upper Cervical Adjustments

Many people hesitate to seek chiropractic care due to concerns about manual adjustments involving cracking, popping, or twisting of the neck. However, upper cervical chiropractic is distinctly different. At Lavender Family Chiropractic, we use a gentle, targeted technique that does not require forceful manipulations.

Our upper cervical adjustments involve light-force corrections that are precisely calculated based on CBCT imaging. These adjustments help the atlas and axis vertebrae return to their correct alignment, reducing nerve interference and improving overall nervous system function. Because this approach is gentle and specific, it is safe for individuals of all ages, including those with delicate conditions.

How Upper Cervical Chiropractic Differs from Traditional Chiropractic

Traditional chiropractic care often focuses on full-spine adjustments, which involve mobilizing multiple vertebrae using manual thrusts. While effective for certain conditions, this approach does not specifically address the delicate structure of the upper cervical spine, which plays a critical role in balance and neurological health.

Upper cervical chiropractic, on the other hand, is focused solely on correcting misalignments in the C1 and C2 vertebrae. This precision-driven approach allows for targeted improvements in:

Vestibular function (reducing dizziness and imbalance)
Brainstem communication (enhancing neurological signals)
Cerebrospinal fluid flow (promoting better hydration and function of the brain and spinal cord)
Postural stability (improving overall balance and coordination)

By addressing the root cause of vertigo, upper cervical chiropractic care offers long-term relief without the need for medications or invasive procedures.

Comprehensive Care for Lasting Results

At Lavender Family Chiropractic, we go beyond just adjustments. Our holistic approach includes:

Postural assessments and corrections to reduce strain on the cervical spine.
Lifestyle recommendations, including exercises to support balance and spinal health.
Regular progress monitoring to ensure long-term improvements.

By integrating these elements into our care, we help patients achieve long-lasting relief from vertigo and improve their overall well-being.

Take the First Step Toward Lasting Vertigo Relief

If you or a loved one is struggling with vertigo, don’t settle for temporary symptom relief. At Lavender Family Chiropractic in Sarasota, we are dedicated to addressing the root cause of vertigo through gentle, precise upper cervical chiropractic care. Our innovative approach can help you regain balance, reduce dizziness, and improve your overall quality of life.

What the Research Says About Epley and the Root Cause of Vertigo

Repositioning maneuvers such as Epley have earned their reputation. For posterior-canal BPPV, a Cochrane review found Epley effective compared with a sham procedure (Hilton & Pinder, Cochrane 2014), and the AAO-HNS practice guideline recommends it after a positive Dix-Hallpike test (Bhattacharyya et al., Otolaryngol Head Neck Surg 2017). What the maneuver cannot do is prevent recurrence, since BPPV is known to come back (Kim & Zee, N Engl J Med 2014), nor can it help the many people whose positional testing is negative. Those two groups are the ones who tend to keep searching for an explanation after the maneuver has been done correctly.

For some of them, the explanation sits a few inches lower, in the joints between the skull and the top two vertebrae. Disturbed input from those joints changes how the brain controls head and eye movement and produces dizziness and unsteadiness independent of the inner ear (Kristjansson & Treleaven, J Orthop Sports Phys Ther 2009). A randomized trial found that two upper cervical manual techniques reduced dizziness compared with placebo, with the benefit lasting 12 months (Reid et al., Phys Ther 2014). Upper cervical chiropractic is how we examine that possibility: 3D imaging of the atlas, a correction matched to those images rather than a generic adjustment, and re-imaging to confirm the position changed.

Frequently Asked Questions

If the Epley maneuver worked, why does my vertigo keep coming back?

The Epley maneuver repositions loose crystals in the inner ear and is the right treatment for confirmed BPPV. It does not address why the brainstem keeps misreading balance signals. The brainstem combines upper-neck position input with inner-ear and eye input, and a misaligned atlas distorts the neck’s share. Correcting that alignment addresses recurrence at its source, and thermography before and after each correction shows how the nervous system is regulating.

Should I try upper cervical care instead of the Epley maneuver?

If you have confirmed BPPV, the Epley maneuver belongs in your care, and your ENT or physician guides that decision. We work alongside it. What upper cervical care adds is attention to the neck, which the Epley maneuver does not change. We measure atlas position with 3D CBCT, correct it with a precise, low-force adjustment, and verify the response with thermography. Many patients notice episodes become less frequent as the correction holds.

How does a neck misalignment cause dizziness?

The upper neck sends position signals to the brainstem, where they are compared against input from the inner ear and eyes. When the atlas shifts, the neck reports one thing while the ears and eyes report another, and that mismatch is experienced as spinning or unsteadiness. The Knee Chest correction restores the neck’s contribution to that comparison with no twisting, cracking, or rotation. Serious causes should be ruled out by a physician first.

What happens at a vertigo evaluation at your Sarasota office?

We take a detailed history, including head or neck trauma and any Epley treatment you have had. We scan with paraspinal thermography to see how the nervous system is regulating, and if the upper neck appears involved, we take 3D CBCT imaging of the atlas and axis to calculate a correction. Our office is at 5899 Whitfield Avenue, Suite 107, at the corner of University Parkway and Whitfield. Call (941) 243-3729 to schedule an evaluation.

Do you see vertigo patients from Lakewood Ranch, Bradenton, and Venice?

Yes. We are minutes from Lakewood Ranch, Bradenton, and University Park, and about 30 minutes from Venice. Many vertigo patients from these areas have had Epley treatments that helped for a while and then stopped holding. We coordinate with ENTs and share imaging on request. If the inner ear is the issue and the neck is not involved, we say so and refer. When the upper neck is involved, we correct it and confirm the change by measurement.