The most effective thing you can do for vertigo depends on what’s causing it, but the majority of cases stem from a treatable inner ear problem called BPPV, where tiny crystals in your ear shift out of place. For that, a simple head repositioning maneuver you can do at home often resolves symptoms in one or two sessions. Other causes require different approaches, from daily balance exercises to dietary changes or medication. Here’s what works and when to use each approach.
Figure Out What Type of Vertigo You Have
Before you can treat vertigo effectively, it helps to narrow down the cause. The two most common types behave very differently, and recognizing the pattern tells you a lot about what to do next.
BPPV (benign paroxysmal positional vertigo) produces brief spinning episodes lasting 10 to 30 seconds, triggered by specific head movements like rolling over in bed, bending over, or looking up. Between episodes, you feel mostly normal. This is the most common cause of vertigo and the easiest to treat.
Vestibular neuritis causes constant, severe vertigo lasting days to weeks, usually without any specific trigger. It often follows a viral infection and comes with nausea but typically no hearing loss. This type needs time and rehabilitation exercises rather than repositioning maneuvers.
Ménière’s disease causes vertigo episodes lasting 20 minutes to several hours, along with hearing loss, ear fullness, and ringing in the affected ear. This type responds best to dietary changes and sometimes medication.
The Epley Maneuver for BPPV
If your vertigo hits in short bursts when you move your head, the Epley maneuver is the first thing to try. It works by guiding the displaced crystals in your inner ear back to where they belong through a series of head positions. Many people feel significant relief after just one attempt.
To perform it for right-ear BPPV: sit on a bed and turn your head 45 degrees to the right. Quickly lie back so your shoulders rest on your pillow with your head still turned. Hold this position for about 30 seconds. Then turn your head 45 degrees to the left without lifting it, and hold again. Next, roll your body onto your left side so your head angles down toward the bed, hold for 30 seconds, and slowly sit up from that side. Stay upright for a few minutes afterward.
If your left ear is affected, reverse all the directions. You can repeat the maneuver two or three times in a row if the first attempt doesn’t fully resolve the spinning. Some people experience mild dizziness during the maneuver itself, which is actually a sign you’re moving the crystals.
The Half Somersault as an Alternative
The half somersault maneuver (sometimes called the Foster maneuver) is another option for BPPV that some people find easier to do alone, since it doesn’t require lying flat on a bed. Research comparing it to the Epley maneuver shows similar success rates overall, though the Epley tends to reduce the characteristic eye movements of BPPV faster on the first try. The trade-off is that the Epley also tends to cause more dizziness during the procedure. If you struggle with the Epley at home, the half somersault is a reasonable alternative to try.
Vestibular Rehabilitation Exercises
For vertigo caused by vestibular neuritis, Ménière’s disease, or any condition where the inner ear has sustained lasting damage, your brain needs to recalibrate how it processes balance signals. Vestibular rehabilitation therapy uses specific exercises to train this adaptation. Stanford Medicine recommends doing these exercises three times daily, alongside a daily walk.
The core exercises are simpler than you might expect. Gaze stabilization involves turning your head side to side while keeping your eyes fixed on a stationary target. You start with 5 to 10 repetitions, holding each direction for 2 to 3 seconds, and gradually work up to 15 or 20 repetitions as your tolerance improves. The same progression applies to vertical head movements, looking up at the ceiling and down at the floor.
Habituation exercises involve shaking your head in a “no” pattern or nodding “yes” for up to one minute at a time. If a full minute is too intense at first, start with just 10 seconds and add time gradually. These movements deliberately provoke mild dizziness so your brain learns to filter out the faulty signals. The dizziness during exercises should be manageable, not severe. Over weeks, most people notice their baseline symptoms steadily improve.
Dietary Changes That Help
If your vertigo is related to Ménière’s disease, what you eat and drink can directly influence how often episodes occur. The most established dietary recommendation is limiting sodium to 1,500 to 2,000 mg per day, roughly three-quarters to one teaspoon of table salt. Excess sodium causes fluid shifts in the inner ear that can trigger episodes. This means reading nutrition labels carefully, since processed foods, restaurant meals, and condiments often contain far more sodium than people realize.
Alcohol is another common trigger. It narrows the blood vessels supplying the inner ear, which can worsen vertigo symptoms. It also acts as a diuretic, pulling fluid from your blood and potentially causing dehydration that compounds balance problems. Caffeine and alcohol restriction are commonly recommended by doctors for Ménière’s patients, though the evidence supporting caffeine avoidance specifically is less robust than for sodium.
Medication for Acute Episodes
When vertigo is severe enough that you can’t function, medication can help manage the spinning and nausea in the short term. Meclizine is the most commonly used option, an antihistamine that suppresses the signals causing the spinning sensation. It’s available over the counter in many countries. For vertigo specifically, doses range from 25 to 100 mg per day, split into multiple doses.
These medications work best as a short-term bridge during intense episodes rather than an ongoing treatment. Using them for too long can actually slow your recovery, because they suppress the same signals your brain needs to recalibrate through. For most types of vertigo, the goal is to manage the worst of the acute symptoms with medication and then transition to exercises and maneuvers that address the underlying cause.
Warning Signs That Need Immediate Attention
Most vertigo is caused by inner ear problems and, while miserable, isn’t dangerous. But vertigo can occasionally signal a stroke affecting the back of the brain. What makes this tricky is that up to 20% of posterior circulation strokes present without the classic stroke symptoms like weakness, slurred speech, or facial drooping.
Get emergency help if your vertigo comes with any of these: sudden severe headache, difficulty walking or coordinating movements, double vision, numbness or weakness on one side, trouble speaking or swallowing, or the inability to keep your eyes still even when looking straight ahead. In the emergency department, doctors use a specialized eye exam called the HINTS test to distinguish inner ear vertigo from a stroke-related cause by examining how your eyes respond to rapid head movements and whether your eyes are vertically misaligned.
Vertigo that comes on suddenly, is constant rather than positional, and occurs without any obvious trigger warrants faster medical evaluation than the brief, position-triggered episodes typical of BPPV.