09/07/2026
People sometimes ask me: “Dr. Bell, with all your own vestibular experience, how do you personally avoid going to the ER during severe spinning episodes?”
First, let me say this: Not every severe dizziness episode should be managed at home.
If symptoms are new, unusual, accompanied by neurological symptoms, chest pain, severe headache, fainting, weakness, speech changes, or anything concerning, emergency medical evaluation may be appropriate.
But for people who live with recurrent vestibular conditions, learning a personal symptom-management toolbox can be incredibly valuable.
Here are some strategies I personally use when the Santa Ana winds blow here in Southern CA and flare up vertigo symptoms:
• Practice “active rest” by slowing down and reducing sensory overload without remaining in bed longer than necessary
• Dim the lights and rest in a quiet, cool environment
• Apply a soft ice pack to the back of the neck while sitting upright
• Prioritize sleep and hydration, especially with electrolytes
• Follow your physician-guided plan for managing vertigo, nausea, or migraine symptoms with prescription medication when needed
• Pay attention to neck tension or discomfort
• Use breathing, prayer, worship music, or another calming practice to help settle your nervous system
• Reduce your schedule temporarily. I try to determine if I can reschedule any of my commitments for that day so I have enough time to rest and recover. For example - If I'm dealing with a BPPV flare up, I usually move all my morning appointments to the afternoon because I usually feel better by mid-day.
• Initiate BPPV maneuvers. If I know I'm having a BPPV recurrence, I start a sequence of home maneuvers as soon as possible to get relief. I only suggest this strategy for people who have been trained by a professional and I do not recommend DIY attempts to self-treat BPPV with YouTube videos
• Take vestibular suppressants. If I need to sleep or work but the spinning feeling is debilitating, I take over-the-counter motion sickness pills short term so I can continue to function while I'm seeking outpatient medical care or doing home maneuvers for BPPV vertigo. Ask your doctor if a vestibular suppressant is reasonable for you as a short term or intermittent strategy to get relief.
The goal is not always to make every symptom disappear immediately. Sometimes it is to reduce the intensity enough to safely rest and recover.
Because vertigo can have many different causes, an accurate diagnosis is essential for creating the right treatment and home-management plan. The root cause is the key to decision-making.
Read the full blog: https://vertigodetective.com/how-to-manage-severe-vertigo-at-home/
