What are the home remedies for managing vertigo?

Home Remedies for Vertigo

For benign paroxysmal positional vertigo (BPPV)—the most common cause of vertigo—the Epley maneuver (canalith repositioning procedure) is the definitive home treatment, with success rates of 90-98% when performed correctly, and can be self-administered after proper instruction. 1, 2

Self-Administered Canalith Repositioning Procedures

The most effective home remedy is learning to perform the Epley maneuver yourself after receiving initial instruction from a healthcare provider. Self-administered canalith repositioning shows 64% improvement rates compared to only 23% with alternative home exercises. 1, 2

How to Perform the Self-Administered Epley Maneuver:

• Start sitting upright with your head turned 45° toward the affected ear 2
• Rapidly lie back to a supine position with your head hanging 20° below horizontal for 20-30 seconds 2
• Turn your head 90° to the opposite side and hold for 20-30 seconds 2
• Roll your entire body to the side-lying position while maintaining head position, hold for 20-30 seconds 2
• Return to sitting upright 2

This maneuver is significantly more effective than other home exercises and should be your first-line approach. 2

Brandt-Daroff Exercises (Less Effective Alternative)

If you cannot perform the Epley maneuver due to physical limitations (cervical stenosis, severe arthritis, spinal issues), Brandt-Daroff exercises are an alternative, though substantially less effective. 1, 2

Proper Technique:

• Move quickly from sitting to right-side lying position with head rotated 45° upward 1
• Hold for 30 seconds after vertigo stops 1
• Rapidly move to left-side lying position with head rotated 45° upward 1
• Repeat the cycle multiple times per session 1
• Perform three times daily for two weeks 1

Critical caveat: These exercises show only 23-24% success rates at one week compared to 71-74% for repositioning maneuvers, making them a poor substitute for the Epley maneuver. 1, 2

What NOT to Do at Home

Do not use over-the-counter medications like meclizine, antihistamines, or other vestibular suppressants as home treatment for BPPV. 1, 2 These medications:

• Have no evidence of effectiveness for treating BPPV 1, 2
• Cause drowsiness and cognitive deficits 1
• Increase fall risk, especially in elderly patients 1
• Interfere with your brain's natural compensation mechanisms 1, 2
• May only be considered for severe nausea/vomiting, not for the vertigo itself 1

Post-Treatment Instructions

You can resume normal activities immediately after performing repositioning maneuvers—no activity restrictions are necessary. 1, 2 The outdated practice of maintaining head positions or avoiding certain movements after treatment provides no benefit and may cause unnecessary complications. 1, 2

When Home Treatment Isn't Enough

Reassess your symptoms after one month of home treatment. 1, 2 Seek professional evaluation if:

• Symptoms persist despite proper technique 1, 2
• You experience severe disabling symptoms or falls 2
• You have difficulty performing the movements due to physical limitations 2
• You develop additional neurological symptoms (abnormal vision, severe headache, weakness) 3

If initial home treatment fails, you may need repeat professional repositioning maneuvers, which achieve 90-98% success rates. 1, 2 Failure may indicate canal conversion (affecting a different canal), multiple canal involvement, or a different diagnosis requiring professional assessment. 1, 2

Special Populations Requiring Caution

Elderly patients with BPPV are at particularly high risk for falls—9% of patients in geriatric clinics have undiagnosed BPPV, and three-quarters have fallen within the previous three months. 1 If you are elderly, have balance problems, or live alone, consider having someone present when performing home maneuvers and ensure your home environment is safe. 3, 1

Vestibular Rehabilitation as Adjunctive Home Therapy

After successful repositioning, home-based vestibular rehabilitation exercises can improve long-term outcomes and reduce recurrence rates. 1 These exercises focus on:

• Gaze stabilization during head movements 1
• Balance and postural control training 1
• Habituation to movement-provoked symptoms 1

Home-based vestibular therapy appears equally effective as clinician-supervised therapy, though initial instruction is important. 1