How Long Does Vertigo Last? Understanding Causes, Symptoms, and Relief

Vertigo, the unsettling sensation that the world is spinning around you, can be a disruptive and alarming experience. It’s not just a fleeting dizziness; it’s a distinct feeling of motion when there is none, often leaving individuals disoriented and seeking answers. If you’ve experienced vertigo, one of the first questions you likely have is: “How Long Does Vertigo Last?”

This article, based on insights from leading physicians, delves into the duration of vertigo, its various causes, and what you can do to find relief. Understanding vertigo is the first step towards managing it effectively and improving your quality of life.

Vertigo: A Symptom, Not a Condition

It’s crucial to understand that vertigo itself isn’t a disease but a symptom. Think of it like a sore throat or ear pain—it signals an underlying issue. As Dr. Man-Kit Leung, an otolaryngologist, explains, “vertigo is a symptom, not a medical condition.” This means pinpointing the cause is essential for effective treatment.

Dr. Benjamin Wycherly, another otolaryngologist specializing in vertigo, emphasizes that the duration and onset of vertigo can vary significantly depending on the cause. “Sometimes it does come on very suddenly and other times it can build a little more gradually,” he notes. Therefore, understanding the characteristics of your vertigo episodes is vital for diagnosis.

The Sensation of Movement

Vertigo is more than just feeling lightheaded; it’s a specific type of dizziness characterized by a sensation of movement. Dr. Wycherly clarifies, “Vertigo is a feeling like you’re in motion. Things are moving or you’re moving when you’re really not.” This sensation can manifest differently:

Spinning: Often described as the room or yourself rotating.
Floating or Rocking: In milder cases, it might feel like floating or rocking, similar to being on a boat.

Recognizing this sensation of false movement is key to differentiating vertigo from other forms of dizziness.

Ear-Related Causes: The Most Common Culprits

The inner ear plays a crucial role in balance, and problems within this intricate system are the most frequent cause of vertigo. Dr. Leung highlights Benign Paroxysmal Positional Vertigo (BPPV) as a prime example, stating, “Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo… It is caused by crystals inside the inner ear being dislodged from their normal positions.”

These “crystals,” known as otoconia, are tiny calcium carbonate particles that help sense gravity. When displaced, they send false signals to the brain about body position, leading to vertigo. Dr. Deema Fattal, a neurologist specializing in balance disorders, estimates that “Most vertigo are 80% or 90% peripheral causes or ear causes. And then about 10% or 20% are the central causes.” Peripheral vertigo originates from the inner ear, while central vertigo stems from brain-related issues.

Other ear-related conditions causing vertigo include:

Meniere’s Disease: An inner ear disorder affecting balance and hearing.
Vestibular Neuritis/Labyrinthitis: Often caused by viral infections of the inner ear.

While less common, central causes of vertigo, such as strokes, multiple sclerosis, brain tumors, or migraines, are serious and require prompt medical attention.

Episode Duration: Seconds to Days

The question of “how long does vertigo last” doesn’t have a single answer, as the duration of vertigo episodes varies greatly depending on the underlying cause. Dr. Fattal explains, “When it comes to episodes of vertigo, they can be 30 seconds or days. Also, a person may have chronic dizziness for months or years.”

Here’s a breakdown of typical vertigo durations based on common causes:

BPPV: Episodes are typically short, often lasting seconds to less than a minute, usually triggered by changes in head position. While individual episodes are brief, the residual sensation of imbalance can linger, making it seem longer.
Migraine-Associated Vertigo: Vertigo from migraines can vary, lasting minutes to hours, and may occur with or without a headache.
Meniere’s Disease: Episodes are generally longer, lasting from 30 minutes to several hours, and are often accompanied by hearing loss and tinnitus (ringing in the ear).
Vestibular Neuritis/Labyrinthitis: Vertigo due to these conditions can be prolonged, lasting days to weeks, gradually improving as the vestibular nerve recovers.
Central Vertigo: The duration of central vertigo is highly variable and can be persistent, depending on the specific neurological condition.

It’s important to accurately describe the duration of your vertigo episodes to your doctor, as this information is crucial for diagnosis.

Diagnosing Vertigo: History and Examination are Key

Determining the cause of vertigo relies heavily on a detailed medical history and a thorough physical examination. Dr. Fattal emphasizes, “The key is the history—when it started, how it is changing over time, how long each episode lasts, what are the triggers, and any associated symptoms.”

Doctors will ask questions about:

Onset and Duration: When did the vertigo start? How long do episodes last?
Triggers: What activities or positions trigger vertigo?
Associated Symptoms: Are there other symptoms like hearing loss, headache, nausea, or neurological symptoms?
Medical History: Pre-existing conditions like heart disease, migraines, or history of stroke.

A physical exam often includes tests to assess balance and eye movements (nystagmus). The Dix-Hallpike maneuver, mentioned by Dr. Leung, is a common test for BPPV, where specific head movements are performed to observe eye movements that indicate BPPV.

Neurological exams may also be conducted to rule out central causes of vertigo, especially if there are accompanying neurological symptoms like slurred speech, weakness, or numbness.

When Vertigo Becomes an Emergency

While most cases of vertigo are not emergencies, certain symptoms warrant immediate medical attention. Dr. Fattal advises going to the emergency department if vertigo is:

Sudden and Severe: Making it impossible to walk or function.
Accompanied by New Neurological Symptoms: Clumsiness, weakness, numbness, facial drooping, hiccups, slurred speech, hearing loss, new headache, neck pain, or swallowing problems.
In Older Individuals with Risk Factors: Especially those with hypertension or diabetes.

Dr. Leung also highlights sudden hearing loss with vertigo as an emergency, stating, “If you have vertigo and loss of hearing at the same time, that could be an emergency, meaning that your hearing may not recover.”

Treatment and Relief: Addressing the Cause

Treatment for vertigo is highly dependent on identifying the underlying cause. Fortunately, many causes of vertigo are treatable.

BPPV: Often effectively treated with physical therapy maneuvers like the Epley maneuver. This maneuver, performed by a healthcare professional or at home with guidance, involves a series of head and body movements to reposition the dislodged otoconia crystals.
Meniere’s Disease: Management may involve medications like diuretics (“water pills”) to reduce fluid buildup in the inner ear, dietary changes (low-salt diet), and in some cases, injections or surgery.
Migraine-Associated Vertigo: Treating the underlying migraines with appropriate medications and lifestyle modifications can help reduce vertigo episodes.
Vestibular Neuritis/Labyrinthitis: Treatment focuses on managing symptoms and may include medications to reduce nausea and vertigo while the vestibular nerve recovers. Vestibular rehabilitation therapy can also aid in recovery.
Central Vertigo: Treatment depends on the specific neurological condition and may involve medication, surgery, or other therapies.

Over-the-counter medications like meclizine (Antivert or Bonine), as mentioned by Dr. Leung, can help manage vertigo symptoms like dizziness and nausea, particularly for motion sickness-related vertigo.

Lifestyle Factors and Self-Care

Beyond medical treatments, lifestyle adjustments can play a significant role in managing vertigo and potentially reducing its duration and frequency.

Hydration and Diet: Dehydration and high salt intake can exacerbate vertigo in some individuals, especially those with Meniere’s disease. Maintaining proper hydration and tracking sodium intake, as suggested by Dr. Wycherly, can be beneficial. A balanced diet and regular meals are also important to prevent migraine triggers.
Nutrition, Exercise, Sleep, and Stress (NESS): Dr. Fattal emphasizes the importance of NESS for overall health and vertigo management. Regular exercise, sufficient sleep, stress management techniques (like relaxation exercises and deep breathing), and a healthy diet can positively impact vertigo symptoms.
Vitamin D: Dr. Wycherly notes the link between vitamin D deficiency and BPPV. Ensuring adequate vitamin D levels, especially through supplementation if deficient, may be beneficial for individuals with BPPV.

Don’t “Just Deal With It”: Seek Help

Vertigo is not something you have to simply endure. Dr. Wycherly stresses, “Vertigo is not just something you need to live with.” Untreated vertigo can significantly impact daily life, and seeking medical help is crucial.

Dr. Fattal shares a poignant example: “The longest I’ve seen is 20 years of undiagnosed vertigo, which is really sad. We can diagnose and help vertigo and dizziness in the vast majority of patients.”

If you are experiencing vertigo, start by consulting your primary care physician or an ear, nose, and throat (ENT) specialist. They can accurately diagnose the cause of your vertigo and recommend appropriate treatment strategies to help you find relief and improve your well-being. If needed, they can refer you to a neurologist or other specialist for further evaluation and management.

Vertigo can be unsettling, but understanding its causes, typical durations, and available treatments empowers you to take control of your health and seek the help you need to live a more balanced and comfortable life.

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