Mar 15, 2005 Table of Contents

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education Web site.

Information from Your Family Doctor

Vertigo–A Type of Dizziness

Am Fam Physician. 2005 Mar 15;71(6):1129-1130.

What is vertigo?

Vertigo is a type of dizziness. If you have vertigo, you may feel like you are moving or spinning. It is not the same as feeling like you are off balance or about to faint.

What causes vertigo?

Vertigo has many causes. You may have this type of dizziness because you have small calcium deposits in your inner ear. You may have vertigo because of swelling or fluid in your inner ear. Vertigo may happen if you have migraine headaches or an anxiety disorder. Rarely, vertigo is caused by poor blood flow or a tumor.

How can my doctor tell what is causing my vertigo?

Your doctor will ask how long your dizziness lasts and if you have any other symptoms.

Your doctor also may do a test. For this test, your doctor will turn your head to the right and then support your head as you lie back quickly on the exam table, ending with your head hanging off the table. The doctor will do the test again with your head turned to the left.

Patients with vertigo usually do not need to have costly tests. Some patients may need hearing tests or brain imaging.

Balance Exercises

Thumb-tracking: Hold your thumb out 1 to 2 feet in front of your face. As you look at your thumb, turn your head from right to left, then left to right, then up and down. Increase speed gradually. Do the exercise for 90 seconds. Repeat the exercise four times a day.

Target-change: Pick two objects (targets) that you have to turn your head from left to right to look at. Look at one object, blink your eyes, and then turn your head quickly to look at the other object. Go back and forth quickly between the objects. Repeat several times per session, at least two sessions per day.

Lying-to-standing: Move from a lying-down position on a sofa or bed to a standing position as quickly as possible without falling. Get up toward both right and left sides quickly. Do the exercise five times on each side per session, at least two sessions per day.

Tightrope: Walk heel to toe as if you are walking on a tightrope or a line. Do the exercise in a hallway with available support, such as a wall or railing. For 30 minutes per day, practice walking 10 steps at a time without using a support.

Walking turns: Walk toward an eye-level target on a wall (such as a picture). As you get near the wall, turn your body to one side but keep your eyes and head locked on the target. When your body cannot move any farther, close your eyes and quickly turn your head to face forward. Repeat the exercise five times for each side, turning your eyes and head to the right and left sides. Slowly increase your speed for at least 30 minutes per day.

Ball toss: While standing or sitting, toss a tennis ball at least 3 feet above your head and catch it. Practice for five to 10 minutes per day. When you can do the exercise easily, try it while walking.


Adapted with permission from Fife TD. Episodic vertigo. In: Rakel RE, ed. Conn’s Current therapy. 51st ed. Philadelphia: Saunders, 1999:927; and Baloh RW. Vertigo in older people. Curr Treat Options Neurol 2000;2:88.

Balance Exercises

View Table

Balance Exercises

Thumb-tracking: Hold your thumb out 1 to 2 feet in front of your face. As you look at your thumb, turn your head from right to left, then left to right, then up and down. Increase speed gradually. Do the exercise for 90 seconds. Repeat the exercise four times a day.

Target-change: Pick two objects (targets) that you have to turn your head from left to right to look at. Look at one object, blink your eyes, and then turn your head quickly to look at the other object. Go back and forth quickly between the objects. Repeat several times per session, at least two sessions per day.

Lying-to-standing: Move from a lying-down position on a sofa or bed to a standing position as quickly as possible without falling. Get up toward both right and left sides quickly. Do the exercise five times on each side per session, at least two sessions per day.

Tightrope: Walk heel to toe as if you are walking on a tightrope or a line. Do the exercise in a hallway with available support, such as a wall or railing. For 30 minutes per day, practice walking 10 steps at a time without using a support.

Walking turns: Walk toward an eye-level target on a wall (such as a picture). As you get near the wall, turn your body to one side but keep your eyes and head locked on the target. When your body cannot move any farther, close your eyes and quickly turn your head to face forward. Repeat the exercise five times for each side, turning your eyes and head to the right and left sides. Slowly increase your speed for at least 30 minutes per day.

Ball toss: While standing or sitting, toss a tennis ball at least 3 feet above your head and catch it. Practice for five to 10 minutes per day. When you can do the exercise easily, try it while walking.


Adapted with permission from Fife TD. Episodic vertigo. In: Rakel RE, ed. Conn’s Current therapy. 51st ed. Philadelphia: Saunders, 1999:927; and Baloh RW. Vertigo in older people. Curr Treat Options Neurol 2000;2:88.

How is vertigo treated?

The treatment of vertigo depends on the cause.

Your doctor may do a special procedure to move calcium deposits to a different spot in your inner ear.

You may need to take medicine for a few days to relieve your dizziness and any nausea or vomiting. Then you may need to do special balance exercises (see table on page 1).

If you have Ménière’s disease, you may need to start a low-salt diet and take a diuretic (“water pill”).

If you have migraine headaches or an anxiety disorder, you will need to take medicine.


This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

Copyright © 2005 by the American Academy of Family Physicians.
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