Understanding Recurrent Vertigo, Why It Happens and What You Can Do About It
“I thought it was gone… then it came back.”
One of the most common questions we hear at The Vertigo Co is:
“Why does my vertigo keep coming back?”
You finally start feeling better.
You return to work.
You go out for dinner.
You stop thinking about your balance.
Then one morning you roll over in bed, walk into a supermarket, experience a stressful week or catch a virus and suddenly the dizziness returns.
For many people this is incredibly frustrating.
Some begin to think:
“There must be something seriously wrong with me.”
“Why can’t anyone fix this?”
“Will I always be like this?”
The reassuring news is that recurrent vertigo is extremely common. Many vestibular disorders naturally fluctuate over time, and understanding why symptoms return is often the first step towards long-term recovery.
Is recurrent vertigo normal?
Yes.
Many vestibular conditions are characterised by periods of improvement followed by temporary flare-ups.
This does not necessarily mean:
- your condition is getting worse
- treatment has failed
- permanent damage is occurring
Instead, the vestibular system is highly sensitive to a range of internal and external factors including stress, illness, hormones, fatigue and sleep.
For many people, symptoms fluctuate rather than progressing.
The most common causes of recurrent vertigo
Benign Paroxysmal Positional Vertigo (BPPV)
BPPV is one of the most common causes of recurrent vertigo.
Tiny calcium carbonate crystals normally sit inside part of the inner ear called the utricle.
Occasionally these crystals become dislodged and migrate into one of the semicircular canals.
When you move your head, these crystals move when they shouldn’t, creating a brief spinning sensation.
Many people believe that once treated it will never return.
Unfortunately, this isn’t always the case.
Why does BPPV come back?
Research suggests recurrence is common.
Some people experience one episode in their lifetime.
Others experience episodes every few years.
Some experience multiple episodes each year.
Risk factors include:
- increasing age
- osteoporosis
- Vitamin D deficiency
- migraine
- previous head trauma
- prolonged bed rest
- previous BPPV
Fortunately, recurrent BPPV is usually very treatable with repositioning manoeuvres.
Vestibular Migraine
Vestibular Migraine is another leading cause of recurrent vertigo.
Unlike BPPV, episodes are not always positional.
Instead, patients may experience:
- rocking
- swaying
- floating
- imbalance
- motion sensitivity
- visual motion sensitivity
- brain fog
Symptoms may last:
- minutes
- hours
- days
- or even weeks.
Many patients feel completely normal between attacks.
Why does Vestibular Migraine flare?
Migraine works like a threshold.
Imagine a bucket slowly filling with water.
Each trigger adds a little more.
- Stress.
- Poor sleep.
- Hormonal changes.
- Bright lights.
- Dehydration.
- Skipped meals.
- Alcohol.
- Illness.
Eventually the bucket overflows.
The result is a migraine attack.
Many people focus on the final trigger without recognising that several smaller triggers accumulated beforehand.
Ménière’s Disease
Ménière’s Disease naturally fluctuates.
Patients may experience:
- months of complete normality
followed by
- hours of spinning vertigo
- hearing fluctuation
- aural fullness
- roaring tinnitus
before returning to baseline again.
Recurrence is part of the condition rather than evidence that treatment has failed.
Vestibular Neuritis
Most people recover well after Vestibular Neuritis.
However, many notice temporary flare-ups months later.
Common triggers include:
- viral illness
- stress
- poor sleep
- fatigue
- busy environments
These episodes usually represent temporary decompensation rather than a new injury to the balance nerve.
Why stress brings vertigo back
Stress is one of the most powerful vestibular triggers.
When the nervous system enters threat mode it becomes hypervigilant.
Muscles tighten.
Breathing changes.
Visual scanning increases.
Balance becomes consciously controlled.
The brain starts monitoring every movement.
Ironically this increased attention amplifies symptoms.
Many patients notice dizziness during:
- moving house
- changing jobs
- relationship stress
- financial pressure
- family illness
- travel
- bereavement
The dizziness is real.
The trigger simply comes from the nervous system rather than structural damage.
Why illness makes vertigo worse
Many people notice dizziness worsening after:
- COVID
- influenza
- colds
- gastroenteritis
- vaccinations
- viral infections
Illness increases inflammation, disrupts sleep and places additional stress on the nervous system.
Even if the infection does not directly affect the inner ear, it can temporarily lower the brain’s tolerance for vestibular symptoms.
Hormones and recurrent vertigo
Many women notice worsening symptoms:
- before menstruation
- during perimenopause
- during menopause
- when changing hormonal contraception
Hormonal fluctuations alter migraine thresholds and nervous system sensitivity.
Keeping a symptom diary often reveals patterns that previously went unnoticed.
Why fatigue makes everything worse
The vestibular system is one of the most energy-demanding systems in the brain.
When tired, the brain becomes less efficient at processing balance information.
Patients often describe:
- more rocking
- more swaying
- more brain fog
- more motion sickness
- more supermarket dizziness
This does not necessarily mean the vestibular disorder has worsened.
It often means the brain has fewer resources available.
The fear of recurrence
Perhaps the biggest challenge is psychological.
After one severe vertigo episode many people become frightened of another.
They begin monitoring every sensation.
Every slight imbalance becomes a potential warning sign.
This creates:
- hypervigilance
- anxiety
- avoidance
- muscle tension
- increased dizziness
known as the Dizzy-Anxious Cycle.
Breaking this cycle is often a key component of recovery.
Does recurrent vertigo mean my condition is getting worse?
Usually not.
Many vestibular disorders naturally fluctuate.
Think of recovery like climbing a mountain.
There are good days.
Bad days.
Plateaus.
Temporary setbacks.
Overall progress is measured over months rather than individual days.
One bad day does not erase six weeks of improvement.
How can I reduce recurrence?
Although no strategy completely prevents recurrence, the following significantly improve long-term control.
Sleep
- Maintain regular sleep and wake times.
Hydration
- Even mild dehydration can trigger Vestibular Migraine.
Regular meals
- Avoid prolonged fasting and significant blood sugar fluctuations.
Exercise
- Gentle regular movement promotes vestibular compensation.
- Walking, Pilates and strength training are often excellent options.
Stress management
- Breathing exercises.
- Mindfulness.
- Vestibular Psychology.
- Progressive muscle relaxation.
- Regular enjoyable activities.
Continue moving
- Avoiding movement often prolongs recovery.
- The brain improves through safe, repeated exposure.
Vestibular Rehabilitation
- Individualised exercises improve:
- balance
- gaze stability
- visual tolerance
- motion sensitivity
- confidence
- reducing future symptom burden.
When should I seek medical review?
Seek medical assessment if:
- your vertigo changes significantly
- you develop new neurological symptoms
- episodes become more frequent
- hearing suddenly changes
- you experience severe headache unlike previous episodes
- you develop double vision, weakness or difficulty speaking
- or your symptoms are significantly affecting daily life.
The good news
One of the biggest misconceptions about recurrent vertigo is that every recurrence represents failure.
It doesn’t.
Most vestibular conditions fluctuate.
Many people experience temporary setbacks while continuing to make excellent long-term progress.
At The Vertigo Co we regularly see patients who initially believed they would never recover because symptoms kept returning. With the correct diagnosis, education and Vestibular Rehabilitation, they gradually become less sensitive, less fearful and more confident.
The goal is not necessarily to eliminate every symptom immediately.
The goal is to help your brain become resilient enough that when symptoms do occur, they are shorter, milder and no longer control your life.
Recovery is rarely perfectly linear—but recovery is absolutely possible.
