People often ask me, “Should I try to move around with vertigo or sit still?”

Whether movement is beneficial to recovery or unbeneficial suffering, depends on the root cause of your vertigo symptoms.

Until you have a thorough and proper evaluation by a Vestibular Physical Therapist to determine the root cause(s) of your vertigo symptoms, you will not know if it best for you to try to move around despite the discomfort, or if it is better for you to stay as still as possible to avoid triggering your vertigo symptoms.

The movement recommendations depend on the root cause of your vertigo symptoms and may change over the course of treatment. To move around with vertigo symptoms, or not to move, depends on the treatment plan that your vestibular health care provider creates for you.

In this blog, I share examples of the general progression of movement recommendations for three specific root causes of dizziness and vertigo:

1. BPPV
2. Migraine-associated vertigo
3. Cervicogenic dizziness

For example, if you have BPPV crystals loose, then I recommend keeping your head propped up on at least 2-3 pillows and avoid moving your head around as much as possible to prevent triggering vertigo symptoms from BPPV until it is successfully treated.

While you have BPPV crystals loose, I suggest moving your body slowly like a block if you do need to move around, in order to avoid triggering the BPPV symptoms.

Immediately after BPPV crystals are treated, the post-treatment precautions to ensure the best outcome include sitting upright for 20 minutes without head movement and then avoiding vigorous head shaking for one week.

Believe it or not, I actually did treat one college student who resumed head-banging to his favorite song the next morning after I successfully treated him for BPPV, forgetting my recommendations, and then he shook the BPPV crystals loose again! He called me right away after he realized what he had accidentally done.

After BPPV crystals have been successfully treated, I recommend moving your head around as much as you can tolerate in order to re-program your brain and get your brain used to moving around again. If you are scared to move around or having left-over symptoms, you may benefit from further Vestibular Rehabilitation with a physical therapist.

If your vertigo is caused by a migraine episode, then I would recommend to move as little as possible until the migraine is resolved. Many people experience vertigo with movement during vestibular migraines and “pushing” through this discomfort is really of no value.

Movement and exercise during a migraine often makes it feel worse. Movement during a vestibular migraine may also convert nausea into vomiting.

It is important to keep still in a dark, quiet room until the migraine resolves. As soon as the migraine episode is resolved, it is important to get moving again as soon as you are feeling better to prevent getting out of shape and losing muscle strength from too much time in bed.

If you have a problem with your neck, then movement restrictions would need to be recommended based on your individual pain-free range of motion available until your neck issues are properly treated and resolved.

Too much head movement while your neck is out of alignment can make symptoms of dizziness and vertigo feel worse, and even cause debilitating headaches or vomiting. This is especially true if your first (C1) or second (C2) cervical bones are causing your vertigo symptoms.

It is important to clear up any problems with your neck before beginning to perform any vestibular rehabilitation exercises that involve head shaking or repeated head turns.

Those are three examples of how the results of your examination by a Vestibular Physical Therapist will let you know whether you should push yourself to move around with vertigo or sit still, and how the recommendations may change over time.

However, the reality is that we all have to go to the bathroom a few times per day. So even if you are trying to remain as still as possible to keep your vertigo symptoms at bay, you will still need to safely move around sometimes to perform basic human functions.

In my next blog, I offer some safety tips if you need to move around with vertigo to perform your daily activities.