What makes vertigo go away depends entirely on what’s causing it. The most common type, triggered by tiny calcium crystals drifting into the wrong part of your inner ear, can be resolved in minutes with a simple head repositioning technique that works for about 90% of people. Other forms of vertigo require different approaches, from dietary changes to specialized physical therapy. Here’s what works for each type and what you can do right now.
BPPV: The Most Common (and Most Fixable) Type
Benign paroxysmal positional vertigo, or BPPV, causes brief but intense spinning when you change head position: rolling over in bed, looking up, or bending down. It happens when tiny calcium carbonate crystals break loose inside your inner ear and drift into one of the semicircular canals, where they don’t belong. Every time you move your head, those crystals shift and send false signals to your brain about your body’s position.
The fix is physical, not chemical. A set of specific head movements can guide those crystals back where they came from. The Epley maneuver is the gold standard: your head is turned 45 degrees toward the affected side, then you lie back quickly so your head hangs slightly over the edge of the table. After holding that position for at least 30 seconds, your head is rotated 90 degrees to the opposite side and held again. Then you roll your whole body to that side with your head angled toward the floor and hold once more before sitting back up. Each position is held for a minimum of 30 seconds while the crystals slowly migrate through the canal.
In clinical studies, 72% of patients had complete resolution immediately after the Epley maneuver, and 92% were symptom-free within one week. Epley himself reported success rates above 90% after a single session.
A Simpler Version You Can Do Alone
The Epley maneuver can be tricky to do on yourself because it requires precise head angles and often triggers intense spinning mid-exercise. The half-somersault maneuver, developed at the University of Colorado, is designed specifically for home use without an assistant. Research comparing the two found that both relieved symptoms, but patients reported less dizziness and fewer complications with the half-somersault when self-applying. The technique involves kneeling, tipping your head toward the floor, turning it toward the affected ear, then raising your head while keeping it turned before sitting back upright. Printable instructions are available from the University of Colorado Anschutz Medical Campus.
There is one important risk with any repositioning maneuver: it’s possible to accidentally move the crystals into a different canal, making symptoms temporarily worse. If your vertigo changes character or shifts to a different triggering position after attempting a maneuver, stop and have a professional evaluate which canal is involved.
What to Do After Treatment
After a successful repositioning maneuver, some clinicians recommend sleeping with your head elevated at about 45 degrees for 48 hours, either in a reclined armchair or propped up on two pillows. You may also be told to avoid sleeping on the affected ear and to limit sudden head movements, particularly looking sharply up or down, for up to a week. These precautions aim to keep the crystals from sliding back into the canal before they fully settle.
That said, research on whether post-treatment position restrictions actually improve outcomes is mixed. Some studies have found no significant difference in cure rates between patients who followed strict positioning rules and those who didn’t. Still, many people find the precautions easy enough that they’re worth taking.
Preventing BPPV From Coming Back
BPPV has a frustrating tendency to recur. Risk factors for repeat episodes include older age, being female, high blood pressure, diabetes, and osteoporosis. One factor that has gained strong research support is vitamin D deficiency. People with recurrent BPPV consistently show lower vitamin D levels than those who have a single episode and never deal with it again. In one study, the recurrent group averaged vitamin D levels of 12.9 ng/mL compared to 19.2 ng/mL in those without recurrence.
Supplementing vitamin D in deficient patients appears to help. One intervention study found that the annual recurrence rate dropped from 1.10 episodes per year in the observation group to 0.83 in the supplementation group, with 37.8% experiencing recurrence compared to 46.7%. In a smaller study, 100% of patients had recurrent BPPV before vitamin D correction, but after supplementation only about 31% had even a single recurrence. If you’ve had BPPV more than once, checking your vitamin D level is a reasonable step.
Vestibular Migraine
Vestibular migraine is the second most common cause of recurrent vertigo. It produces episodes of spinning or unsteadiness that can last minutes to days, often alongside (or instead of) headache. Unlike BPPV, there’s no single maneuver that fixes it. Management centers on identifying and avoiding triggers.
The dietary trigger list is extensive. Key categories include aged cheeses (cheddar, brie, parmesan, gouda, and others), cured and processed meats like pepperoni, salami, and hot dogs, chocolate, nuts and peanut butter, red wine and most other alcohol, MSG in its many forms (including “natural flavoring” and soy sauce), and artificial sweeteners like aspartame. Caffeine doesn’t need to be eliminated entirely, but should be limited to no more than two servings per day and kept consistent in amount and timing. Even certain fruits and vegetables can be triggers: avocados, figs, citrus in large amounts, onions, and most beans.
Not everyone reacts to every item on the list. The practical approach is to eliminate the major categories for several weeks, then reintroduce them one at a time to identify your personal triggers. Many people find that controlling just a few key items, often caffeine consistency, alcohol, and aged cheese, dramatically reduces episode frequency.
Ménière’s Disease
Ménière’s disease causes episodes of vertigo lasting 20 minutes to several hours, along with fluctuating hearing loss, ear fullness, and ringing in the affected ear. It’s driven by excess fluid buildup in the inner ear, and the primary lifestyle intervention is sodium restriction. Daily sodium intake should stay under 2,000 mg, which is significantly less than the average American diet. Some research suggests that reducing intake below 3,000 mg per day is enough to activate the body’s fluid-regulating hormones, but the 2,000 mg target is the standard recommendation.
This means reading labels carefully. Processed foods, restaurant meals, canned soups, and condiments are common sources of hidden sodium. For many people with Ménière’s, a low-salt diet is considered an effective first-line treatment that can meaningfully reduce both the frequency and severity of vertigo attacks.
Vestibular Rehabilitation Therapy
When vertigo stems from lasting damage to the inner ear or when dizziness persists after the initial cause has been treated, vestibular rehabilitation therapy can retrain the brain to compensate. This is a specialized form of physical therapy built around three types of exercises.
- Gaze stabilization: You focus on a stationary target while slowly moving your head side to side or up and down. This teaches your brain to maintain clear vision during head movement, which is one of the first things disrupted by vestibular problems.
- Balance retraining: Starting with simple challenges like standing with feet together, then progressing to standing with one foot ahead of the other, and eventually standing on one foot. The difficulty increases as your balance improves.
- Walking exercises: Practicing walking at different speeds, with head turns, and around obstacles to rebuild confidence and stability in real-world conditions.
The goal isn’t to fix the inner ear itself but to help your brain learn new strategies for maintaining balance using the signals it still receives reliably. Most programs involve both in-clinic sessions and daily home exercises over several weeks.
Medication for Symptom Relief
Anti-dizziness medications like meclizine (sold over the counter as Bonine or Dramamine Less Drowsy) can reduce the spinning sensation during an acute episode. The typical dose for vertigo ranges from 25 to 100 mg per day, and the effects last roughly 8 to 24 hours. It works by dampening the signals from your vestibular system to your brain, essentially turning down the volume on the false motion signals.
Meclizine is useful for getting through a bad episode, but it’s not a long-term fix. Suppressing vestibular signals over time can actually slow your brain’s ability to adapt and compensate, which is the opposite of what vestibular rehabilitation tries to accomplish. Think of it as a tool for the worst days, not a daily strategy.
When Vertigo Signals Something Serious
Most vertigo is caused by inner ear problems and, while miserable, isn’t dangerous. But vertigo can occasionally signal a stroke affecting the brainstem or cerebellum. Warning signs that point to a central (brain-related) cause include vertigo so severe you cannot stand or walk independently, eye movements that change direction when you look in different directions, and a strong feeling that your eyes are misaligned vertically. Purely vertical or purely rotational eye movements during an episode are also red flags.
The combination of these three eye movement tests, known as HINTS, has been shown to be 100% sensitive and 96% specific for identifying strokes in patients with acute vertigo, outperforming even early MRI. If your vertigo comes on suddenly and continuously (not triggered by position changes), lasts hours without letting up, and is accompanied by difficulty walking, new headache, double vision, slurred speech, or weakness on one side of your body, treat it as an emergency.