Dizziness and vertigo - aftercare

Most often, people say the spinning feeling can start when they roll over in bed or tilt their head up to look at something.

Along with dizziness and vertigo, you may also have:

• Nausea and vomiting
• Hearing loss
• Ringing in your ears (tinnitus)
• Vision problems, such as a feeling that things are jumping or moving
• Loss of balance, difficulty standing up

Mild dizziness usually gets better by itself, or is easily treated. However, it can be a symptom of other problems. There are many causes. Medicines may cause dizziness, or problems with your inner ear. Motion sickness can also make you dizzy.

Vertigo can be a symptom of many disorders, as well. Some may be chronic, long-term conditions. Some may come and go. Depending on the cause of your vertigo, you may have other symptoms, like benign positional vertigo or Meniere disease. It is important to have your health care provider decide if your vertigo is a sign of a serious problem.

If you have vertigo, you may be able to prevent your symptoms from getting worse by:

• Avoiding sudden movements or position changes, especially of your head
• Keeping still and resting when you have symptoms
• Avoiding bright lights, TV, and reading when you have symptoms

When you feel better, slowly increase your activity. If you lose your balance, you may need help walking to stay safe.

A sudden, dizzy spell during certain activities can be dangerous. Wait one week after a severe spell of vertigo is gone before you climb, drive, or operate heavy machinery or consult your provider for advice. Chronic dizziness or vertigo can cause stress. Make healthy lifestyle choices to help you cope:

• Get enough sleep.
• Eat a well-balanced, healthy diet. Do not overeat.
• Exercise regularly, if possible.
• Learn and practice ways to relax, such as guided imagery, progressive muscle relaxation, yoga, tai chi, or meditation.
• Keep a diary to record when you have dizziness, and what you were doing when it started. This may help identify triggers to avoid.

Make your home as safe as you can, just in case you lose your balance. For example:

• Remove loose wires or cords from areas you walk through to get from one room to another.
• Remove loose throw rugs.
• Install night lights.
• Put nonskid mats and grab bars near the bathtub and toilet.

Your provider may prescribe medicines for nausea and vomiting. Dizziness and vertigo may improve with some medicines. Commonly used medicines include:

• Dimenhydrinate
• Meclizine
• Sedatives such as diazepam (Valium)

Too much water or fluid in your body may make the symptoms worse by increasing fluid pressure in your inner ear. Your provider may suggest a low salt diet or water pills (diuretics).

Call 911 or the local emergency number, or go to an emergency room if you are dizzy and have:

• A head injury
• Fever over 101°F (38.3°C)
• Headache or a very stiff neck
• Seizures
• Trouble keeping fluids down; vomiting that does not stop
• Chest pain
• Irregular heart beat
• Shortness of breath
• Weakness
• Cannot move an arm or leg
• Change in vision or speech
• Fainting and losing alertness

Contact your provider if you have:

• New symptoms, or symptoms that are getting worse
• Dizziness after taking medicine
• Hearing loss

Meniere disease - aftercare; Benign positional vertigo - aftercare

Chang AK. Dizziness and vertigo. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 15.

Crane BT, Minor LB. Peripheral vestibular disorders. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 167.

Updated by: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.