Vertigo — Wokingham, Berkshire

1. Overview

Vertigo is the sensation of spinning, tilting or swaying when the body is stationary — a false perception of movement of oneself or the surroundings. It is the most common type of dizziness and one of the most frequent complaints seen in both primary care and specialist ENT and neurology practice. It affects approximately 20–30% of the general population at some point in their lives and can range from a brief, mild spinning sensation on lying down to severe, disabling episodes of rotational dizziness with nausea and vomiting that prevent normal functioning.

Acupuncture and Chinese herbal medicine have strong clinical evidence for treating vertigo, particularly for the most common type (BPPV), vestibular neuritis and the recurrent vertigo of Meniere’s disease, with a clear TCM framework that identifies and addresses the underlying causes rather than only suppressing symptoms.

2. Symptoms

Spinning sensation — the cardinal symptom; the world appears to rotate or tilt; it may be triggered by head movement (BPPV), arise suddenly (vestibular neuritis), or occur in episodes (Meniere’s)
Nausea and vomiting — the vestibular system is closely connected to the vagal centres controlling nausea; moderate to severe vertigo is almost always accompanied by nausea and frequently by vomiting
Imbalance and unsteadiness — difficulty walking or standing, a tendency to fall to one side; reflects the disruption of normal vestibular input to balance centres
Nystagmus — involuntary rapid eye movements that accompany vertigo and reflect the abnormal vestibular signal being sent to the oculomotor system
Tinnitus and hearing changes — in Meniere’s disease, vertigo is accompanied by fluctuating hearing loss, tinnitus and a sensation of fullness in the ear
Associated headache — in vestibular migraine (the second most common cause of recurrent vertigo), episodes of vertigo accompany or precede migraine headaches

3. Causes and types

BPPV (Benign Paroxysmal Positional Vertigo) — the most common cause, accounting for approximately 30–50% of vertigo cases; caused by displacement of calcium carbonate crystals (otoconia) from the utricle into the semicircular canals; produces brief but intense spinning triggered by specific head movements (lying down, rolling over, looking up); treated with repositioning manoeuvres (Epley), with acupuncture providing complementary benefit for recurrence prevention and associated dizziness
Vestibular neuritis / labyrinthitis — viral infection of the vestibular nerve or inner ear; produces a single severe episode of continuous vertigo lasting days to weeks, without hearing loss (neuritis) or with hearing loss (labyrinthitis); the acute phase is managed with vestibular suppressants; acupuncture and herbal medicine accelerate recovery and address residual dizziness
Meniere’s disease — characterised by recurrent episodes of vertigo lasting 20 minutes to several hours, accompanied by fluctuating unilateral hearing loss, tinnitus and aural fullness; caused by endolymphatic hydrops (excess fluid in the inner ear); acupuncture has good evidence for reducing attack frequency and severity
Vestibular migraine — the second most common cause of recurrent vertigo; episodes of vertigo, often without headache, in patients with a migraine history; responds well to the same TCM treatment approach as migraine (Liver Yang rising)
Central causes — posterior fossa strokes, cerebellar tumours or multiple sclerosis can cause vertigo with additional neurological signs; these require urgent medical investigation and are not suitable for primary TCM management

4. Vertigo in Chinese medicine

Classical Chinese medicine has a specific category for vertigo: Xuan Yun (眩暈) — literally “dizziness and blurred vision.” The classic text Huang Di Nei Jing states that “all wind and dizziness belong to the Liver.” The major TCM frameworks for vertigo are:

Liver Yang rising — the most common TCM pattern; chronic stress, overwork, or constitutional Liver-Kidney Yin deficiency allows Liver Yang to rise upward to the head, producing spinning dizziness, headache, irritability, tinnitus, flushed face and a wiry pulse; directly corresponds to vestibular migraine and hypertension-related dizziness; treatment anchors Liver Yang and nourishes Liver-Kidney Yin using Tian Ma Gou Teng Yin — the primary formula; Tian Ma (Gastrodia) and Gou Teng (Uncaria) are the key herbs for extinguishing Liver Wind
Phlegm-Damp obstructing the Middle Burner (Spleen) — the second most common pattern; poor diet, overwork or constitutional Spleen weakness generates Phlegm-Damp that rises to obstruct the clear Yang from ascending to the head; produces a heavy, foggy dizziness with a sensation of a band around the head, nausea, fatigue, a swollen tongue with thick coating and a slippery pulse; corresponds well to Meniere’s disease (Phlegm-Damp obstructing the ear channels) and vestibular neuritis; treatment dries Damp, transforms Phlegm and harmonises the Middle Burner using Ban Xia Bai Zhu Tian Ma Tang — the classical formula specifically designed for Phlegm-Damp vertigo; combines Tian Ma with Ban Xia (Pinellia) and Bai Zhu (Atractylodes) to address both the Phlegm and the Liver Wind
Kidney Essence (Jing) deficiency — depletion of Kidney Jing through ageing, overwork or constitutional factors fails to nourish the Brain (Sea of Marrow); produces a chronic, mild dizziness with tinnitus, poor memory, lower back weakness and fatigue; more common in older patients and those with longstanding exhaustion; treatment tonifies Kidney Jing using Liu Wei Di Huang Wan or Zuo Gui Wan
Qi and Blood deficiency — insufficient Qi and Blood fail to nourish the head and sense organs; produces a mild dizziness triggered by standing, exertion or blood loss; pale complexion, fatigue, shortness of breath; treatment tonifies Qi and Blood using Gui Pi Tang or Ba Zhen Tang

5. Acupuncture for vertigo

Acupuncture is one of the most evidence-based complementary treatments for vertigo. A 2020 systematic review and meta-analysis in the Journal of Traditional Chinese Medicine found acupuncture significantly more effective than vestibular suppressants and labyrinthine sedatives for improving vertigo severity scores and quality of life. Acupuncture modulates vestibular function through its effects on the brainstem nuclei, reduces the endolymphatic pressure relevant to Meniere’s disease, regulates autonomic function (relevant to the nausea and vagal symptoms), and addresses the underlying TCM patterns — particularly Liver Yang rising and Phlegm-Damp obstruction. Key acupoints include:

GB 20 (Fengchi) — the primary point for all types of dizziness; descends Liver Yang and Wind from the head; improves vertebral artery blood flow to the cerebellum and brainstem
GV 20 (Baihui) — raises clear Yang to the head and calms the mind; anchors Yang and Wind
ST 8 (Touwei) — frontal headache and dizziness point; resolves Phlegm in the head
LV 3 (Taichong) — anchors Liver Yang and extinguishes Liver Wind
ST 40 (Fenglong) — the master Phlegm point; transforms Phlegm-Damp from the Middle Burner and head channels
SP 6 (Sanyinjiao) — nourishes Liver-Kidney Yin to anchor rising Yang

6. Chinese herbal medicine for vertigo

Chinese herbal medicine provides daily treatment for the underlying pattern and is particularly effective for recurrent or chronic vertigo. The two primary formulae are Tian Ma Gou Teng Yin for Liver Yang rising patterns and Ban Xia Bai Zhu Tian Ma Tang for Phlegm-Damp vertigo. Both contain Tian Ma — one of the most important herbs in Chinese medicine for vertigo, dizziness and internal Wind — which has documented vestibular-modulating, neuroprotective and anti-vertigo properties in modern pharmacological research. Formulae are prescribed as pharmaceutical-grade granules from Sun Ten (Taiwan).

7. Self-care tips

Epley manoeuvre for BPPV — if your vertigo is positional (triggered by lying down or rolling over), the Epley repositioning manoeuvre performed by a physiotherapist or your GP is the most effective first-line treatment; acupuncture complements this by addressing residual dizziness and preventing recurrence
Avoid sudden head movements — move the head slowly during acute episodes; sudden movements worsen both BPPV and vestibular neuritis
Reduce salt and fluid retention (Meniere’s) — for Meniere’s disease, a low-salt diet reduces endolymphatic pressure; in TCM terms this supports the Spleen’s function of transforming and transporting fluids
Reduce stress and improve sleep — emotional tension and sleep deprivation worsen Liver Yang rising; both are major triggers for vestibular migraine and exacerbation of other vertigo types
Avoid caffeine and alcohol — both worsen Liver Yang rising and increase endolymphatic pressure in Meniere’s; caffeine also depletes Kidney Yin over time

8. Treatment at my clinic

I treat vertigo and dizziness at my clinic in Wokingham, Berkshire, using acupuncture and Chinese herbal medicine to address the TCM patterns underlying the specific vertigo type. Most patients see significant improvement within four to six sessions. Related conditions commonly co-treated include migraines, tinnitus, high blood pressure and insomnia.

Visit the prices page for treatment costs or book an online Chinese herbal consultation if you cannot attend in person.

9. Frequently asked questions

Can acupuncture treat BPPV vertigo?

Acupuncture is most effective for recurrent BPPV and the residual dizziness that often persists after the Epley manoeuvre. The primary mechanical treatment for acute BPPV is repositioning (Epley), which should be performed first; acupuncture then reduces recurrence and addresses the underlying TCM pattern.

Can acupuncture help Meniere’s disease?

Yes — clinical evidence supports acupuncture for reducing the frequency and severity of Meniere’s attacks. TCM treats Meniere’s as Phlegm-Damp obstructing the ear channels and Middle Burner, with Ban Xia Bai Zhu Tian Ma Tang as the primary formula.

How many acupuncture sessions are needed for vertigo?

Most patients with acute or recurrent vertigo see significant improvement within four to six weekly sessions. Chronic or recurrent vertigo (Meniere’s, vestibular migraine) typically requires ongoing treatment to reduce attack frequency, though this can often be maintained with monthly sessions once the pattern is under control.