“I’ve been doing VRT for two months for vestibular neuritis. My constant vertigo stopped for days, then came back. Why did my symptoms stop and then resume?”
That is great news, good job to you for this achievement! The fact that your constant vertigo stopped for days is a big stepping stone in your recovery. Now, take a deep breath and know that you are not regressing, or causing further harm to your system. What you’re experiencing is very common during recovery from vestibular neuritis, especially when doing Vestibular Rehabilitation Therapy (VRT). Healing from a vestibular injury can be tricky and challenging to navigate. It isn’t a straight line; it’s more like a winding path with stretches of smooth ground, followed by a few bumps that catch you off guard.
Let’s walk through why symptoms often improve… and then flare up again.
Recalibration isn’t linear
Your brain is still recalibrating.
After vestibular neuritis, one inner ear sends the brain weaker or more distorted signals than the other. Your brain works hard to compensate, and VRT is designed to speed up this process by gently challenging your system. Challenging your system is key to recovery.
As compensation develops and symptoms fade, the brain remains sensitive to new stimuli. When you add a bit more movement, stress, fatigue, screen time, or even a new VRT exercise, you might temporarily experience a dip in symptoms. This does not necessarily mean a setback or that the compensation is gone; it means that it’s still settling in.
Pushing beyond your comfort zone
Your system may have been pushed beyond its comfort zone.
This is not a bad thing; your system does need to be pushed. In VRT, there’s a “sweet spot” though; exercises should provoke mild symptoms that resolve within minutes. However, if exercises become too intense, or life throws extra motion at you (a busy store, scrolling your phone, a car ride, lack of sleep), your system will protect you and notify you by a symptom resurgence. This is simply feedback to indicate that you and your therapist can adjust your routine so your brain can keep adapting without being overwhelmed.
Small changes seem big
When you notice improvement, any increase in symptoms along the way may feel bigger.
When symptoms are constant, they blend into the background. Once you finally get relief, even a small wave of symptoms can feel like a major setback. Remember, you are not at square one when this happens, and the progress you have made to this point is still there. Your body will recover steadily over time. You will see that flare-ups start to resolve quickly along the way.
Triggers
Life factors can trigger temporary flare-ups
Common culprits include:
- Stress or anxiety
- Fatigue
- Illness (even a mild cold)
- Hormone changes
- Weather and barometric pressure shifts
- Increased screen time
- Poor hydration
- Skipping VRT or doing too much VRT
These triggers don’t undo your progress—they’re environmental bumps that your brain reacts to more strongly while it’s healing.
Individualized Timelines
Recovery from vestibular neuritis takes time, and the timeline is very individualized.
Two months are still early in the recovery process. Many people improve gradually over three to six months, sometimes longer. The fact that you had days without vertigo is a very positive sign that your brain can compensate and you are on the road to recovery.
Your symptoms returning don’t change that.
What You Can Do Next
- Talk with your vestibular therapist.A slight tweak in exercise intensity, frequency, or progression can make a big difference. It is a balancing act—no pun intended.
- Aim for “challenged, not overwhelmed.” You can ease or nudge into symptoms. If your symptoms spike and take hours to settle, you may be doing too much.
- Be mindful of your triggers. This is so you can modify things that may ramp your system up too much.
- Give yourself grace and honor rest when needed. The brain heals best when it isn’t exhausted.
- Stay the course. You got this! Fluctuations are normal. Consistency—not perfection—is what moves recovery forward.
Reviewed by Danielle Beatty, DPT
