Vertigo causes and treatment (2023)

Treatment for vertigo depends on the cause and severity of your symptoms.

During a vertigo attack, lying still in a quiet, darkened room may help to ease any symptoms of nausea and reduce the sensation of spinning. You may be advised to take medication.

You should also try to avoid stressful situations, as anxiety can make the symptoms of vertigo worse.

Read more aboutwhat to do if you're struggling with stress

Labyrinthitis

Labyrinthitis is an inner ear infection that causes the labyrinth (a delicate structure deep inside your ear) to become inflamed. It's usually caused by a viral infection and clears up on its own without treatment. In rare cases, where labyrinthitis is caused by a bacterial infection,antibiotics may be prescribed.

If you've experienced any hearing loss, your GP may refer you to an ear, nose and throat (ENT) specialist or an audiovestibular physician. This is a doctor who specialises in hearing and balance disorders. You may need emergency treatment to restore your hearing.

Labyrinthitis may also be treated with vestibular rehabilitation– also called vestibular rehabilitation training or VRT (see below).

See treating labyrinthitis for more information

Vestibular neuronitis

Vestibular neuronitis, also known as vestibular neuritis, is inflammation of the vestibular nerve (one of the nerves in your ear that's used for balance). It's usually caused by a viral infection.

The symptoms of vestibular neuronitisoften get better without treatmentover several weeks. However, you may need to rest in bed if your symptoms are severe. See your GP if your symptoms get worse or don't start to improve after a week.

(Video) Vertigo, Causes, Signs and Symptoms, Diagnosis and Treatment.

You may find your balance is particularly affected if you:

  • drink alcohol
  • are tired
  • have another illness

Avoiding these can help to improve your condition.

Vestibular neuronitis can also be treated with vestibular rehabilitation and medication.

Benign paroxysmal positional vertigo (BPPV)

Like vestibular neuronitis, benign paroxysmal positional vertigo (BPPV) often clears up without treatment after several weeks or months. It's thought that the small fragments of debris in the ear canal that cause vertigo either dissolve or become lodged in a place where theyno longercause symptoms.BPPV can sometimes return.

Until the symptoms disappear or the condition is treated, you should:

  • get out of bed slowly
  • avoid activities that involve looking upwards, such as painting and decorating or looking for something on a high shelf

BPPV can be treated using a procedure called the Epley manoeuvre.

The Epley manoeuvre

The Epley manoeuvre involves performing four separate head movements to move the fragments that cause vertigoto a place where they no longercause symptoms. Each head position is held for at least 30 seconds. You may experience some vertigo during the movements.

Your symptoms should improve shortly after the Epley manoeuvre is performed, although it may take up to two weeks for a complete recovery. Return to your GP if your symptoms haven't improved after four weeks. The Epley manoeuvre isn't usually a long-term cure and may need tobe repeated.

Brandt-Daroff exercises

If the Epley manoeuvre doesn't work, or if it's not suitable – for example, because you have neck or back problems–you can alsotry Brandt-Daroff exercises. These are a series of movementsyou can do unsupervised at home.

Your GP will need to teach you how to do the exercises. You repeat them three or four times a day for two days in a row. Your symptoms may improve for up to two weeks.

(Video) Understanding the Causes of Vertigo

Referral to a specialist

Your GP may refer you to a specialist, such as an ear, nose and throat (ENT) specialist if:

  • the Epley manoeuvre doesn't work or can't be performed
  • you still have symptoms after four weeks
  • you have unusual signs or symptoms

In rare cases, where the symptoms of vertigo last for months or years, surgery may be recommended. This may involve blocking one of the fluid-filled canals in your ear. Your ENT specialistcan give more advice on this.

Ménière's disease

If your vertigo is caused by Ménière's disease, there are a number of treatment optionsfor both the vertigo and other symptoms caused by the condition.

Possible treatments for Ménière's disease include:

  • dietary advice– particularly a low-salt diet
  • medication to treat attacks of Ménière's disease
  • medication to prevent attacks of Ménière's disease
  • treatment fortinnitus (ringing in your ears)– such as sound therapy,which works by reducing the difference between tinnitus sounds and background sounds, to make the tinnitus sounds less intrusive
  • treatment for hearing loss– such as using hearing aids
  • physiotherapy to deal with balance problems
  • treatment for the secondary symptoms of Ménière's disease– such as stress, anxiety and depression

See treating Ménière's disease for more information

Central vertigo

Central vertigo is caused by problems in part of your brain, such as the cerebellum (which is located at the bottom of the brain) or the brainstem (the lower part of the brain that's connected to the spinal cord).

Causes of central vertigo includemigraines and, less commonly,brain tumours.

If your GP suspectsyou have central vertigo, they may organise ascan or refer you to a hospital specialist,such as a neurologist or an ENT (ear, nose and throat specialist) or audiovestibular physician.

Treating your migraine should relieve your vertigo if it's caused by a migraine.

Vertigo with an unknown cause

If the cause of your vertigo is unknown, you may be admitted to hospital if:

(Video) Vertigo: causes, symptoms, and treatments

  • you have severe nausea and vomiting, and can't keep fluids down
  • your vertigo comes on suddenly and wasn't caused by you changing position
  • you possibly have central vertigo
  • you have sudden hearing loss, but it's not thought to be Ménière's disease

Alternatively, you may be referred to a specialist, such as:

  • a neurologist – a specialist in treating conditions that affect the nervous system
  • an ENT specialist – a specialist in conditions that affect the ear, nose or throat
  • an audiovestibular physician – a specialist in hearing and balance disorders

While waiting to see a specialist, you may be treated with medication.

Vestibular rehabilitation

Vestibular rehabilitation, also called vestibular rehabilitation training or VRT, is a form of "brain retraining". It involves carrying out a special programme of exercises that encourage your brain to adapt to the abnormal messages sent from your ears.

During VRT, you keep moving despite feelings of dizziness and vertigo. Your brain should eventually learn to rely on the signals coming from the rest of your body, such as your eyes and legs, rather than the confusing signals coming from your inner ear. By relying on other signals, your brain minimises any dizziness and helps you to maintain your balance.

An audiologist (hearing specialist) or a physiotherapistmay provide VRT. Your GP may be able to refer you for VRT, although it depends on availability in yourarea.

In some cases,itmay be possible touse VRT without specialist help. Research has shown thatpeople with some types of vertigo can improve their symptoms using a self-helpVRT booklet. However, you should discuss this with your doctor first.

Medicines

Medication can be used to treatepisodes of vertigo caused by vestibular neuronitisorMénière's disease. It may also be used for central vertigo or vertigo with an unknown cause.

The medicines are usually prescribed for3to 14 days, depending on which condition they're for. The two medicines that are usually prescribed are:

  • prochlorperazine
  • antihistamines

If these medicines are successful in treating your symptoms, you may be given a supply to keep at home, so you can take them the next time you have an episode of vertigo.

In some cases you may be advised to take long-term medication, such as betahistine, for conditions like Ménière's disease.

(Video) Vertigo: The Best Remedy

Prochlorperazine

Prochlorperazine can help relievesevere nausea and vomiting associated with vertigo. It works by blocking the effect of a chemical in the brain called dopamine.

Prochlorperazine can cause side effects, including tremors (shaking) and abnormal or involuntary body and facial movements.

It can also make some people feel sleepy. For the full list of possible side effects, check the patient information leaflet that comes with your medicine.

Antihistamines

Antihistamines can be used to help relieve less severe nausea, vomiting and vertigo symptoms. They work by blocking the effects of achemical called histamine.

Possible antihistamines that may be prescribed include:

  • cinnarizine
  • cyclizine
  • promethazine teoclate

Like prochlorperazine, antihistamines can also make you feel sleepy. Headaches and an upset stomach are also possible side effects. Check the patient information leaflet that comes with your medicine for the full list of possible side effects.

A medication called betahistine works in a similar way to antihistamines. It has been used to treat Ménière's disease and may also be used for other balance problems. It may have to be taken for a long period of time. The beneficial effects vary from person to person.

Safety

If you have vertigo, there are some safety issuesto consider. For example:

  • you should inform your employer if your job involves operating machinery or climbing ladders
  • you may be at increased risk of falls – see preventing falls for adviceon making your home safer and reducing your risk

Vertigo could also affect your ability to drive. You should avoid driving if you've recently had episodes of vertigo and there's a chance you may have another episode while you're driving.

It's your legal obligation to inform the Driver and Vehicle Licensing Agency (DVLA) about a medical condition that could affect your driving ability. Visit the GOV.UK website for more information on driving with a disability.

(Video) Treating BPPV: The Epley Manuever - Boys Town National Research Hospital

FAQs

What is the number one cause of vertigo? ›

Vertigo is commonly caused by a problem with the way balance works in the inner ear, although it can also be caused by problems in certain parts of the brain. Causes of vertigo may include: benign paroxysmal positional vertigo (BPPV) – where certain head movements trigger vertigo. migraines – severe headaches.

What is the cause and treatment of vertigo? ›

If vertigo is caused by an infection or inflammation, antibiotics or steroids may reduce swelling and cure infection. For Meniere's disease, diuretics (water pills) may be prescribed to reduce pressure from fluid buildup. Surgery. In a few cases, surgery may be needed for vertigo.

What is the most common treatment for vertigo? ›

Acute vertigo is best treated with nonspecific medication such as dimenhydrinate (Dramamine®) and meclizine (Bonine®).

What will a neurologist do for vertigo? ›

In a general sense, vertigo-associated disease is commonly treated using vestibular blocking agents or VBAs. These include medications such as antihistamines (promethazine or betahistine), benzodiazepines (diazepam or lorazepam), or antiemetics (prochlorperazine or metoclopramide).

Is vertigo causes by stress? ›

About 5 percent of American adults experience vertigo, and many people notice it when they're feeling stressed or anxious. Even though stress doesn't directly cause vertigo, it can contribute to dysfunction of the part of your inner ear that controls balance, called your vestibular system.

What medications cause vertigo? ›

The list of drugs that may cause vertigo or dizziness is impressive. It includes anti-convulsants, anesthetics, anti-depressants, analgesics, anti-diabetics, contraceptives, anti-inflammatory drugs, cardiovascular drugs, sedatives, tranquillizers, cytotoxic agents, and anti-hypertensive agents.

Is there a vitamin deficiency that causes vertigo? ›

Benign paroxysmal positional vertigo (BPPV) is linked to vitamin D deficiency.

What over the counter medicine is good for vertigo? ›

In general, short periods of vertigo or motion sickness respond well to over-the-counter antihistamines. Two common ones are dimenhydrinate (Dramamine) and meclizine (Bonine).

Why vertigo will not go away? ›

Inner ear problems

Vertigo caused by inflammation or an infection in the inner ear may remain until the inflammation subsides. If you have any signs of inner ear problems, it's important to talk to your doctor about treatment so they can get the vertigo under control.

How many days does it take for vertigo to go away? ›

Vertigo feels like you or everything around you is spinning – enough to affect your balance. It's more than just feeling dizzy. A vertigo attack can last from a few seconds to hours. If you have severe vertigo, it can last for many days or months.

How long does it usually take for vertigo to go away? ›

In about half of all people who have BPPV, the symptoms go away after only 1 to 3 months. So treatment isn't always needed. If the dizzy spells don't go away on their own or are very difficult for the person to cope with, repositioning maneuvers can help.

Should I go to ENT or neurologist for vertigo? ›

If you have been experiencing vertigo for more than a day or two, it's so severe that you can't stand or walk, or you are vomiting frequently and can't keep food down, you should make an appointment with a neurologist.

Does vertigo mean brain tumor? ›

Is vertigo a symptom of a brain tumor? Room spinning dizziness is a not a common brain tumor symptom and is more often related to an inner ear problem.

What does an ENT doctor do for vertigo? ›

If a build-up of fluids in the inner ear causes vertigo, prescription medications are the first point of call. In this case, antibiotics or antihistamines are helpful. Sometimes, because nausea, and in some cases, vomiting, accompany vertigo, the ENT doctor may prescribe motion sickness medications to provide relief.

What causes vertigo in older adults? ›

Although the causes of dizziness in older people are multifactorial, peripheral vestibular dysfunction is one of the most frequent causes. Benign paroxysmal positional vertigo is the most frequent form of vestibular dysfunction in the elderly, followed by Meniere's disease.

Can anxiety cause vertigo? ›

Vertigo is just one symptom that can occur with chronic stress and anxiety. So learning a few stress management techniques can help with vertigo and your overall well-being. Mental health experts recommend habits such as: Getting enough sleep.

What viruses can cause vertigo? ›

The most common causes of vestibular neuritis and labyrinthitis are viral infections, often resulting from a systemic virus such as influenza (flu) or the herpes viruses, which cause chickenpox, shingles and cold sores.

Will vertigo go away on its own? ›

Vertigo can go away on its own, as your brain adapts to the changes in your inner ear. Other times, treatment is needed, which could include: Canalith repositioning maneuvers are a specific series of exercises to treat BPPV by moving the calcium deposits out of the inner ear to be reabsorbed by the body.

What causes the crystals in your inner ear to move? ›

Blame it on crystals

BPPV happens when tiny crystals of calcium carbonate in one part of your inner ear become dislodged and float into another part. That doesn't sound too serious, but small head movements cause the loose crystals to move, triggering your inner-ear sensors to send mixed messages to your brain.

How do you dissolve crystals in your inner ear? ›

Canalith repositioning consists of a series of provider-led head movements that are done in order to move the dislodged crystals from your inner ear's semicircular canals back into the Otolith organs where they'll eventually be reabsorbed or dissolve altogether.

Can dehydration cause vertigo? ›

Can dehydration lead to vertigo? If you're dehydrated, you may start to feel dizzy. This feeling can cause you to also experience lightheadedness, wooziness, fairness and unsteadiness. You may also experience a very specific form of dizziness called vertigo.

What increases risk of vertigo? ›

Some Factors Put You at Increased Risk for Vertigo

Osteoporosis. Migraine. Past head trauma. High total cholesterol level.

What electrolyte imbalance causes vertigo? ›

A few examples of electrolytes include sodium, potassium, and chloride. If someone is dehydrated, these electrolytes could be thrown out of balance. This could lead to vertigo.

Are there any supplements that help vertigo? ›

Several natural agents such as vitamin D, calcium, ginkgo biloba, and coenzyme Q10 may be effective adjuvants in the management of vertigo. Depending on the cause of vertigo, some dietary and lifestyle considerations, such as a low-sodium diet, may reduce the severity or frequency of symptoms as well.

Is B12 good for vertigo? ›

Vitamin B12 Deficiency: A simple vitamin deficiency can also cause vertigo and dizziness. Vitamin B12 helps prevent anaemia and keeps nerves and blood cells healthy. Low levels of this vitamin can cause neurological problems that in turn cause vertigo.

Can vertigo be cured without medication? ›

Sometimes vertigo goes away without any treatment. Options range from medication to specific exercises to surgery. Your healthcare provider can help you determine which therapies are likely to help your symptoms based on your diagnosis.

Can vertigo be a symptom of something more serious? ›

Although less common, vertigo may be a sign that something serious is happening. More severe conditions to watch for include: Head injury. Brain tumors.

Can vertigo indicate a stroke? ›

Recurrent attacks of vertigo have been reported to be important predictors of a future stroke. A recent study reported that vertigo is one of the most common symptoms of vertebrobasilar ischemia, which comprises about 20% of all ischemic strokes.

Is vertigo a symptom of a brain tumor? ›

Is vertigo a symptom of a brain tumor? Room spinning dizziness is a not a common brain tumor symptom and is more often related to an inner ear problem.

What illness has vertigo as a symptom? ›

Meniere's disease is an inner ear problem that can cause dizzy spells, also called vertigo, and hearing loss. Most of the time, Meniere's disease affects only one ear. Meniere's disease can happen at any age. But it usually starts between the ages of 40 to 60.

What kind of tumor causes vertigo? ›

Acoustic neuroma (vestibular schwannoma)

Acoustic neuroma, also known as vestibular schwannoma, is a noncancerous and usually slow-growing tumor that develops on the main (vestibular) nerve leading from your inner ear to your brain.

When should you worry about vertigo? ›

Generally, see your doctor if you experience any recurrent, sudden, severe, or prolonged and unexplained dizziness or vertigo. Get emergency medical care if you experience new, severe dizziness or vertigo along with any of the following: Sudden, severe headache. Chest pain.

Why wont my vertigo go away? ›

Inner ear problems

Vertigo caused by inflammation or an infection in the inner ear may remain until the inflammation subsides. If you have any signs of inner ear problems, it's important to talk to your doctor about treatment so they can get the vertigo under control.

Can you drive with vertigo? ›

Driving with Dizziness is Against the Law

If you are dizzy at all or recovering from a vertigo attack, then driving should be avoided.

What helps vertigo go away fast? ›

A technique called canalith repositioning (or Epley maneuver) usually helps resolve benign paroxysmal positional vertigo more quickly than simply waiting for your dizziness to go away. It can be done by your doctor, an audiologist or a physical therapist and involves maneuvering the position of your head.

What vitamin helps with vertigo? ›

Vitamin D and calcium supplements reduced vertigo recurrence after successful vestibular rehabilitation, especially among patients with subnormal vitamin D levels, a trial in Neurology reported.

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