Finding the right approach to vertigo

Vertigo may arise from a position-sensitive inner-ear problem, migraine, an ear infection, or another balance disorder. Benign Paroxysmal Positional Vertigo tends to follow specific head movements; Meniere's Disease may include hearing symptoms; Migraine may bring light or sound sensitivity with or without head pain. A Middle Ear Infection may cause ear pain, fever, discharge, or reduced hearing.

A clinician will ask when the spinning begins, how long it lasts, what triggers it, and whether you have hearing, vision, neurological, or headache symptoms. This information helps select a safe approach. Start with the overview of [Vertigo](/symptoms/vertigo/).

During an attack, sit or lie down, keep the environment calm, and move slowly when standing. Avoid driving, heights, and machinery until your balance is reliable. Keep a diary of timing, head position, food or sleep changes, headache, hearing symptoms, and medicines.

Treatment may involve addressing an ear problem, managing migraine triggers, balance rehabilitation, or a clinician-guided repositioning technique. The [Epley Manoeuvre](/treatments/minor-procedures/epley-manoeuvre/) is intended for selected positional vertigo and may be unsuitable with some neck or back problems. Do not begin it from a general description alone.

Seek emergency help for vertigo with new weakness, facial drooping, speech difficulty, fainting, severe new headache, new double vision, chest pain, or inability to walk safely. Get prompt care for severe vomiting, dehydration, a recent head injury, or rapidly worsening symptoms.

Book an appointment when vertigo is new, recurrent, persistent, causing falls, or accompanied by hearing loss, ear discharge, or fever. The aim is to identify the pattern before choosing a treatment.

Ask which cause best fits your pattern, whether you need hearing or balance testing, and which treatment is appropriate. Ask whether home exercises are safe for your neck and back, what side effects to watch for, and when you can return to driving or work at height.