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Dizziness & Vertigo

Feeling faint, woozy or as if the room is spinning. Most dizziness isn’t serious and often settles or is easy to treat — but sudden dizziness with stroke or heart warning signs is an emergency.

Call 911 right away if dizziness comes on suddenly with any sign of a stroke. Sudden dizziness, loss of balance or trouble walking can be a stroke, especially with sudden trouble seeing, numbness or weakness of the face, arm or leg (often on one side), confusion, trouble speaking, or a sudden severe headache with no known cause (CDC). Vertigo with double vision or loss of vision, hearing loss, trouble speaking, or weakness, numbness or tingling in an arm or leg also needs emergency help right away (NHS). The CDC uses B.E. F.A.S.T.:

  • B — Balance: is the person suddenly off-balance or dizzy?
  • E — Eyes: any sudden trouble seeing?
  • F — Face: ask them to smile. Does one side droop?
  • A — Arms: ask them to raise both arms. Does one drift down?
  • S — Speech: is their speech slurred or strange?
  • T — Time: call 911 now and note when the symptoms started. Don’t drive to the hospital — an ambulance crew can start treatment on the way (CDC).

Symptoms that pass after a few minutes may have been a “mini-stroke” (TIA), which still needs medical help right away (CDC). A drooping face always needs this check first — our Bell’s palsy guide explains why.

Also get emergency care if dizziness comes with very serious heart symptoms such as chest pain or trouble breathing (NHLBI), or with signs of shock — cold, sweaty skin, rapid breathing, a bluish skin tone, or a weak and rapid pulse; call 911 for shock (NHLBI). Vertigo with a severe headache, a very high temperature, or vomiting or feeling very sick needs an urgent appointment with a doctor (NHS).

Sudden hearing loss with dizziness or spinning is urgent. Sudden hearing loss in one ear — sometimes with dizziness, ringing or a full feeling in the ear — should be treated as a medical emergency: see a doctor immediately, because treatment works best when it starts early (NIDCD).

What is dizziness? Lightheaded, spinning or unsteady

“Dizzy” means different things to different people (NIDCD), so being able to say exactly what you feel helps your doctor find the cause:

Feeling dizzy now and then is common and not usually serious, and dizziness often goes away on its own (NHS, MedlinePlus).

How common is it?

About 15 percent of American adults (33 million) had a balance or dizziness problem in 2008 (NIDCD). Dizziness and vertigo can happen to anyone, but they become more common with age, partly because people tend to have more health conditions and take more medicines (MedlinePlus).

Common causes

  • Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo (MedlinePlus). Tiny calcium crystals in the inner ear tumble into one of its fluid-filled canals, so a certain head movement — bending down, looking up or rolling over in bed — sets off a brief, intense spell of spinning (NIDCD). See BPPV and repositioning maneuvers below.
  • Vestibular neuritis and labyrinthitis. Vestibular neuritis is inflammation of the balance nerve, which can be caused by a virus and mainly causes vertigo (NIDCD). Labyrinthitis is inflammation of the inner ear’s maze of fluid-filled channels, usually caused by a virus such as a cold or flu; it can cause vertigo, feeling sick, hearing loss and ringing in the ears, while vestibular neuritis causes similar symptoms without the hearing loss or ringing. Both usually get better on their own within a few weeks; most people get their balance back over 2 to 6 weeks, though it can take longer (NHS).
  • Vestibular migraine is a form of migraine in which repeated attacks of vertigo are a main feature, often with other migraine features such as headache and sensitivity to light or sound. It is estimated to affect just under 1 in 100 people, and many remain undiagnosed (Cochrane review, 2023). Migraine is a common cause of dizziness (MedlinePlus).
  • Ménière’s disease is an inner-ear disorder with attacks of severe vertigo, ringing in the ear, hearing loss and a feeling of fullness in the ear, usually in one ear (NIDCD). A separate MBHA guide to Ménière’s disease is on the way.
  • Blood pressure that drops when you stand up (postural or orthostatic hypotension) can make you lightheaded or dizzy when you stand up or suddenly change position (NHS). Older adults have a higher risk of dizziness on standing, and are more likely to have low blood pressure as a side effect of blood pressure medicines (NHLBI). See our Blood Pressure guide.
  • Medicines. Some medicines can cause vertigo — check the leaflet to see if it is listed as a side effect (NHS) — and some can damage the balance structures of the inner ear (NIDCD). Dizziness after starting a new prescription medicine may be a side effect, so tell your provider (NHS).
  • Anxiety and stress. A panic attack can bring weakness or dizziness along with a pounding heart (NIMH), and dizziness itself can cause fear, anxiety or panic (NIDCD). See our Anxiety guide.
  • Motion sickness can also make you dizzy (MedlinePlus) — see our Air & Motion Sickness guide.
  • Serious causes. Less often, dizziness or a balance problem comes from the brain or the heart and can be a sign of a stroke (MedlinePlus, CDC). Dizziness and fainting can be symptoms of an irregular heart rhythm (NHLBI), and a sudden drop in blood pressure — for example from blood loss after an injury — can be dangerous (NHLBI).

Doctors try to work out whether dizziness comes from the inner ear or balance nerve (such as BPPV, labyrinthitis or Ménière’s) or from another part of the body, such as the brain or the heart (MedlinePlus). Vertigo that comes with double vision or loss of vision, hearing loss, trouble speaking, or weakness, numbness or tingling in an arm or leg needs emergency help (NHS).

How it’s diagnosed

Your provider will ask about your symptoms and medicines and may do a physical exam, checking your hearing, your balance and how you walk (MedlinePlus). It helps to come ready to describe what the dizziness feels like, whether a particular movement sets it off, how often it happens and how long it lasts, any hearing loss, ringing, ear pressure or headache that comes with it, and with a list of every medicine and supplement you take (NIDCD).

  • The Dix-Hallpike test: for suspected BPPV, the clinician moves you from sitting to lying with your head turned to one side, and watches your eyes for a telltale flicker; the U.S. ear, nose and throat guideline strongly recommends this test for diagnosing the most common form of BPPV (AAO-HNS guideline, 2017). The test can briefly bring on symptoms (NHS).
  • Hearing tests, blood tests, eye-movement and balance testing may be done. Balance and hearing checks are often done by an ear, nose and throat doctor (otolaryngologist) and an audiologist, and several tests may be needed (NIDCD). If lightheadedness keeps happening, have your blood pressure checked (NHS).
  • Imaging only when needed. You may need a scan if your provider thinks you may have had a stroke or if you have had a head injury (MedlinePlus). For someone whose symptoms clearly fit BPPV, the guideline advises against routine imaging or extra balance testing unless other signs or symptoms call for it (AAO-HNS guideline).

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Find the cause first. For BPPV, a clinician guides your head through repositioning moves such as the Epley maneuver; vestibular rehabilitation with a physical therapist for lasting inner-ear dizziness; short-term anti-dizziness or anti-nausea medicines only when needed; and treating the cause — migraine, Ménière’s, blood pressure drops or a medicine side effect. Medicare Part B covers needed outpatient physical therapy (20% after the deductible). With a SingleCare discount card, meclizine tablets (an anti-dizziness medicine named in this guide) were about $9.00 to $20.29 for 30 tablets across the listings (prices updated November 6, 2026). Still unpriced: self-pay therapy, specialist visits, positioning-maneuver visits and testing. Other costs: being researched. Strong evidence: repositioning is the recommended treatment for the most common form of BPPV, though BPPV often comes back. Vestibular rehabilitation is safe and effective for many inner-ear problems. Anti-dizziness medicines can cause drowsiness and are not recommended routinely for BPPV.
Chiropractic Some trained chiropractors perform the Epley maneuver for BPPV. Others treat dizziness thought to come from the neck with hands-on neck treatment and exercises. Without insurance, about $90–$200 for a first visit and $55–$100 for follow-ups. Chiropractors trained in the Epley maneuver can use it for BPPV, but studies of chiropractic BPPV care are small case reports. Evidence that neck treatment helps neck-related dizziness is low to moderate quality. Neck manipulation carries a rare risk of artery tears and stroke — never have it when a stroke is possible.
Acupuncture Fine needles at points on the body; studied mostly for “cervical vertigo” (dizziness linked to the neck). About $125–$230 for a first visit and $90–$185 for follow-ups; community clinics about $50–$90. Reviews report benefits, but the evidence is low to very low quality. We found no good evidence for BPPV, and the NIH says there is no evidence it helps Ménière’s disease.
Herbal medicine Ginkgo is sometimes taken for vertigo, and ginger for queasiness. We found no price range we can cite for herbal consultations or herbal products, so we give none. These are usually paid out of pocket, and prices vary widely by practitioner and product. NCCIH suggests asking your insurer whether an approach is covered (and whether it needs a referral or an in-network practitioner), asking the practitioner what the first and follow-up visits cost and whether there is a sliding scale, and asking what other costs apply, such as tests and supplements; health savings or flexible spending accounts may help with some costs. Evidence for ginkgo in vertigo is small and not conclusive — and dizziness is one of its common side effects. Most studies of ginger for motion sickness haven’t shown it helps. Herbs can interact with medicines.
Massage therapy Gentle relaxation and work on tight neck and shoulder muscles; not a treatment for the causes of vertigo. At one national chain, about $125–$160 for a 60-minute massage for non-members and $65–$90 for members; memberships about $70–$90 a month. May give short-term relief of neck pain. We found no good evidence that it treats dizziness or vertigo.
MBHA Wellness Coach Getting up slowly, drinking enough fluids, home exercises only as your clinician or therapist prescribes, a dizziness or migraine diary, limiting alcohol and caffeine, sleep, stress and anxiety skills, and staying safe behind the wheel. Included with a paid MBHA membership: a monthly wellness coaching email from a certified Holistic Health & Lifestyle Coach and a complimentary Clarity Call (based on availability). Membership is $150 a year for one adult ($15 a month if billed monthly), $200 a year for a couple and $250 a year for a household with dependents; the free tier has occasional email tips only. Members also get discounted rates on one-on-one coaching and group programs (current rates are not published on the membership page, so ask MBHA). Coaching is educational and motivational, not healthcare. Supports — but doesn’t replace — a medical diagnosis. Avoiding known triggers may reduce vestibular migraine episodes, and simple habits such as getting up slowly help with dizziness on standing.

Approach 1 of 6

Conventional medicine (AMA)

Treatment depends on the cause, so the first step is to find it. A specialist will check whether another health condition or a medicine is to blame, and treat that condition, change the medicine or refer you on (NIDCD). Dizziness often gets better on its own, but if it keeps happening your provider can help find the cause and the right treatment (MedlinePlus).

1. BPPV: canalith repositioning (the Epley maneuver)

For BPPV, a clinician moves you through a series of simple movements that help shift the loose crystals out of the balance canal (NIDCD). The 2017 U.S. ear, nose and throat guideline makes a strong recommendation that clinicians treat the most common (posterior canal) form of BPPV with a canalith repositioning procedure, or refer you to someone who can (AAO-HNS guideline, 2017). In many cases one session works; some people need it several times (NIDCD). A Cochrane review of 11 mostly small trials found the Epley maneuver a safe, effective treatment for this form of BPPV: complete relief rose from 21% of people with a sham or no treatment to 56% with the Epley (Cochrane review, 2014). More detail is in BPPV and repositioning maneuvers below.

2. Vestibular rehabilitation

Vestibular rehabilitation is a series of exercises that can help restore balance and ease dizziness, nausea and anxiety; it should be done under the supervision of a specialist such as a physical therapist or audiologist (NHS). A Cochrane review of 39 trials (2,441 people) found moderate to strong evidence that it is safe and effective for problems affecting one inner ear, and moderate evidence that it eases symptoms and improves day-to-day function in the medium term. For BPPV, repositioning maneuvers worked better in the short term, while combining the two helped longer-term recovery (Cochrane review, 2015). A doctor may also recommend it for long-lasting balance problems with Ménière’s (NIDCD). It has also been tried for vestibular migraine, but only in one small study, so it is not yet known whether it helps (Cochrane review, 2023).

3. Short-term medicines for symptoms

For a bad spell, a doctor may prescribe antihistamines, motion sickness tablets or anti-sickness medicines; for labyrinthitis or vestibular neuritis the NHS advises taking them for no more than 3 days, because they can slow recovery (NHS). Meclizine is one such medicine; for dizziness caused by an ear condition it is taken as your doctor directs (MedlinePlus). These “vestibular suppressants” ease symptoms during a spell, with limits:

  • For BPPV, the guideline recommends against routinely treating it with vestibular suppressant medicines such as antihistamines or benzodiazepines (AAO-HNS guideline).
  • Anti-vertigo and anti-nausea medicines can make you drowsy (NIDCD). Meclizine can cause drowsiness, dry mouth and, more seriously, blurred vision, and older adults usually should not take it because other medicines are safer or work better (MedlinePlus).
  • Tell your doctor or pharmacist about every other medicine, vitamin and herbal product you take, and about glaucoma, an enlarged prostate or asthma, before you start (MedlinePlus). We don’t list doses here.

4. Treating the underlying cause

  • Vestibular neuritis and labyrinthitis: these are usually caused by a virus, so antibiotics won’t help, though a doctor may prescribe them if a bacterial infection is suspected. See a doctor if symptoms don’t improve after a few days or are getting worse (NHS).
  • Vestibular migraine: medicines used to prevent episodes are mostly borrowed from headache migraine. A 2023 Cochrane review found only three small trials, of beta-blockers and calcium channel blockers, and the evidence was low or very low certainty (Cochrane review, 2023).
  • Ménière’s disease: there is no cure yet. Options include limiting salt, a diuretic (“water pill”), quitting smoking, medicines during attacks, vestibular rehabilitation, injections into the middle ear and, when other treatments have failed, surgery (NIDCD). Our separate guide will cover these in detail.
  • Blood pressure drops on standing: you may not need treatment. Depending on your symptoms, your provider may suggest more fluids, adjust medicines that lower blood pressure, or prescribe medicine to raise it (NHLBI).
  • Medicines: if dizziness started after a new prescription medicine, it may be a side effect, so tell your provider (NHS). Don’t stop a prescribed medicine on your own — ask whether it can be changed.

What it costs

  • Physical and vestibular therapy: self-pay cost estimate being researched. Medicare Part B covers medically necessary outpatient physical therapy when your provider certifies you need it, with no yearly cap; you pay 20% of the approved amount after the deductible (Medicare.gov).
  • Doctor and specialist visits, hearing and balance tests, scans: cost estimate being researched.

How well it works — what to expect

Results depend on the cause. BPPV often responds to repositioning, but it comes back after treatment fairly often (Cochrane review, 2014). Labyrinthitis and vestibular neuritis usually get better within a few weeks, though balance can take longer to return (NHS). Migraine and Ménière’s can be managed but not cured (NINDS, NIDCD). Some people can’t fully relieve their dizziness, and a vestibular therapist can help them build a plan to cope with it (NIDCD).

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic is a licensed health profession; treatment usually involves hands-on therapy, often spinal manipulation, and may include exercise and nutrition advice (NCCIH). For dizziness, chiropractic care comes up in two different ways.

The Epley maneuver for BPPV

Repositioning for BPPV is a set of head and body movements, not a spinal adjustment, and the guideline asks clinicians to treat BPPV this way or refer to someone who can (AAO-HNS guideline). Some chiropractors are trained to do it. A 2013 case series described eight people with lasting BPPV whose symptoms eased after chiropractors performed the Epley maneuver; it had no comparison group (case series, PubMed). If you see a chiropractor for BPPV, ask about their training in the Dix-Hallpike test and repositioning, and make sure the diagnosis is clear first.

Neck-related (“cervicogenic”) dizziness

Some people’s dizziness seems linked to neck pain or stiffness. The evidence for hands-on neck treatment here is limited:

  • A 2022 review of 13 trials (898 people) found moderate-quality evidence that manual therapy reduces neck-related dizziness, possibly more with exercise — but the evidence for the combination was very low quality (meta-analysis, PubMed).
  • A 2025 review of six trials found low to very low certainty evidence that treatment of the upper neck eases dizziness more than placebo or control treatments (meta-analysis, PubMed).

Neck treatment doesn’t address inner-ear problems, migraine, blood pressure drops or medicine side effects.

Safety: never have your neck manipulated when a stroke is possible. Short-lived soreness, stiffness or headache are common after spinal manipulation. Neck manipulation has been linked to small tears in the neck arteries that can lead to a stroke; this is rare, experts disagree about whether manipulation causes it, and serious side effects may be more likely in people with underlying health problems (NCCIH). Because sudden dizziness can itself be a sign of stroke (CDC), MBHA strongly advises seeing a medical doctor first for any new, sudden or severe dizziness, especially with headache, neck pain or any B.E. F.A.S.T. sign.

What it costs

  • Without insurance: about $90–$200 for a first visit and $55–$100 for follow-up visits (The Pricer).
  • A course of care adds up: an initial exam followed by several weeks of treatment can come to $500–$1,000; insurance can lower this, but deductibles, copays and visit limits still apply (The Pricer).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Most acupuncture research on dizziness looks at “cervical vertigo” — dizziness linked to the neck — and most of the trials come from China. The results sound promising, but the quality of the evidence is low.

What the research says

  • 2017 review: 10 studies (914 people) found acupuncture worked better than the comparison drug treatments for cervical vertigo, but the evidence was low to very low quality and long-term safety was uncertain; the authors called for larger, better trials (systematic review, PubMed).
  • 2026 review: 66 trials (5,797 people) compared needle-based treatments and Chinese massage (tuina) for neck-related vertigo. Acupuncture-based treatments ranked better than tuina alone, but most of the evidence was low or very low certainty and the authors said the rankings should be read cautiously (network meta-analysis, PubMed).
  • Emergency room pilot study: 60 people with dizziness or vertigo (people with life-threatening or brain causes were excluded) reported less discomfort after acupuncture at 30 minutes and 7 days, but a dizziness disability score did not differ after 7 days. It was a small, early study (pilot study, PubMed).
  • Ménière’s disease: the NIH says there is no evidence that acupuncture or acupressure works (NIDCD).

We found no good evidence that acupuncture treats BPPV, which responds to repositioning. If you try acupuncture, use it alongside — not instead of — a medical diagnosis.

Safety

Relatively few complications have been reported, but problems have come from non-sterile needles and poor technique. Needles must be sterile and single-use, and most states license acupuncturists (NCCIH). If you get dizzy easily, tell your acupuncturist and take your time getting up from the table.

What it costs

Private sessions run about $125–$230 for a first visit and $90–$185 for follow-ups; community clinics about $50–$90 a visit (The Pricer).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

No herb has been shown to fix vertigo, and some can make dizziness worse or interact with your medicines.

Ginkgo

For vertigo, a small amount of evidence suggests a benefit from ginkgo, but the overall evidence is not conclusive (NCCIH); NCCIH also notes there is no conclusive evidence that ginkgo helps any health condition (NCCIH). Ginkgo has not been shown to help Ménière’s disease (NIDCD). Dizziness is one of ginkgo’s most common side effects, it may raise the risk of bleeding with blood thinners such as warfarin, and it may be unsafe in pregnancy (NCCIH).

Ginger

Ginger is a popular kitchen remedy for queasiness. Most studies of ginger for motion sickness haven’t shown it to help (NCCIH), and the NIH found no evidence that ginger root helps Ménière’s disease (NIDCD). As a food or drink it is a gentle comfort; check with your provider before ginger supplements if you are pregnant or breastfeeding (NCCIH).

Supplements and dizziness. Tell your doctor about any herbal or alternative therapy you use, because some can change how well or how safely conventional medicines work (NIDCD). Bring vitamins, supplements and herbal remedies to every visit along with your prescriptions (NIDCD). We don’t list doses here.

Approach 5 of 6

Massage therapy

Massage doesn’t treat the causes of vertigo — inner-ear problems, migraine, blood pressure drops or medicines — and we found no good research showing it eases dizziness. It may help you relax, and for neck or shoulder pain it may give short-term relief (NCCIH).

If you have BPPV, tilting your head to look up or rolling over can set off spinning (NIDCD), so tell your therapist, change position slowly, and sit for a moment before you stand up.

Safety

The risk of harm appears to be low, but rare serious problems — a blood clot, nerve injury or broken bone — have been reported, some with vigorous deep-tissue massage or in people at higher risk, such as older adults (NCCIH). MBHA suggests avoiding forceful neck work if you have new or unexplained dizziness, and seeing a doctor first.

What it costs

Prices vary by location. At one national chain, franchise price lists show about $125–$160 for a 60-minute massage for non-members and about $65–$90 for members, whose memberships run about $70–$90 a month (The Pricer). Tips are extra.

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

Much of living with dizziness happens day to day. An MBHA Wellness Coach can help you turn your care team’s advice into habits — always alongside a medical diagnosis, never instead of one. For home safety and fall prevention, see our Balance guide.

During a spell

  • Sit down straight away when you feel dizzy, and lie still in a quiet, dark room to ease the spinning (NHS). Move slowly and carefully, get plenty of rest, and don’t bend down or get up suddenly (NHS).
  • After an inner-ear infection, start going for walks outside as soon as you can — with someone to steady you at first (NHS).

Getting up slowly and drinking enough

If you get lightheaded when you stand, get up slowly, and when getting out of bed move from lying to sitting to standing (NHS); sitting down may relieve the symptoms (NHLBI). Dehydration can cause low blood pressure, and your provider may suggest drinking more fluids (NHLBI). Ask your provider how much is right for you, especially if you have heart or kidney problems or Ménière’s.

Home exercises — only as prescribed

  • For BPPV, an audiologist may perform an Epley maneuver in clinic and then recommend the Brandt-Daroff exercises to do at home, because they are easier to do without supervision. They are likely to bring on dizziness, so they should be done somewhere safe, preferably with another person present (NHS hospital leaflet). In one trial, a single Epley treatment worked better than a week of Brandt-Daroff exercises (Cochrane review, 2014). Do them only if a clinician has confirmed BPPV and shown you how.
  • Balance (vestibular) exercises should be done under the supervision of a specialist such as a physical therapist or audiologist (NHS); for BPPV, the U.S. guideline allows vestibular rehabilitation either self-administered or with a clinician (AAO-HNS guideline). A coach can help you keep up the routine your therapist sets.

Keep a dizziness diary

Noting what the dizziness feels like, what sets it off, what else comes with it, how often it happens and how long it lasts helps your doctor make a diagnosis (NIDCD). If migraine may be involved, a headache journal noting the time, how long it lasted, sleep, stress, food and drink, weather and any medicines can help your doctor diagnose and treat it (NINDS). Common migraine triggers include too much or too little sleep, stress, skipped meals, too much alcohol and some medicines (NINDS). For vestibular migraine specifically, there is very little research on whether diet, sleep or other lifestyle changes prevent attacks (Cochrane review, 2023).

Alcohol, caffeine and sleep

  • For Ménière’s disease, the NHS advises trying to avoid caffeine (in tea, coffee and chocolate), not drinking alcohol, not smoking, and talking to your doctor about a low-salt diet (NHS).
  • While you are dizzy, avoid coffee, cigarettes and alcohol (NHS). Alcohol can make labyrinthitis symptoms worse, and so can tiredness, so try to get enough sleep (NHS). If you have low blood pressure, don’t drink too much alcohol (NHS).

Stress and anxiety

Long-term dizziness is stressful, and anxiety can make vertigo worse, so try to relax (NHS). For Ménière’s, counselling and relaxation techniques such as breathing exercises can help (NHS), and vestibular rehabilitation can ease anxiety as well as dizziness (NHS). If panic or anxiety seem to come with your dizzy spells, talk to a health care provider; they will also check that a physical problem isn’t the cause (NIMH). Our Anxiety guide has more.

Driving and safety

Talk with your doctor about whether it is safe to drive (NIDCD). Don’t drive, climb a ladder or use heavy machinery while you are dizzy (NHS), and with Ménière’s, take care with activities such as swimming, climbing ladders or using dangerous machinery (NHS). MBHA coaching cost estimate being researched.

Another approach

BPPV and repositioning maneuvers

BPPV is the most common cause of vertigo (MedlinePlus). It can follow a head injury or simply come with age (NIDCD).

What it feels like

Brief, intense spinning set off by a certain head movement — bending down, looking up or over your shoulder, or rolling over in bed (NIDCD). The spells are short-lived and come with quick changes in head position (Cochrane review, 2014). Sudden dizziness with vision problems, slurred speech or weakness may be a sign of something more serious and needs emergency help right away (MedlinePlus).

Diagnosis and treatment

The Dix-Hallpike test confirms the most common type, and a “roll test” checks for another type if needed (AAO-HNS guideline). The Epley maneuver can be done by an ear specialist or an audiologist (NIDCD). Watching and waiting is also an option the guideline allows, with a recheck within a month (AAO-HNS guideline).

After treatment

Advice differs. General NHS advice for vertigo includes squatting rather than bending over and sleeping with your head slightly raised on two or more pillows (NHS), while for the most common form of BPPV the 2017 guideline recommends against routine position restrictions after treatment (AAO-HNS guideline). Follow your own clinician’s instructions.

If it comes back

BPPV often comes back: in the trials reviewed by Cochrane, about 36 percent of people had it return after treatment (Cochrane review, 2014). The maneuver can be repeated, and some people need it several times (NIDCD). The guideline asks clinicians to recheck you within a month and to look for unresolved BPPV or another cause if symptoms persist (AAO-HNS guideline), so contact your provider if symptoms return, get worse, or home exercises don’t help.

General wellness

Everyday comfort, sleep and energy

Many people ask what they can do day to day to feel more comfortable, sleep better and have more energy. The habits below come from public health agencies. They are general wellness habits, not treatments for Dizziness & Vertigo, and they do not replace your doctor’s care. They are not personal stories or testimonials.

  • Sleep habits. The U.S. National Heart, Lung, and Blood Institute suggests going to bed and getting up at about the same time every day, using the hour before bed for quiet time, avoiding caffeine and heavy meals close to bedtime, keeping the bedroom quiet, cool and dark, and limiting naps to about 20 minutes (NHLBI).
  • Gentle movement. CDC says physical activity helps people “feel better, function better, and sleep better,” and that moderate activity such as brisk walking is generally safe for most people (CDC). Ask your doctor what kind and how much is right for you, especially if you have a heart condition or pain in your joints, hips or feet.
  • Relaxation practices. Slow breathing and similar practices are generally considered safe for healthy people, and some reviews suggest they may help with stress. On their own they “don’t seem to be especially promising for sleep,” and a few people report more anxiety or intrusive thoughts, so stop and tell your provider if that happens (NCCIH).

Please note: MBHA makes no medical claims. Results vary. Never stop or change a prescribed medicine without talking to your doctor, and see a doctor about severe or lasting symptoms.

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This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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