vertigo with nausea

Overview

Vertigo is a false feeling that you or the world around you is spinning or moving, even when you are still. It is a type of dizziness, not a disease itself. Nausea (feeling sick to your stomach) often goes along with vertigo because the spinning sensation can upset your balance and stomach. Vertigo usually comes from a problem in the inner ear, which helps control your balance.

Yes, vertigo is a very common reason for doctor visits. Many people experience vertigo with nausea at some point in their lives, and it becomes more common as people get older.

Vertigo can happen at any age, but it is more frequent in adults over 60. Certain types of vertigo, like positional vertigo, are more likely in middle-aged and older people. Children can also have vertigo, though it may be harder for them to describe.

Symptoms

Common symptoms

• Feeling that you or the room is spinning
• Nausea or vomiting
• Loss of balance or feeling unsteady
• Sweating or cold sweats
• Headache or pressure in the ear
• Ringing in the ears (tinnitus)
• Hearing loss or muffled hearing
• Feeling tired or weak after an episode

Symptoms in children

• Children may not be able to describe the spinning feeling well, so they might just say they feel 'dizzy' or 'funny'.
• They may suddenly stop playing, hold onto furniture, or sit down.
• Nausea and vomiting can happen, and sometimes the child looks pale.
• They may have a headache or complain that their ears feel weird.

Symptoms in older adults

• Older adults may have more severe loss of balance, increasing the risk of falls.
• They may feel unsteady even after the spinning stops.
• Vertigo can be mistaken for weakness or confusion.
• It may take longer to recover from an episode.
• Also, dehydration from nausea and vomiting can be more dangerous for older adults.

Causes

Main causes

• Benign paroxysmal positional vertigo (BPPV): tiny calcium crystals in the inner ear move to a place they should not, causing brief spinning when you move your head.
• Vestibular neuritis or labyrinthitis: an infection, often viral, that inflames the inner ear or the nerve that controls balance.
• Meniere's disease: a build-up of fluid inside the inner ear that can cause vertigo, hearing loss, and ringing in the ear.
• Migraine-associated vertigo (vestibular migraines): people with migraines may have vertigo as part of their migraine attacks.
• Head injury: damage to the inner ear or brain after a blow to the head.
• Certain medicines that can damage the inner ear (but we do not name specific drugs here).
• Rarely, more serious conditions like a stroke or tumor affecting the brain.

Risk factors

• Being over 50 years old
• Having had a head injury before
• Having migraines or a family history of migraines
• Having an inner ear infection or recent viral illness
• Smoking or drinking too much alcohol
• Taking certain medicines that affect the ear (ask your doctor)
• Stress, lack of sleep, or dehydration

When to see a doctor

See a doctor urgently if:

• If vertigo is severe, lasts more than a few minutes, or keeps coming back
• If you have hearing loss, ringing in the ear, or ear pain
• If you cannot keep fluids down due to nausea and vomiting
• If you are unsteady and have fallen or nearly fallen
• If you have a history of heart disease or diabetes

Book a routine appointment if:

• If vertigo happens multiple times and interferes with daily life
• If you feel anxious or worried about when the next episode will happen
• If over-the-counter motion sickness remedies (used with your pharmacist's advice) do not help

Diagnosis

A doctor will ask you about your symptoms, what brings them on, how long they last, and whether you have other medical issues. They will also need to check your eyes, ears, and balance. Your answers and a physical exam often give the diagnosis.

Tests that may be done

• Eye movement tests (the doctor may ask you to watch a moving object)
• The Dix-Hallpike test: you lie down quickly with your head turned to one side to see if that triggers vertigo and eye twitching
• Hearing tests to check for inner ear problems
• Balance tests, such as standing with eyes closed
• MRI or CT scan of the head if the doctor suspects a more serious cause
• Blood tests if an infection or other medical condition is possible

What to expect at your appointment

The doctor may perform some simple tests in the clinic that make you feel dizzy for a few moments. This is normal and helps them figure out the cause. You may also be referred to an ear, nose, and throat (ENT) specialist or a balance clinic for more detailed testing.

Treatment

Treatment depends on what is causing the vertigo. In many cases, the condition improves with time or simple exercises. Your doctor will help you choose a plan based on your specific situation. Never try to treat yourself with medications without medical advice.

Self-care at home

• Sit or lie down in a safe place until the spinning stops
• Hold onto a fixed object and keep your eyes on a still point
• Avoid sudden head movements, bending down, or looking up
• Move slowly when changing positions, especially when getting up from bed
• Drink plenty of fluids to avoid dehydration
• Rest in a quiet, darker room if light and noise make it worse
• Use a walking aid if you feel unsteady, to prevent falls
• Try a cold or warm compress on your forehead if it helps with nausea

Medical treatments

For vestibular neuritis or other inner ear problems, a doctor may prescribe medication to suppress the spinning sensation or to reduce nausea. These are usually taken for only a short time because they can slow down the brain's ability to compensate. For some types of vertigo, especially BPPV, doctors may recommend a series of head and body movements (like the Epley maneuver) that can be taught to you. In other cases, vestibular rehabilitation therapy with a physical therapist helps the brain learn to adjust to the inner ear problem. These approaches are not medications, but they are very effective for many people.

When is surgery considered?

Surgery is rarely needed for vertigo. It is mostly considered only when all other treatments have failed and the vertigo is caused by a serious inner ear disorder, such as severe Meniere's disease, or if there is a structural problem in the ear. Your doctor will explain if this is ever an option for you.

Living with this condition

Living with vertigo can be unpredictable, but there are ways to manage it. Keep a symptom diary to track what triggers your attacks, how long they last, and your nausea levels. Plan your day with breaks so you can rest if needed. Tell friends, family, and coworkers about your condition so they can help you during an attack. If you feel a vertigo episode starting, stop what you are doing and find a safe place to sit or lie down.

Lifestyle tips

• Get enough sleep and try to keep a regular sleep schedule
• Avoid alcohol and caffeine if they seem to make your vertigo worse
• Avoid smoking
• Manage stress with relaxation techniques like deep breathing, meditation, or gentle yoga
• Be careful when moving your neck — try to turn your whole body instead of just your head
• Keep your home well lit and remove tripping hazards like loose rugs or cables
• If you have Meniere's disease, your doctor may recommend a low-salt diet

Diet and exercise

For some people, a low-salt diet can reduce fluid build-up in the inner ear and help with Meniere's disease. Staying hydrated is important, but try to drink small amounts throughout the day. Gentle exercises that improve balance, such as tai chi, walking, or customized vestibular exercises, can help you feel more steady. Always ask your doctor or physiotherapist before starting a new exercise routine.

Mental health and emotional wellbeing

Vertigo can make you feel anxious, frustrated, or isolated. The fear of having an unexpected attack can stop you from going out or enjoying activities. It is completely normal to feel this way. Talk to your doctor if you feel low or anxious — psychological support and 'talking therapies' can help you cope with the emotional side of living with dizziness.

Prevention

You cannot always prevent vertigo, especially if it is caused by inner ear crystals or a viral infection. But you can lower your risk of attacks by managing triggers. Identify your personal triggers (like sudden head movements, stress, or certain foods) and avoid them when possible. For BPPV, avoiding lying flat or looking upward suddenly can help. Staying physically active and maintaining good balance can also reduce your risk of falls.

Vaccines

Some infections that can cause vertigo, such as flu or other viral infections, can be prevented with vaccines. Ask your doctor or pharmacist about recommended vaccinations, but do specifically note that vaccines do not prevent vertigo itself.

Screening programmes

There is no routine screening test for vertigo. But if you have falls or dizziness, it is important to have your hearing and balance checked regularly, especially as you get older. Speak to your doctor if you notice any changes.

Complications

If left untreated

• Falls and injuries, including hip fractures or head injuries, especially in older adults
• Dehydration and electrolyte imbalance due to nausea and vomiting
• Anxiety or depression because of fear of attacks
• Long-term balance problems or increased risk of falls
• If vertigo is a sign of a more serious condition like a stroke, not getting help can lead to permanent damage

Long-term outlook

The outlook for vertigo is generally very good. Most people improve within a few days to a few weeks, especially with proper treatment. Even conditions like BPPV can be effectively treated with simple repositioning maneuvers. Some people have ongoing episodes, but with the right support and management, most live full, active lives. It is important to follow your doctor's advice and be patient with your body's recovery.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.