Vertigo and Migraines – what’s the link?

TOM COOPER commonly treats migraine and vertigo and here he gives us the rundown:

Vertigo is the unpleasant sensation of movement or spinning. It can feel like the room is spinning, you might be on a boat, had a few too many alcoholic drinks or generally feeling like you are moving when you are not. 

Migraines are a common cause of vertigo symptoms. Around 1% of the population suffer migraines and at least 30-50% of migraine sufferers will experience vertigo during a migraine attack at some point in their life (Stolte et al., 2015). Migraines can cause vertigo when sitting still or with head movement. Vertigo will be the main symptoms of the migraine and not usually associated with a severe head ache like a typical migraine. Other symptoms of a migraine can be present however, such as sensitivity to light or noise, altered vision or altered sensation in face or hands (Neuhauser & Lempert, 2009). You may feel feeling unsteady or struggle with your balance (Cohen et al., 2011). 

The key criteria to diagnose a vestibular migraine are: 

  • recurrent vestibular symptoms 
  • history of migraine 
  •  a temporal association between vestibular symptoms and migraine symptoms 
  • exclusion of other causes of vestibular symptoms. 
  • Duration of acute vertigo lasting between 5 minutes and 72 hours of moderate to severe intensity (Lempert et al., 2012) 

So how can a physio help? A personalised vestibular rehabilitation programs have been shown to be effective at improving vertigo symptoms for people who suffer with Vestibular Migraines (Vitkovic et al., 2013). Your rehabilitation program could include balance exercises, gaze retraining, desensitising exercises for head and postural movements as well as education. Many people who suffer from episodes of vertigo become less active and more fearful of movement over time which makes their vertigo worse. 

You should always follow up with your GP to if you have new or worsening vertigo for a medical check up. Your GP is also well placed to assist you with your migraine management and specialist referral if required. 

So if you suffer from vestibular migraine, or other vertigo symptoms book in for an appointment today with one of our experienced physiotherapists today. 

Thomas Cooper



Cohen, J.M., Bigal, M.E. & Newman, L.C. (2011) Migraine and Vestibular Symptoms. Headache, 51(9), 1393-1397.  

Lempert, T., Olesen, J., Furman, J., Waterson, J., Seemungal, B., Carey, J., Bisdorff, A., Versino, M., Evers, S. & Newman-Toker, D. (2012). Vestibular Migraine: diagnostic criteria. Journal of Vestibular Research, 22(4),167-172 

Neuhauser, H. & Lempert, T. (2009) Vestibular Migraine. Neurologic clinics, 27(2), 379-391. 

Stolte, B., Holle, D., Naegel, S., Diener, H. & Obermann, M. (2015) Vestibular migraine. Cephalalgia, 35(3), 262-270. 

Vitkovic, J., Winoto, A., Rance, G., Dowell, R. & Paine, M. (2013) Vestibualr rehabilitation outcomes in patients with and without vestibular migraine. Journal of Neurology, 260(12), 3039-3048.