4 exercises to relieve vertigo symptoms

You might feel lightheaded or off-balance when you get overheated or dehydrated. Perhaps you even get dizzy. Vertigo, in particular, is dizziness that causes a feeling of movement when a person is not moving. Almost 40% of Americans experience vertigo at least once in their lifetime. Some people experience vertigo—a nausea-inducing tilting or spinning sensation—even when well-rested and hydrated. 

Here, two doctors share what to know about vertigo, what causes the condition, and how to treat it.

What is vertigo?

Vertigo is a balance-related condition that causes dizziness and a spinning sensation when a person is not moving. The attacks can last from seconds to days, according to Amy Lee, MD, RDN, chief medical officer at Lindora Clinic. She says dehydration or ear infections are common triggers; underlying conditions such as migraine or a vestibular disorder can also cause episodes.

The condition is most prevalent in people 50 and older and is more common in women than men. Most cases of persistent vertigo are due to problems with the vestibular system. This sensory system in the inner ear “provides your brain with information about balance, motion, and the location of your head and body in relation to your surroundings,” according to the American Speech-Language-Hearing Association. When there is a problem sending signals within the vestibular apparatus, a feeling of imbalance or that the world is spinning occurs. 

Vertigo can also be a side effect of some health conditions, including:

• Benign paroxysmal positional vertigo (BPPV)
• Labyrinthitis
• Vestibular neuritis
• Meniere’s disease
• Head injury

BPPV is one of the most common causes of vertigo. Dr. Lee says BPPV is likely caused by misplaced pieces of calcium (canaliths) in the ear canal. These free-floating canaliths (like little pieces of sand) can upset the delicate vestibular system, creating a feeling of movement when standing still. 

Because vertigo is a symptom of several diagnoses rather than a diagnosis itself, it can take longer for healthcare providers to figure out the cause. Sometimes the exact cause of vertigo will remain unknown.

4 exercises to help with vertigo

When you experience vertigo, you’re not doomed to sit in a dizzy spell. There are exercises you can do to relieve the symptoms.

1. Epley maneuver 

Also known as the canalith repositioning procedure (CRP), the Epley maneuver, is used to alleviate the most common type of vertigo, BPPV. It dislodges the canaliths from your ear’s semicircular canals and brings them back to the utricle in the inner ear. According to a recent study, the Epley maneuver was deemed a “safe and effective procedure to treat benign paroxysmal positional vertigo in [a] majority of patients.” 

You should learn the Epley maneuver under a doctor’s or physical therapist’s guidance, says Megan Daley, DPT, founder of Move On The Daley in Scottsdale, Arizona. After that, you can practice a version of the exercise at home. 

Here is how to do the modified Epley maneuver that you can perform by yourself at home, according to Daley:

1. Place a pillow about one foot from the top of your bed so that if you were to lay down, it would elevate your shoulders (not your head).
2. While sitting upright at the foot edge of the bed, turn your head in the direction that causes vertigo. For example, if that is your right side, you will turn your head to the right.
3. Keeping your head in the same position, quickly lie back so your shoulders are elevated, head hanging over the back of the pillow.
4. Stay there for 30 seconds. 
5. While holding your body still, slowly turn your head in the opposite direction.
6. Stay still for another 30 seconds.
7. Slowly rotate your body so that it is in line with your head. You will end up lying on your side.
8. Stay in this position for 30 seconds.
9. Slowly sit upright while holding your head in the same turned position.
10. Sit still for 30 seconds before turning your head to face forward.

“That is one round of the maneuver,” Daley says. “Typically, I have people do this a couple of times a day until symptoms are fully resolved.” This exercise will help move the canallith to a more appropriate part of the semicircular canal, to a position that does not cause vertigo. The maneuver will often cause dizziness while performing it.

2. Brandt-Daroff exercises

Similar to Epley, the Brandt-Droff exercises may relocate the canliths in your ear and help your body respond to confusion signals from your inner ear. A 2018 study of 50 patients with vertigo found that Brandt-Daroff exercises and Epley maneuvers were equally effective at treating symptoms.

Here is how to do the Brandt-Daroff exercise:

1. Begin in a seated position.
2. Lie down on one side with your head turned so your noise points up in a 45-degree position.
3. Rest for 30 seconds.
4. Slowly move back into a seated position.
5. Repeat on the other side. 

Moving slowly and intentionally when performing Brandt-Daroff exercises on your own is essential. “In general, avoid quick head movements,” Daley says.

3. Semont maneuver

Complete this exercise with the help of a healthcare provider or physical therapist to reduce the risk of falling and side effects. The Semont maneuver is very similar to the Epley maneuver. Research in 2021 found that while both exercises are practical for treating vertigo, people report more dizziness after the Semont versus the Epley maneuver.

Here is how to complete the Semont maneuver with a healthcare provider:

1. Sit on the exam table with legs dangling.
2. Turn your head slightly away from the side that causes vertigo.
3. The doctor or physical therapist will quickly lower you onto the side that causes vertigo so that your head looks at the ceiling.
4. Hold for 30 seconds. 
5. The doctor will quickly move you to the other side so your head looks down at the table.
6. Hold for 30 seconds. 
7. The doctor will help you sit upright again.

4. Half-somersault maneuver

In a 2021 study of 43 patients with unilateral vertigo, the people who performed the half-somersault maneuver (HSM) had less post-exercise dizziness than those who completed the Epley maneuver. However, the Epley maneuver helps vertigo go away faster, with improvement after just one move (compared to repeated HSMs).

Here’s how to complete a half-somersault maneuver for vertigo:

1. Sit on your knees on the floor and look straight up at the ceiling.
2. Lower your head down to the floor in a somersault position.
3. With your crown resting on the floor, turn your head to the side that triggers vertigo.
4. While keeping your face turned, quickly raise your head to back level.
5. While keeping your face turned, quickly raise your head fully upright. 
6. Once any vertigo symptoms go away, pull back into a seated position.

Vertigo treatment and other options

Ultimately, the best vertigo treatment depends on the underlying cause of your symptoms. If vertigo is a symptom of a migraine attack, seek treatment options to prevent migraine. If dehydration triggers vertigo, focus on staying hydrated.

When treating BPPV, the most common form of vertigo, healthcare providers focus on relieving uncomfortable symptoms. “Vertigo can go away by itself, but most people do ask for a medication,” says Dr. Lee. In her practice, she often recommends Dramamine Motion Sickness (a brand name for meclizine, an antihistamine), but if vertigo is secondary to an infection, she can prescribe other medication.

For minor vertigo, simply drinking enough water and moving slowly might be the fastest home remedies. In some cases, your primary care physician might recommend vestibular rehabilitation through physical therapy.

While you can treat minor or infrequent vertigo with maneuvers, hydration, or OTC medications, get help for longer-term issues. Consult a healthcare professional if you experience frequent, sudden, unexplained, or prolonged dizzy spells, as vertigo may signify a more serious underlying condition.