When vertigo hits, the most important thing you can do is stop moving, sit or lie down, and wait for the spinning to ease. Most vertigo episodes are brief and not dangerous, but they can cause falls and injuries if you try to push through them. What you do in the first few minutes, and in the days that follow, depends on what’s causing the spinning and how often it happens.
What to Do During an Episode
Sit or lie down as soon as the spinning starts. If you’re standing, lower yourself to the ground or grab something stable. Sudden movements, especially of your head, tend to make vertigo worse, so keep as still as you can until the sensation passes. Close your eyes or fix your gaze on a single, stationary point. Avoid looking at screens, bright lights, or anything that scrolls or moves, as these flood your brain with conflicting signals and intensify the dizziness.
Once the worst of the spinning fades, get up slowly. Use furniture or walls for support. If you can’t walk steadily on your own, ask someone to help you. Falling during a vertigo spell is one of the biggest real-world risks, particularly on stairs or hard surfaces.
After a severe episode, avoid driving, climbing ladders, or operating heavy machinery for at least a week, or until you’ve confirmed with a provider that it’s safe. A sudden dizzy spell at the wheel or on a ladder can be life-threatening.
The Epley Maneuver for Positional Vertigo
The most common type of vertigo, called BPPV, happens when tiny calcium crystals in your inner ear drift into the wrong canal. It triggers short bursts of intense spinning when you tilt your head, roll over in bed, or look up. The Epley maneuver is a series of slow head position changes designed to guide those crystals back where they belong, and you can do it at home.
If the problem is in your right ear, start by sitting on a bed and turn your head 45 degrees to the right. Lie back quickly, keeping your head turned, so your shoulders land on a pillow and your head reclines slightly past the edge. Hold that position for about 30 seconds or until the dizziness stops. Then turn your head 45 degrees to the left without raising it, hold again for 30 seconds, and roll your body onto your left side while keeping your head angled. Hold once more, then slowly sit up. Reverse the directions if the left ear is the problem.
Most people feel relief within one to three sessions. You can repeat the maneuver up to three times in a row if the dizziness doesn’t resolve on the first attempt.
Brandt-Daroff Exercises
If the Epley maneuver doesn’t fully resolve your symptoms, or if your vertigo keeps coming back, Brandt-Daroff exercises can help your brain adapt. Sit on the edge of a bed, then quickly lie down on one side with your nose pointing upward at a 45-degree angle. Stay there for about 30 seconds, or longer if the dizziness persists. Sit back up, wait for things to settle, then repeat on the other side. Do several repetitions at least twice a day. Over a week or two, the episodes typically become less intense as your brain recalibrates.
Over-the-Counter Relief
Meclizine (sold under brand names like Antivert or Bonine) is the most widely used medication for vertigo symptoms. It works by dampening the signals your inner ear sends to your brain, which reduces the spinning sensation and the nausea that often comes with it. The typical dose ranges from 25 to 100 mg per day, split into smaller doses throughout the day depending on how you respond. It’s available without a prescription in many countries, though it can cause drowsiness.
Meclizine is best used as a short-term tool. Relying on it for weeks can actually slow your brain’s natural ability to compensate for the inner ear problem, making recovery take longer.
Vestibular Rehabilitation
For vertigo that lingers or recurs, vestibular rehabilitation retrains your brain to process balance signals more accurately. A physical therapist designs the program, but the exercises themselves are simple enough to do at home three times a day.
One common exercise involves sitting in a chair about five feet from a wall, fixing your eyes on a target at eye level, and slowly nodding your head up and down. As your tolerance builds, you increase the speed of the head movement, then progress to doing the exercise while standing, and eventually while walking toward the target and back. Each step challenges your balance system a little more.
Diaphragmatic breathing is another core component. Dizziness triggers your body’s stress response, which in turn makes the dizziness worse, creating a feedback loop. To break it, sit upright with one hand on your stomach and one on your chest. Breathe in through your nose for four seconds, feeling your belly expand, then breathe out through pursed lips for eight seconds. This technique activates your body’s calming system and can reduce the intensity of symptoms during a flare.
Daily walks are also part of most vestibular rehab programs. Even short ones help your brain practice integrating balance information in a real-world setting.
Managing Vertigo Tied to Migraines
Vestibular migraine is the second most common cause of recurrent vertigo. It can produce spinning episodes lasting minutes to hours, sometimes without any headache at all. If your vertigo tends to come with light sensitivity, sound sensitivity, or visual aura, migraine may be the underlying driver.
Preventive treatment focuses on reducing how often episodes occur. Options include beta blockers, certain antidepressants, anti-seizure medications, and newer injectable medications that block a protein involved in migraine signaling. Supplements like magnesium, riboflavin, and vitamin D are sometimes used alongside prescription treatments. Finding the right combination usually takes some trial and error with a provider.
Reducing Vertigo From Inner Ear Fluid Problems
Ménière’s disease causes vertigo through excess fluid buildup in the inner ear, often accompanied by hearing loss, ringing, and a feeling of fullness in the ear. One of the most effective lifestyle changes is cutting sodium intake to under 2 grams per day. Salt drives fluid retention throughout the body, including the inner ear, and lowering it can significantly reduce the frequency and severity of attacks. This means reading labels carefully: processed foods, restaurant meals, and canned soups are common culprits.
Making Your Home Safer
If vertigo is a recurring problem, small changes to your environment can prevent injuries between episodes. Remove loose throw rugs and any cords or cables that cross walkways. Install grab bars in the shower and next to the toilet. Keep a clear path between your bed and the bathroom, since nighttime trips are when falls most commonly happen. Use a nightlight so you’re not navigating in the dark with an unreliable sense of balance.
When Vertigo Signals Something Serious
Most vertigo comes from the inner ear and resolves on its own or with simple treatment. But vertigo can, in rare cases, signal a stroke, particularly in the brainstem or cerebellum. The key difference is what accompanies the dizziness. If vertigo comes with difficulty speaking, facial or limb weakness, double vision, loss of vision in part of your visual field, numbness on one side of the body, or a sudden severe headache, those are signs of a central nervous system problem that needs emergency evaluation.
One less obvious red flag: if you feel intensely dizzy but cannot walk independently, that pattern correlates strongly with stroke rather than an inner ear cause. Similarly, the abrupt onset of any neurological symptom alongside dizziness should be treated as a stroke until proven otherwise. Call emergency services immediately in any of these situations.