What is vertigo?
Vertigo is a sensation of spinning or moving when you're not — usually from inner ear or central nervous system issues. Most common cause: BPPV (benign paroxysmal positional vertigo) from displaced calcium crystals in the inner ear.
BPPV is treated with specific head-positioning maneuvers (Epley) — often dramatic relief. Other causes (vestibular neuritis, Meniere's, vestibular migraine) need different approaches.
Do I have vertigo? Common signs
If most of these describe what you're experiencing, telehealth may be a good next step:
What causes it
BPPV: displaced inner ear crystals. Vestibular neuritis: viral inflammation. Meniere's: fluid imbalance in inner ear. Vestibular migraine. Rarely: stroke, MS, tumor.
Is it contagious?
No.
If your vertigo only lasts 30 seconds at a time and is triggered by head position changes, it's almost certainly BPPV — and the Epley maneuver can fix it.
Can it be treated online?
Routine BPPV and benign vertigo causes are well-suited to telehealth. Sudden severe vertigo with neurologic symptoms (weakness, slurred speech, severe headache), hearing loss with persistent vertigo, or atypical presentations need in-person care immediately to rule out stroke.
How vertigo is treated
BPPV: Epley maneuver — specific head positioning that repositions ear crystals. Can be done at home with guidance. Meclizine for symptom relief in vestibular neuritis (short-term, can prolong recovery if overused). Dimenhydrinate alternative. Vestibular rehab therapy for chronic vestibular issues. Migraine treatments for vestibular migraine. Meniere's: low-salt diet, diuretics.
Self-care while you wait
- Move slowly when changing positions
- Sit on edge of bed before standing
- Sleep with head elevated initially
- Avoid quick head turns
- Hydration
- Cannalith repositioning (Epley) exercises
- Vestibular rehab exercises
- Identify and avoid triggers
How long does it last?
BPPV: usually clears within days to weeks. Vestibular neuritis: weeks to months. Chronic conditions: ongoing management.
Frequently asked questions
How do I know it's BPPV?
Brief episodes triggered by head position change — rolling in bed, looking up. Lasts under 1 minute per episode.
Can I do Epley at home?
Yes — many people successfully use guided videos. A clinician can confirm diagnosis and teach the maneuver.
Why isn't meclizine helping?
Meclizine masks symptoms but doesn't fix BPPV. Repositioning maneuvers address the cause.
Will it come back?
BPPV has 50% recurrence rate within 5 years. Often re-treatable with maneuvers.
Is it stress-related?
Vestibular migraine is linked to stress. Pure BPPV is mechanical, not stress.
