This blog lists common vertigo triggers that you may want to note and share with your healthcare provider if they are affecting you.
Sleeping Positions
Certain sleeping positions may be vertigo triggers. Are you having to sleep upright to avoid vertigo?
Perhaps lying down in bed with your head in a certain position such as lying on your right side, on your left side, or lying on your back causes vertigo?
I suggest you make a note of which sleeping positions are vertigo triggers.
To be clear, I’m not suggesting for you to test yourself by trying any of the following vertigo triggers or positions I share below!
The reason I share all of the following examples is to help you think through what may be triggering your symptoms, or what activities you are avoiding so that you can share that with your healthcare provider to demonstrate how this is affecting your quality of life, how this is limiting your participation in society, and to help them direct their exam.
Motion-Activated Vertigo Triggers
Are you having symptoms with these specific triggering positions as you go about your day?
- Walking and looking back?
- Quick turns?
- Reaching up and looking up to the left?
- Reaching up and looking up to the right?
- Reaching straight up and looking up?
- Bending down?
- Getting up quickly?
- Leaning forward at your waist and turning to look up to the left?
- Leaning forward at your waist and turning to look up to the right?
Note: If you’re having symptoms looking up, be specific about whether your head is tilted backward, or your eyes are just looking up with your head level. Those are two different distinct symptoms.
Are any of the following movements vertigo triggers?
- looking to the left and tilting your head down
- looking to the right and tilting your head down
- bending over quickly and standing up quickly
- bending forward at your waist with your head turned to the right
- bending forward at your waist with your head turned to the left
- bending forward for a prolonged period of time and then standing up
Triggers during Normal Activities of Daily Life or Work
Normal activities of daily living or activities you have to do for work may be vertigo triggers. If certain activities are causing you to feel discomfort, or if you are having to avoid them to prevent triggering dizziness or vertigo, then I suggest you make a note to tell your provider. Some examples of activities that may be vertigo triggers include:
- emptying the lower rack of the dishwasher
- reaching into the back of the dryer
- hanging clothes on a clothesline
- leaning down and looking to the side to clean underneath a table, for example
- looking under the bed
- fixing the pipes under the sink
- painting the ceiling
- picking up after your dog
- cleaning up toys or clutter on the floor
Exercise-Related Vertigo Triggers
Make a note of any certain exercises that are vertigo triggers, such as:
- lying flat on your exercise mat or weight bench
- rolling side to side on a mat
- reaching or turning to one side to stretch out while lying down
- walking up or down stairs or curbs
- walking up or down ramps or inclines
- certain exercises where you are looking upwards at your top hand, such as a side plank
- rolling out your upper back on a foam roller and dropping your head backwards
- abdominal crunches with the rotation of the chest and shoulders
For example, one of my patients told me that one of her vertigo triggers was whenever she rotated to the left during abdominal crunches with a twist. That what preceded her feeling of dizziness. That gave me a lot of valuable information for her exam!
Driving, Riding, Flying, and Walking
Other common vertigo triggers of symptoms that may be useful to share include:
- driving on switchbacks or mountain passes
- riding in the car
- riding backward on a train
- while flying on a plane
- after traveling on a plane
- walking on a moving platform, such as in the airport
- walking in the dark
- walking on an uneven surface
- walking on the beach
- riding amusement park rides (especially if you used to be ok with it!)
Visual Triggers
If the waves are crashing while you walk along the beach, there is a lot of movement in your peripheral vision. Does that make you feel your symptoms?
Is walking through a supermarket triggering symptoms for you?
Other vertigo triggers could be complex, busy environments or things moving within your visual field.
Visual vertigo triggers include:
- watching a ceiling fan spin
- looking at any spinning fan
- the ticker scrolling horizontally across the bottom of the television screen if you are watching the news
- the film credits that roll at the end of a movie
- scrolling vertically on your phone, tablet, or computer, such as quickly skimming through an article
- scrolling through social media posts on your phone
- driving and checking your blind spot over your shoulder
- sitting in a car during heavy, slow moving traffic
- waves crashing at the beach
- supermarket or other big box store
Are any of these or other visual experiences triggering your symptoms?
Is your vision getting blurry or wavy when you turn your head quickly?
Food Triggers
Do you get dizzy spells after certain foods? Certain food triggers are known to set off vestibular migraines or Meniere’s episodes. Other foods may promote inflammation.
If you notice certain foods are causing dizziness or vertigo, I suggest you add that to your list of vertigo triggers.
For more on the connection between the Gut and Vertigo, check out this blog.
Track Symptom Onset, Trigger, and Duration
In your summary for your healthcare providers, you should include your vertigo triggers, with specifics about onset, and how long it lasts.
Your diagnosis and treatment will be easier to work through if you can provide very specific information about your symptom onset, duration, and trigger(s).
Some people become obsessed with tracking their vertigo triggers. That is not healthy and causes anxiety.
I suggest for you to track your symptoms and work closely with your Vertigo Expert to reduce or resolve the symptoms.
Disclaimer
This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.
My vertigo happens in air travel after airplane landing, it lasted many hours afterwards.
Hi Jack,
That is a good point and very common trigger!
Thank you for sharing.
Hi one of my major triggers which affects my life are dental appointments, I can’t lie back flat for any treatments which means my dental hygiene suffers as most dentists are not willing to work any other way than you lying flat. I need root canal and I can’t find a dentist willing to preform this with my vertigo. I have not yet seen a specialist to perform the manoeuvre to correct my BPPV so Im partly to blame!
Hi Chevi,
I am sorry to hear what you are going through!
You may be interested in this article and this article because I specifically talk about dizziness related to the dentist.
Also, you can use this article to find someone in your area who can treat you for BPPV.
I hope you are able to sort things out soon, since dental hygiene is an important part of overall health.
Best wishes,
Dr. Kim Bell, DPT
I had a car accident and I have traumatic brain injury. I get vertigo often. I have done the vestibular treatment and my ear seems like it’s going to explode with pressure. Any suggestions would be greatly appreciated
Hi Freda,
I am sorry to hear about the car accident!
I suggest you look for a PT at NeuroPT.org who is “Certified Neurological Clinical Specialist,” which is displayed with the credentials: NCS.
Also you may need to see an orthopedic manual physical therapist for your neck or other painful areas. You can search for a skilled provider at this website. That could help your ear pressure.
Seeing an Ear Nose and Throat doctor (ENT) would be a helpful step to assess the cause of your ear pressure also.
Support groups or other psychological support can be helpful for people recovering from traumatic brain injury, since there may be strong emotional effects.
Best wishes,
Kim Bell, DPT
I have been dizzy and lightheaded for about a week now. It’s a constant all day feeling of lightheadedness. I am still able to workout and do things, but I just feel lightheaded, especially when I lay down in bed to go to sleep. It seems better when I am walking around, moving and doing things. When I stand and speak with someone, I feel as if I’m going to fall over! I am actually walking around all day like I was drunk and have a hangover. Please help
Hi Frank,
I suggest you find a Vestibular Physical therapist using this article.
This article may help as well.
Best wishes,
Kim Bell, DPT
Hi Frank,
I am facing similar issues on a day to day basis. Is your problem resolved? Can you provide me some advice and guidance?
Can vision problems and/or allergies cause lightheadedness and dizziness?
Hi Frank,
This blog and this blog are about vision problems that contribute to dizziness. The answer is yes!
Vision problems can definitely cause dizziness – and dizziness can cause vision problems.
The key is a root cause evaluation.
You can find a vestibular provider using this article.
You can find a Neuro-Optometrist using the Doctor Locator tool on this website. I refer my patients to this type of specialty doctor for a comprehensive eye exam.
You may need to see an Ophthalmologist MD for an eye health exam as well.
I hope that helps!
I have observed that allergies can precede an onset of BPPV. However, the research shows limited connection. Sinus infections are linked with BPPV onset.
You can consult an ENT or Allergist MD for allergy relief.
Best wishes,
Kim Bell, DPT
This was hugely useful…at least I know I am not insane in thinking my vertigo gets triggered by the following
1.A big cooking session involving lots of quick head movements. Looking down to knead dough etc
2. Drying clothes on a line
3. Trying to get the seatbelt on , head swinging from straight towards bottom right….I keep my neck straight and grope around to fix the seatbelt
4. Looking around me to look at objects while on a walk or in a mall
5. Trying to tie my kid’s school laces, or even mine for that matter
A lot of the movements listed by you are triggers for me. What i would like to know is if vestibular therapy can help make me less sensitive to these triggers so I can cook and get about daily activities with more ease and comfort. Right now it’s downright depressing to know all the things I love doing are triggers…
Hi Gauri,
In general, yes the goal of vestibular physical therapy is to reduce, if not completely resolve, the uncomfortable feelings you have from the vertigo triggers.
I hope you are able to find someone to help you in your area!
Sincerely,
Kim Bell, DPT
Hi , I have had vertigo for 8 months. Almost daily. I can not work. It’s very debilitating. I have been to many doctors they all come up with something different. I have taken 2 round of antibiotics. Had ear drained. I have been told I have vestibular migraine, tmj, bppv, tmd. I do have pinched nerve back of neck. Diagnosis by a neurologist. Going to atlas doctor now for 3 months . No more back pain. But vertigo is still there . Every time I bend down . Or reach up to grab something . I get dizzy , pretty much in a fog though out the day. Left ear been blocked for 8 months some days it hurts and I feel like a nerve is irrated in the ear. Another Doctor told me it’s not my ear it’s my jaw . Got a night guard dentist . She said I grind my teeth. I have been going to physical therapy doing Epley maneuver. Vertigo did happen when I was being turned. I Ice , heat though out the day. My Quality of life is awful, I sit home all day. Can’t drive. I need to be able to get back to my life back and get back to work. Any suggestions.
Hi Tammy,
I am sorry to hear what you are going through!
There are some reasons why the Epley maneuver does not work and I discuss them in this blog.
You may need a different type of treatment if you are not getting relief with the Epley maneuvers.
Also, this blog has Vertigo Home Remedies that may help.
I suggest that you answer the questions I ask in this blog in order to share your story with your providers in a clear and concise way.
You may also want to consult an orthopedic manual therapist PT which you can find online at this website.
I hope you feel better soon!
Sincerely,
Kim Bell, DPT
Hi,
I’m grateful to have stumbled upon you! There’s comfort in knowing I’m not the only one dealing with vestibular issues but saddened when I see how many suffer from them.
I’ve had a wonky vestibular system (very technical) for years and years.
I started noticing it decades ago that after flying I would experience Mal De Debarqument Syndrome – as shared by a neurologist specializing in vertigo. My brain also perseverates motion.
I’ve had BPPV a number of times and sleep elevated to avoid setting off. I’m very careful to not set off my system which can be exhausting at times and seems to progress in different ways over the years.
I’m more recently noticing my sensitivity to different floor surfaces. Whether it’s our rough irregular tiling in kitchen or the bathtub which slopes down. I put on a new pair of sandals the other day that were very soft with a bit of a heel and this set my vestibular system off for an hour or so. It’s getting a little ridiculous at how sensitive it can be – is it really just a matter of habituation and retraining? You’d think I could help myself a bit, PT is my background, hah! But I’m very rusty! Any thoughts you have would be so appreciated!
Hi Annie,
Well even within the field and profession of PT, this topic is a specialty.
I have treated lots of healthcare providers who are very experienced but have no clue about vertigo issues. I am not surprised that your past clinical experience has left you still asking these excellent questions!
The first step is to make sure you don’t have BPPV. That is “phase I” of any balance or dizziness recovery program according to my methods. Any BPPV must be treated to resolution.
Then you can go about with the habituation and retraining on variable surfaces etc for “phase II” of your recovery. If you initiate that kind of training while you have BPPV, then you are working with impaired vestibular input.
Especially since you have had BPPV recurrences in the past, getting assessed is key before you embark on any vestibular retraining program.
You can use this blog to find a vestibular provider in your area.
You may also want to wear shoes with a thin, non-skid sole since proprioception from the feet is the dominant sensory input that creates our balance on firm surfaces.
In this blog and this blog, I write about barriers to vestibular recovery.
If you don’t get the results that you want, I suggest you might consider if perhaps one of those common barriers is limiting your progress?
I hope you feel better soon!
Hello! I’m just now seeing your response! Wasn’t sure you would get back, so thank you so much for your thoughts!
My latest symptom is feeling really off balance – still from un-level surfaces but now after bending at the waist – whether it’s to crouch down or just sitting and flexing forward … getting laundry out of the dryer really stirs things up. Could this be coming from my spine, either cervical or lumbar issues? Just when I think things are calm, my vestibular system challenges things again.
Lastly, I’m not on any medications – only take vitamins … I notice that my symptoms are quietest when I’ve had a glass of wine. I can generally move about like all is well. Thoughts?
You are doing God’s work by reaching out and helping a population of people who are many times scared, frustrated and overwhelmed by vestibular symptoms.
Thanks again,
Annie
Hi Annie,
Symptoms from the spine are very real possibility for any patient with dizziness and I believe it should be considered in every case.
I talk about cervical dizziness specifically in this blog.
In this blog, I talk about who might be able to help with spinal problems causing dizziness or vertigo.
BPPV can also occur or recur at anytime, so consulting a vestibular PT is typically valuable. You can search for a vestibular provider using this blog.
BPPV can cause dizziness bending forward. Vestibular PT should be able to resolve that issue, if it caused by BPPV.
Patients who feel better with some alcohol usually have a strong anxiety component or vertigo from stress. You can learn more about the link between anxiety and vertigo here and here.
Thank you for your kind comments! I have been working hard on a book for this population of people for over two years now. I hope it will be published in early 2024.
I hope you feel better soon.
Hi Dr. Bell,
I’ve been dealing with vertigo/disequilibrium since last Sept. I have two spinning vertigo episodes last fall (less than 30 secs) and was referred to a vestibular rehab therapist. They tested me for BPPV but I did not have a nystagmus so they gave me VOR exercises for motion sickness and visual vertigo.
I felt 95% better in a few months but never fully recovered. I recently saw a neurologist who specializes in dizziness and suggested I have symptomatic BPPV without nystagmus. She performed the Epley maneuver and I felt perfect for a few days but I turned my head too quickly a few days later and now worse. She recommended I continue the maneuver at home.
You mentioned in your comment about not treating for phase 2 (with impaired visual input) before treating phase 1. I think that’s exactly what happened to me because my original vestibular therapist did not seem to know about the possibility of BPPV without nystagmus. Is there any way for my vestibular system to go back to normal now?
Thanks for your insight.
Your analysis is very insightful!
This is a common problem that I observe in patients who come to me after working with another vestibular PT. Unfortunately, it’s not unusual.
If BPPV is identified at any time during vestibular recovery, then the simple solution is to back up to phase 1 until BPPV is clear.
Once BPPV is cleared up or resolved, then it is ok to continue on to phase 2 once again — or resume phase 2 exercises.
BPPV can recur at anytime, so some patients rotate back and forth between phase 1 and phase 2 multiple times.
In cases like this, a full recovery is still very possible.
I wrote another article about vestibular rehab and upper cervical issues, which may be interesting to you as well. You can find it here.
I would also like to acknowledge the exceptional neurologist who recognized that you have BPPV without nystagmus. Hats off to her! Well done Doc.
Ive had 2 verry bad vertigo episodes when i was young that lasted for over a weak both times. After that no problems for years. The occasionnal light dizziness if i tilted my head back. But nothing more. Then when i took the plane 2 years ago i started feeling uneasy. Like i was drunk trying to catch my balance. It never went away. I saw a couple different specialists and VPPB wad diagnosed. My left ear is my bad one. I did exercises for vppb which didnt do much. But then i got better after a while. I e had a few good months but since last march when i got covid i got another bout of vertigo where the room was spinning. This time it was when i rolled on my right side in bed. I did the right manoeuvres myself and no more vertigo but the unsteadiness is still there. So after seeing a physio, he told me to do the exercises for vppb everyday. I always feel a wave on my left side, like the vertigo is going to start but then it doesnt. This happens every time. I then started the exercises with vibration. After a week it started to get better. But then i still have bad days where i feel off center all day. Today was a bad one. I was on my phone most of the day (which isnt good) and then randomly while watching a show, sitting on the couch, i felt the same wave i talked about. But i was sitting straight and my head wasnt moving. Maybe caused by a visual cue? I had the fan blowing on me so maybe that was a trigger? I am now wondering if i have central vertigo. This thing is a nightmare. I cant go out and do things anymore because i’m afraid i will get so dizzy i’ll lose my mind. I’m also worried it could be something more serious. One theory thrown at me was that i might have a light cupula on one side No one knows for sure. I understand that i have to get rid of the vppb completely before doing the phase 2. And on my left side i always feel that weirdness when doing the exercises. Right side seems fine. So either i keep at it and hope for the best or maybe its something else.
Hi Pat,
I think you need a professional evaluation by a vestibular health care provider.
You can go back to the vestibular physio you saw before or find someone new.
I suggest you search for a vestibular physical therapist in your area using this blog article.
I have been suffering what I believe to be vertigo, not dizziness but a floating feeling like walking on the moon. It is also not just in my head, it feels as if it affecting my whole body. It has been 8 weeks now, with no solution. Starting to feel like it is gut related, have had multiple blood tests done, have seen an immunologist and waiting to see an ENT. Constant ringing in the ears.
Hi Nicole,
You may be interested in this article on the gut and vertigo.
Thank you so much for all of this information.
I have been suffering from vertigo for a few years now but I am just now finding your blog and website, and it is explaining so much more than anyone has ever been able to explain to me.
I do have an ENT who seems to know what he’s doing, but he wants me to come to his office during an episode which is usually impossible for me.
I will continue to explore options in hopes of finding some kind of resolution.
I also really enjoyed reading your blog about the connection between anxiety and vertigo because I definitely see the connection there.
I think all of us want to get back to our normal lives.