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Stop the spinning: Exercises and manoeuvers that help with vertigo

The Bottom Line

  • Vertigo is a common symptom of inner ear disorders. In extreme cases, it can last for weeks, affecting quality of life.
  • Certain movements and manoeuvers can help improve symptoms by training the brain and body to adjust to inner ear issues.
  • Begin by talking to a health care professional who can diagnose your condition and develop a personalized treatment plan.

You’re dizzy, disoriented and off balance and when you try to lie down it feels like the whole room is spinning. Assuming you haven’t overindulged in alcohol (a completely different issue) you probably have some type of vestibular (inner ear) problem causing vertigo.


Vertigo can be the result of various disorders – including benign paroxysmal positional vertigo (BPPV), vestibular neuritis or Ménière’s disease (1) – but it’s generally the presence of something (e.g. particles, fluid, infection) in the inner ear canal that affects your sense of gravity and causes the dizziness, vision issues and other odd sensations (2). Often, only one side of your head is affected (unilateral). The symptoms may come and go and can last minutes to hours… or sometimes much longer. Besides the physical unpleasantness, vertigo can also affect quality of life since many people stop doing their regular activities and going out for fear of falling or getting hurt (2,3).


So how do you get off the crazy ride?  “Vestibular rehabilitation” is the term for exercises and movements that ease the symptoms (4) by helping your brain adjust to what’s happening inside the ear (habituation), controlling eye movements so that your vision isn’t affected by head motion (gaze stabilization) and improving steadiness (balance training).


Several studies have tested the effectiveness of vestibular rehabilitation exercises including 39 good quality randomized controlled trials that were part of a systematic review (1). Under the direction of experts, more than 2,400 participants – all with vertigo – performed combinations of exercises and were compared to those who received “sham” or other types of treatment.


In another review of 11 studies with 745 participants, researchers measured the effectiveness of “repositioning manoeuvers” for people with BPPV (5). These manoeuvers are aimed at moving particles in the ear canal to another part of the ear where they won’t cause problems.


What the research tells us

There was moderate to strong evidence that vestibular rehabilitation helps reduce dizziness and disorientation and improves vision issues, balance and mobility (1). The exercises are safe and simple and some may be done at home, but it’s recommended you first see a doctor or therapist to determine the best treatment plan for your condition.


There is also evidence that repositioning manoeuvers like the Epley manoeuver – in which a medical professional guides the patient through a series of sitting and reclining positions – can effectively treat symptoms safely (5).


The benefits of both types of approaches are short-term and many people with vertigo will experience more than one episode (1,5). A combination of both vestibular rehabilitation and physical maneuvers may help provide longer-term benefits (1).


Vertigo is common – even turning your head quickly can bring it on for some people. But if it persists or is interfering with your activities, find out if a few simple moves can get you feeling back on solid ground and in control.

Featured Resources

  1. Web Resource Rating: Epley maneuver
  2. Web Resource Rating: Canalith repositioning

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References

  1. McDonnell MN, Hillier SL. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2015; Issue 1, Art. No.: CD005397. doi: 10.1002/14651858.CD005397.pub4
  2. Vestibular Disorders Association. About vestibular disorders. [Internet] 2017. [cited February 2017]. Available from https://vestibular.ong/about-vestibular-disorders/causes-dizziness
  3. Perez N, Garmendia I, Garcia-Granero M et al. Factor analysis and correlation between Dizziness Handicap Inventory and dizziness characteristics and impact on quality of life scales. Acta Otolaryngologica. 2001; 545:145–54. doi: 10.1080/000164801750388333
  4. Hoffer M, Balaban C. Vestibular rehabilitation: Ready for the mainstream. NeuroRehabilitation. 2011; 29:125. doi: 10.3233/NRE-2011-0686
  5. Hilton M, Pinder D. The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo. Cochrane Database of Syst Rev. 2014; Issue 12, Art. No.: CD003162. doi: 10.1002/14651858.CD003162.pub3

DISCLAIMER: The blogs are provided for informational purposes only. They are not a substitute for advice from your own healthcare professionals.

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