long lasting vertigo

Overview

Vertigo is the false feeling that you or the world around you is spinning or moving, even when you are still. Long-lasting vertigo means this feeling sticks around for weeks, months, or keeps coming back. It usually points to a problem in the inner ear or the parts of the brain that control balance, but it can also be linked to other health conditions.

Yes. Vertigo is very common. About 1 in 5 adults will experience dizziness or vertigo at some point. Long-lasting vertigo is less common but still affects many people, especially older adults.

Long-lasting vertigo can affect anyone, but it is more common in adults over 40. It affects women more often than men. People with anxiety, migraine, or a history of head injuries may be more likely to have long-lasting vertigo.

Symptoms

Common symptoms

• A spinning or rocking feeling that makes you feel unsteady
• Balance problems that make it hard to stand or walk
• Nausea or feeling sick to your stomach
• Vomiting
• A feeling of fullness or pressure in one ear
• Ringing in the ears (tinnitus)
• Hearing loss or muffled hearing
• Blurred vision or trouble focusing your eyes
• Lightheadedness or faintness (though this can be separate from vertigo)

Symptoms in children

• Children may not be able to describe the spinning feeling. They might just seem unsteady, clumsy, or keep falling.
• They may complain of feeling sick or have a headache.
• They might hold onto furniture or refuse to walk.
• They may have unusual eye movements (the eyes darting from side to side).

Symptoms in older adults

• Dizziness and a feeling of unsteadiness are more common in older adults.
• They may have a higher risk of falling and fracturing a bone.
• They may feel dizzy when standing up from a chair or bed (sometimes called postural dizziness).
• Long-lasting vertigo in older adults can lead to loss of confidence, less activity, and social isolation.

Causes

Main causes

• BPPV (Benign Paroxysmal Positional Vertigo): small calcium crystals in your inner ear move into the wrong place and cause brief, intense spinning when you move your head.
• Inner ear infections (vestibular neuritis or labyrinthitis): inflammation from a viral infection can injure the balance nerve in your inner ear.
• Meniere's disease: a build-up of fluid in the inner ear that causes recurring vertigo attacks, hearing loss, and ringing in the ears.
• Vestibular migraine: migraine headache that includes vertigo or dizziness as a main symptom, even without a headache.
• Poor blood flow to the brain or inner ear, which can happen with age or vascular problems.
• Head injury or whiplash that damages the inner ear or the brain's balance pathways.
• Certain medicines that affect the inner ear (but we are not naming specific drugs here).
• In rare cases, a non-cancerous growth (acoustic neuroma) pressuring the balance nerve.

Risk factors

• Being over 40
• Having had a previous head injury
• Having migraines
• Having a viral infection that affects the inner ear
• Having a family history of Meniere's disease or migraine
• High blood pressure or diabetes
• Prolonged bed rest or being very inactive
• Stress and anxiety, which can make dizziness worse

When to see a doctor

See a doctor urgently if:

• If you have ever experienced sudden hearing loss, you should see a doctor as soon as possible, ideally within 24 hours.
• If you have vertigo accompanied by a new severe headache, fever, double vision, or difficulty speaking.
• If you have vertigo and you have had a recent head injury.
• If you are unable to keep down drinks or eat due to nausea.

Book a routine appointment if:

• If you have vertigo that lasts longer than a few days.
• If you have repeated episodes of vertigo that interfere with your daily life.
• If you have new dizziness and you are older than 60.
• If you are concerned about any balance problems, see your general practitioner (GP).

Diagnosis

A doctor will listen to your story, ask you about your symptoms and triggers, and do a physical exam. They may refer you to an ear, nose, and throat (ENT) specialist or a balance clinic if the diagnosis is not clear or the vertigo does not improve.

Tests that may be done

• Checking your eye movements (nystagmus) while you move your head and body
• The Dix-Hallpike maneuver: a quick movement of your head and body to see if it triggers vertigo and nystagmus
• Hearing tests to check for hearing loss
• Videonystagmography (VNG): a test that measures eye movements to see how well your balance system works
• MRI or CT scan of the head if a more serious cause, like a tumor or stroke, needs to be ruled out
• Blood tests to check for anemia, thyroid problems, or other conditions

What to expect at your appointment

Diagnosis may take a few visits as vertigo can have many causes. The doctor will try to reproduce your symptoms safely and may ask you to wear special goggles to track your eye movements. You might feel a bit dizzy during these tests, but they are short and are an important part of finding out what is wrong.

Treatment

Treatment for long-lasting vertigo depends on the cause. For many people, the brain can learn to adapt with special exercises. For others, medicines or targeted procedures help control symptoms. A healthcare professional will tailor a plan to your needs and your specific type of vertigo.

Self-care at home

• Stay safe: if you feel vertigo starting, sit or lie down immediately to avoid falling.
• Move slowly when getting up from lying or sitting to give your balance time to adjust.
• Avoid sudden head movements, bending down, or looking upward (like reaching for a high shelf).
• Keep a diary of when you feel dizzy and what you were doing, to identify triggers.
• For BPPV, your doctor may teach you a safe repositioning exercise (like the Epley maneuver) to do at home.
• Get plenty of rest, but also try to stay gently active as your symptoms allow.

Medical treatments

Medical treatment may include medicines to reduce nausea and dizziness (such as antihistamines or certain sedatives) or medicines to lower fluid pressure in the inner ear for Meniere's disease. These are not specific drug names; your doctor will decide what is appropriate. Short-term use is usually advised because some can make you sleepy or affect balance. Your doctor might also suggest vestibular rehabilitation therapy (VRT), a special exercise program designed to train your brain to compensate for balance problems. In some cases, an injection of medicine into the middle ear or a small pressure device may be recommended.

When is surgery considered?

Surgery is rarely needed. It may be considered for severe Meniere's disease or if there is a growth pressing on the balance nerve. Procedures aim to reduce fluid pressure or remove the problematic part of the inner ear. Surgery is usually a last resort after other treatments have not worked.

Living with this condition

Living with long-lasting vertigo can be challenging, but you can adapt to your environment to feel safer. Remove trip hazards at home, use handrails on stairs, and make sure rooms are well lit. When walking, focus on a stationary object ahead. Avoid reading or using a phone while moving. Plan your day so you can rest when needed.

Lifestyle tips

• Make sure you take extra care in the dark, like at night when going to the bathroom.
• If you drive, check with your doctor about when it is safe. Some medicines can make you drowsy, and vertigo itself can make driving dangerous.
• Consider using a walking stick for extra support if you feel unsteady.
• Tell family and friends about your condition so they can help if you feel dizzy.
• Reduce stress in your life, as stress and anxiety can trigger or worsen vertigo.

Diet and exercise

Eat regular meals and stay hydrated. Some people find that reducing salt, caffeine, and alcohol helps, especially if they have Meniere's disease. A balanced diet supports overall health. Gentle exercise like walking, tai chi, or yoga can retrain your balance system, but do it slowly and stop if you feel very dizzy. A physical therapist can guide you safely.

Mental health and emotional wellbeing

Long-lasting vertigo can be emotionally exhausting. The constant fear of a vertigo attack can cause anxiety, and some people avoid leaving home, which can lead to depression. It is normal to feel frustrated or scared. Talk to your doctor or a mental health professional if you notice your mood is suffering. Remember, you are not alone, and many people live well with vertigo.

Prevention

Not all causes of long-lasting vertigo can be prevented, but you can reduce your risk of some types. Avoiding head injuries by wearing seatbelts and using appropriate safety equipment during sports helps prevent post-trauma vertigo. Managing blood pressure and diabetes may reduce the risk of poor blood flow to the balance system. Staying active and maintaining good general health may also help.

Vaccines

There is no vaccine that prevents vertigo specifically. However, some infections that can affect the inner ear (like influenza or COVID-19) can be prevented with vaccines. Keeping your vaccinations up to date may lower your risk of viral inner ear infections.

Screening programmes

There is no routine screening test for vertigo in the general population. If you have risk factors or recurring dizziness, your doctor may do tests to monitor your balance and hearing. If you have Meniere's disease, regular check-ups can help manage the condition.

Complications

If left untreated

• Falls and fractures, as unsteadiness can make you more likely to fall
• Anxiety and depression due to the stress of constant dizziness
• Social isolation and loss of confidence
• Reduced ability to work or do daily activities
• In rare cases, untreated inner ear infections can lead to permanent hearing loss

Long-term outlook

The outlook for long-lasting vertigo is very good for most people. Many sources of vertigo improve on their own or respond well to treatment. Even when the cause is chronic, such as Meniere's disease, you can learn to manage symptoms and live a full, active life. It's important to work closely with your healthcare team to find the best strategy for you. You are more than your dizziness — with support, you can regain control.

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