When everything is spinning, a few minutes can feel like an eternity. Vertigo episodes can last from minutes to weeks, and a doctor should evaluate vertigo, especially when it is prolonged, says Rebecca Andrews, a physical therapist who specializes in vertigo and vestibular issues at Gaylord Specialty Healthcare in Connecticut.
Vertigo is the feeling that the room is spinning around you even when you are not moving. It is often related to an inner-ear issue, according to the Cleveland Clinic. The underlying cause helps determine how long symptoms may last.
How Long Vertigo Can Last
“It really depends on the underlying cause. Some conditions can resolve within a few sessions, while others require weeks or months of rehabilitation,” Andrews says. Vertigo related to Meniere’s disease, for example, can last from 20 minutes to 12 hours. Other conditions can last for seconds to days.
Conditions that may be involved include:
- Benign paroxysmal positional vertigo (BPPV): Often responds quickly to treatment. Many patients improve after a few sessions, although some may need additional visits depending on the canal involved or whether multiple canals are affected.
- Vestibular migraine: Tends to be chronic and recurrent. Treatment usually aims to reduce how often and how severely episodes occur and improve tolerance to movement.
- Persistent postural-perceptual dizziness (PPPD): Once identified and appropriately treated, many patients begin to improve within weeks. Recovery can take longer depending on how long symptoms have been present and how much avoidance or visual dependence has developed.
- Vestibular neuritis or labyrinthitis: Recovery is typically measured in weeks to months.
- Concussion-related dizziness: Recovery varies with the injury’s severity and the systems affected. A concussion can involve vestibular dysfunction, impaired eye movements, sensitivity to visual motion, balance deficits, neck dysfunction, migraine, autonomic dysfunction or problems with exertion. When several issues are present, recovery can take months.
“The important point is that there isn’t one standard timeline for ‘vertigo.’ The underlying diagnosis, severity, duration of symptoms and response to treatment all influence recovery,” Andrews says.
What May Help Shorten an Episode
For BPPV, positional repositioning maneuvers performed by a trained physical therapist can often resolve symptoms quickly, sometimes within one or a few treatment sessions, Andrews says. The maneuvers use specific head and body positions to guide displaced inner-ear crystals, or otoconia, out of a semicircular canal and back to their proper location.
Some causes, such as vestibular migraine, vestibular neuritis or PPPD, are not as easily shortened. They may require other approaches, including vestibular rehabilitation, migraine management, habituation exercises or treatment aimed at the underlying cause, Andrews says.
When Vertigo May Need Urgent Attention
Andrews and Dr. Jason Bellak, principal investigator for clinical research at the Allergy and Asthma Center in Las Vegas, say to watch for symptoms that may require medical attention:
- Changes in vision or speech
- Sudden falls without loss of consciousness
- Numbness
- Nystagmus, or involuntary eye movements
- Nausea
- Hearing loss
- One-sided limb weakness or facial droop
- Sudden, severe headache
- Loss of consciousness or fainting
“Do not drive or operate machinery. Do not drink alcohol. Rest,” Bellak says. He adds that meclizine is used for motion sickness and ondansetron (Zofran) may help some symptoms. “I recommend always seeing a medical professional for vertigo. I recommend urgently seeing a medical professional if any of the above signs/symptoms occur.”
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