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Motion Sickness & Altitude Sickness

Queasiness on the road, at sea or in a VR headset, and the headache and nausea of going up into thin mountain air. Both are common and usually mild — but severe altitude illness is an emergency that needs descent.

At high altitude, these signs can mean a life-threatening brain or lung problem (HACE or HAPE):

  • confusion, unusual drowsiness or being hard to wake;
  • loss of balance or coordination — stumbling as if drunk;
  • a headache or other altitude symptoms that keep getting worse despite rest and painkillers;
  • breathlessness even when resting;
  • a cough, especially with frothy or bloody spit, or blue or grey lips or nails (NHS, CDC Yellow Book).

Go down right away — about 300 to 1,000 metres (roughly 1,000 to 3,300 feet) if you can — and get emergency medical help (NHS). Untreated, coma can follow within 12 to 24 hours of losing coordination, and HAPE can kill even faster (CDC Yellow Book).

Vomiting that won’t stop. Severe dehydration can be life-threatening. Get medical help right away for confusion, fainting, passing no urine, a racing heartbeat or fast breathing (MedlinePlus), and contact a provider if vomiting lasts more than 24 hours or there is blood in the vomit (MedlinePlus).

This guide covers two different travel problems: motion sickness, from movement your brain can’t make sense of, and altitude sickness, from the thin, low-oxygen air of the mountains. Flying has its own Air Sickness guide.

Part 1: Motion sickness

What causes it?

Cars, buses, trains, boats, roller coasters, virtual reality and simulators can all bring it on, and given enough motion almost anyone with a working inner-ear balance system can get it (CDC Yellow Book). The leading explanation is sensory conflict: your inner ear, eyes and body send signals about movement that don’t match what your brain expects. Below deck on a boat, for example, your inner ear feels the rolling while your eyes report a still cabin (CDC Yellow Book).

It usually builds gradually — stomach awareness, warmth, yawning, sweating and dizziness, then nausea and finally vomiting. Drowsiness, pallor, a “cold sweat” and extra saliva are common. Virtual reality and simulators cause more eyestrain and headache than real-world motion does (CDC Yellow Book).

Who is more prone?

Part 2: Altitude sickness

What causes it?

The higher you go, the less oxygen each breath carries. At about 10,000 feet (3,050 m) the oxygen you breathe in is only about 69% of what it is at sea level (CDC Yellow Book). The body can adjust (acclimatize), but the key early adjustments take 3 to 5 days, and altitude illness can only develop before they are complete (CDC Yellow Book). It usually affects people above about 2,500 metres (8,200 feet), especially those who go up quickly (NHS).

Three forms of altitude illness

  • Acute mountain sickness (AMS) is the most common — it affects about a quarter of visitors sleeping above 8,000 feet in Colorado. It feels like a hangover: a headache plus loss of appetite, dizziness, tiredness or nausea. It usually starts 2 to 12 hours after arriving, often during or after the first night, and generally settles within 12 to 48 hours if you go no higher. Babies and toddlers who can’t yet say how they feel may go off their food, turn pale and become irritable (CDC Yellow Book).
  • High-altitude cerebral edema (HACE) is swelling of the brain — in effect, end-stage AMS. It is rare, especially below about 14,000 feet. Its warning signs are confusion, drowsiness and loss of coordination that looks like drunkenness (CDC Yellow Book).
  • High-altitude pulmonary edema (HAPE) is fluid in the lungs. It starts with chest congestion, a cough, unusual breathlessness on exertion and tiring easily, and can progress over a day or two to breathlessness at rest, often with bloody sputum. It can be fatal faster than HACE, so early recognition is key (CDC Yellow Book).

Risk factors

  • How high you sleep, and how fast you get there. Anyone not yet acclimatized who sleeps at 8,000 feet (2,450 m) or higher is at risk, and sometimes lower. Flying straight into places above about 11,150 feet puts travelers at high risk — rates of altitude illness there can approach 50% (CDC Yellow Book).
  • Past altitude illness. How you did before is the best guide, though not a perfect one (CDC Yellow Book).
  • Genes play a part; fitness does not protect you. Children are as susceptible as adults; people over 50 have slightly less risk (CDC Yellow Book).

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) Motion: behavioral steps, then meclizine, dimenhydrinate, promethazine or a scopolamine patch taken before the trip. Altitude: gradual ascent and acetazolamide; for treatment, descent, oxygen, dexamethasone and nifedipine. Cost estimate being researched. Motion medicines lower the odds of sickness but often cause drowsiness. AMS usually settles in 1 to 3 days; HACE and HAPE need immediate descent.
Chiropractic No established role. For motion sickness there is only a three-patient case report; for altitude headache, one small trial with 24 hours of follow-up. Not a treatment for motion or altitude sickness, so no cost is listed. No good evidence of benefit. Never a reason to delay descent at altitude.
Acupuncture Acupressure wristbands on the P6 (Neiguan) point for motion sickness; a few small trials of ear acupressure and acupuncture for altitude sickness. Acupuncture: about $125–$230 for a first private visit and $90–$185 for follow-ups; community clinics about $50–$90. Wristbands: cost estimate being researched. Mixed evidence: some lab studies found the bands helped, better-controlled ones found them no better than placebo. Altitude research is early and small.
Herbal medicine Ginger for queasiness; ginkgo has been tried to prevent altitude sickness. Cost estimate being researched. Most studies haven’t shown ginger helps motion sickness. Ginkgo trials for altitude disagree; a large trial found it no better than placebo. Both can interact with medicines, especially blood thinners.
Massage therapy No role in preventing or treating either condition. We found no studies. Not a treatment for motion or altitude sickness, so no cost is listed. May feel relaxing on a rest day, but does nothing for altitude illness — never a substitute for going down.
MBHA Wellness Coach Front seat, horizon, fresh air, no reading, light meals, slow breathing; at altitude, slow ascent, rest days, water, no alcohol, knowing when to turn back. Cost estimate being researched. Habituation is the most effective motion-sickness remedy of all, though slow. A well-paced itinerary is the best protection against altitude illness.

Approach 1 of 6

Conventional medicine (AMA)

Motion sickness: what doctors suggest

Behavioral steps come first, especially for children (see MBHA Wellness Coach). Medicines suit occasional trips and work best taken before the journey: once nausea starts, the stomach slows down and may not absorb tablets (CDC Yellow Book).

  • Meclizine (Bonine, Dramamine Less Drowsy) and dimenhydrinate (Dramamine Original) are older antihistamines sold over the counter and suit mild to moderate motion (CDC Yellow Book). A Cochrane review found that first-generation antihistamines probably help: in real travel, 40% of people taking them stayed symptom-free versus 25% on placebo, though they may also make sleepiness more likely (Cochrane review).
  • Promethazine is suggested for short, intense motion; it is the most sedating of these medicines (CDC Yellow Book).
  • Scopolamine skin patch (Transderm Scop) is suggested for longer trips with moderate to intense motion. It is slightly less sedating than the antihistamines, but dry mouth and dry eyes are more common (CDC Yellow Book). It goes on the skin behind the ear at least 4 hours before it is needed, and must never be cut (MedlinePlus).
  • What doesn’t work: non-drowsy allergy pills and the anti-nausea drug ondansetron (CDC Yellow Book).

The CDC suggests a trial run of a medicine before the trip, since side effects vary (CDC Yellow Book). We don’t list doses.

Motion medicine cautions

Altitude: preventing illness

Going up gradually gives your body crucial time to adjust. The Wilderness Medical Society recommends (CDC Yellow Book; see also its 2024 guideline, PubMed):

  • don’t go from low ground to a sleeping altitude above 9,000 feet (2,750 m) in a single day;
  • once above about 9,800 feet (3,000 m), raise your sleeping altitude by no more than about 1,650 feet (500 m) a night;
  • add an extra night to acclimatize for every 3,300 feet (1,000 m) of sleeping altitude gained.

Spending 2 to 3 nights at 8,000–9,000 feet before going higher is markedly protective (CDC Yellow Book). Hence the saying “climb high, sleep low”: oxygen falls lowest during sleep, so day trips up high with a lower night are much easier on the body. Flying into Cusco or La Paz, sleeping lower for a night or two first may avoid the need for medicine (CDC Yellow Book).

  • Acetazolamide (Diamox) speeds up acclimatization and is FDA-approved for altitude illness (the other altitude medicines named here are used off-label). The CDC advises doctors to consider it for medium-risk trips and to strongly encourage it for high-risk ones, such as flying straight to a high city (CDC Yellow Book). Side effects include tingling and upset stomach; tell your doctor about drug allergies (including sulfa drugs), other health conditions and pregnancy (MedlinePlus).
  • Ibuprofen helps prevent AMS, though not quite as well as acetazolamide (CDC Yellow Book).
  • Dexamethasone, a steroid, can also prevent AMS, but it is generally kept for treatment; nifedipine may be used to prevent HAPE in people known to be prone to it (CDC Yellow Book).

Altitude: treatment

  • Mild AMS: tell your companions, rest at the same height and go no higher; painkillers such as ibuprofen or paracetamol (acetaminophen) and anti-sickness medicine can ease symptoms (NHS). AMS improves quickly with a descent of 1,000 feet (300 m) or more. Oxygen helps (handheld cans hold too little), and acetazolamide or, for moderate to severe AMS, dexamethasone can treat it. If symptoms get worse despite treatment, descent is mandatory (CDC Yellow Book).
  • HACE: start down, with dexamethasone and oxygen if available. If descent is impossible, oxygen or a portable hyperbaric (pressure) bag plus dexamethasone can be lifesaving (CDC Yellow Book).
  • HAPE: descent is usually urgent, with oxygen and as little exertion as possible; if going down isn’t an option, oxygen or a portable hyperbaric bag is critical. Nifedipine can be added, or a phosphodiesterase inhibitor if nifedipine isn’t available — but descent and oxygen work much better than any medicine (CDC Yellow Book).
  • Sleep: don’t use alcohol or opioids as sleep aids at altitude; they suppress breathing (CDC Yellow Book).

What it costs

Cost estimate being researched.

How well it works — what to expect

Motion medicines lower the odds of getting sick but don’t guarantee it (Cochrane review). In a large trial on the way to Everest base camp, AMS affected 34% of trekkers on placebo but 12% of those taking acetazolamide (PHAIT trial, BMJ). AMS usually clears in 1 to 3 days with rest (NHS).

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

There is no established chiropractic treatment for motion sickness or altitude sickness.

  • Motion sickness: the only report we found is a 2006 series of three patients, with no comparison group; the author called for further study (case series, PubMed).
  • Altitude sickness: a 2020 study randomly assigned 100 travelers to Tibet to spinal manipulation or standard pain treatment for AMS headache. Headache eased in both groups, and symptoms were followed for only 24 hours (trial, PubMed) — not enough to recommend it.

Safety: neck manipulation has been linked to rare but serious artery tears that can cause a stroke (NCCIH). At altitude, treat a headache with dizziness as altitude illness first: rest, go no higher, and go down if it gets worse (CDC Yellow Book).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

In Traditional Chinese Medicine, the P6 (Neiguan) point on the inner wrist is linked with nausea. Elastic wristbands such as Sea-Band press on it; electrical bands stimulate it.

Motion sickness: what the research says

Altitude sickness

Research is new and small. In a 2025 Taiwanese study of 45 hikers, ear (auricular) acupressure with seeds was linked with less AMS at the highest point (trial, PubMed). A 2026 pilot study of 125 people found slightly lower altitude-sickness scores 6 hours after press-needle treatment, but no differences in other measures at 48 hours (pilot trial, PubMed). Neither is a reason to skip gradual ascent, medicine your doctor advises, or descent.

Safety and cost

Acupuncture has relatively few reported complications when done properly with sterile, single-use needles (NCCIH). Private sessions run about $125–$230 for a first visit and $90–$185 for follow-ups; community clinics about $50–$90 (The Pricer). Wristbands: cost estimate being researched.

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

Ginger for motion sickness

Ginger is the remedy most travelers reach for, and the NHS suggests trying it as a tablet, biscuit or tea (NHS). But the U.S. National Institutes of Health notes that most studies of ginger for motion sickness haven’t shown it to help (NCCIH), and the CDC calls the evidence for ginger weak and contradictory (CDC Yellow Book). As food or a drink it is a gentle comfort; don’t rely on it in place of the steps that work.

Ginger can cause stomach discomfort, heartburn and diarrhea. Check with your provider before using ginger supplements if you take any medicine or are pregnant (NCCIH).

Ginkgo for altitude sickness

Ginkgo biloba has been tested to prevent AMS, with conflicting results:

The NIH says there is no conclusive evidence that ginkgo helps any health condition (NCCIH).

Safety. Ginkgo’s most common side effects are dizziness, stomach upset and headache (NCCIH) — easy to confuse with altitude sickness. Taken with the blood thinner warfarin, ginkgo is linked to a higher risk of major bleeding, and it should not be combined with the HIV medicine efavirenz (NCCIH). It may be unsafe in pregnancy (NCCIH). Talk with your doctor or pharmacist before taking any herb with your travel medicines. We don’t list doses.

Approach 5 of 6

Massage therapy

Massage has no role in preventing or treating motion sickness or altitude illness. A PubMed search for massage with motion, altitude or mountain sickness found no studies. A massage on a rest day may feel relaxing, and serious harm from massage is rare (NCCIH) — but altitude symptoms need rest, no further ascent and, if they worsen, descent (CDC Yellow Book), not bodywork.

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

An MBHA Wellness Coach can help you plan a trip that keeps both problems to a minimum.

On the road, on the water and on rides

In the mountains

A coach supports, but never replaces, your doctor’s advice — especially about medicines to carry.

Another approach

Before you go high: who should see a doctor first

Anyone with a long-term health condition should make sure it is stable before departure and have a plan for flare-ups at altitude (CDC Yellow Book). The CDC advises people with coronary artery disease, any long-term lung disease or low oxygen levels, obstructive sleep apnea or sickle cell trait to consult a physician familiar with altitude medicine before high-altitude travel, even when the condition is well controlled (CDC Yellow Book). Talk to a doctor or travel clinic too if you’ve had altitude sickness before or are going up quickly (NHS).

In their own words

Wellness and lifestyle testimonials

Please read first. These are personal experiences, not medical advice. MBHA makes no medical claims and does not claim any product heals or cures; the insoles are not proven to prevent altitude sickness. Altitude illness can be dangerous — if symptoms get worse, go down and seek medical care, and follow your doctor’s advice about medicines.

My daughter just returned from Tibet and Nepal and couldn’t have been happier with her insoles. She was the only one in her group who didn’t suffer from altitude sickness — and they all live just a foot or two above sea level! When they had to climb the many, many steps up to the Buddhist temples, she was the only one who wasn’t exhausted afterward.

— Sally

Shared with first names only. Lightly edited for length and spelling.

Member stories

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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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