Dizziness after a concussion: preparing for evaluation and managing daily tasks
Track when dizziness strikes and find safer ways to walk, shop, travel and do chores
Imagine a 44 year old dental hygienist whose hatchback was bumped hard by a pickup truck at an intersection. Six weeks on, the room spins for a few seconds each time she rolls over in bed. The cereal aisle makes the floor feel like it is tilting. She has stopped carrying laundry down the basement stairs, and she is not sure how to explain any of this at her next visit.
Dizziness after a concussion is real, and it can be hard to put into words. The clearer you can be about when it happens and what sets it off, the easier it is to find the cause [1].
This guide gives you two tools: a dizziness diary and a daily tasks table for walking, shopping, travel and housework. The site’s shorter page on dizziness and balance after a car crash covers the basics.
What dizziness after a concussion can feel like
Dizziness is a broad word. TBICoE, the Traumatic Brain Injury Center of Excellence, is a U.S. military health center. Its fact sheet says dizziness can mean anything from feeling faint to feeling weak or unsteady [2]. Some people feel the room spin, which is called vertigo. Others feel off balance, as if they might tip over [2].
It is common. TBICoE guidance for clinicians who treat service members and veterans cites estimates that 24% to 83% of people feel dizzy after a mild traumatic brain injury (mild TBI). Early on, it may be up to 90% [1]. The CDC lists dizziness and balance problems among the physical signs of concussion [5]. Many people feel dizzy in the first week or two, and it usually clears without treatment [2].
When it lingers, the concussion may not be the only cause. The fact sheet also names headaches, neck injuries, anxiety and side effects of medicines, and more than one can play a part [2].
Common types and the clues for each
Clinicians sort dizziness partly by its pattern. Does it come and go, or is it there all the time? Does something set it off, or does it start on its own [1]? The table shows common types after a concussion. Use it to describe what you feel, and let your care team work out the cause.
Comparison compiled by Safety Behind the Wheel Foundation
Types of dizziness after a concussion
| Type | What it may feel like | Common clues |
|---|---|---|
| Positional vertigo (BPPV) | Short bursts of spinning, sometimes nausea | Rolling over in bed or looking up; lasts under a minute |
| Inner ear balance problem | Unsteady, off balance | Worse when you turn your head or walk |
| Neck related dizziness | Spells that last minutes to hours | Moving the neck or holding it in certain positions |
| Motion sensitivity | Queasy or disoriented | Elevators, escalators, car rides, crowds |
| Lightheaded on standing | Faint or woozy | Getting up quickly; some medicines |
| Migraine related dizziness | Dizzy spells along with headaches | Headache days; poor sleep can make it worse |
Sources: TBICoE guidance [1]; TBICoE fact sheet [2]; Living Concussion Guidelines [3]. Only a clinician can confirm the type.
The Living Concussion Guidelines, a Canadian guideline for adults, say BPPV is the most common inner ear cause of dizziness after a head injury [3]. BPPV stands for benign paroxysmal positional vertigo. Spells of spinning, often with an upset stomach, start when you move quickly, such as rolling over in bed or tipping your head back [3].
Worry and dizziness often travel together. The same guideline notes that people with dizziness often have anxiety too [3]. Mention both to your care team.
Keep a dizziness diary
The Canadian guideline recommends tracking symptoms on a standard rating scale and checking balance and vision symptoms again at follow up visits [3].
Aim for one to two weeks of entries before your visit. Write each spell down soon after it happens, or ask a family member to jot it down.
What to write down
- When it started and how long it lasted: seconds, minutes, hours or all day.
- What you were doing: rolling over, standing up, turning your head, riding in a car, walking through a store.
- What it felt like: spinning, rocking, lightheaded, unsteady, queasy, or as if your eyes could not keep up.
- How strong it was, from 0 (none) to 10 (worst).
- What helped: sitting down, closing your eyes, holding on to something, resting.
- Anything else that day, such as a headache, a bad night, a new or changed medicine, or a near fall.
Worksheet from Safety Behind the Wheel Foundation
My dizziness diary
| Date, time and length | What I was doing | What it felt like (0 to 10) | What helped or happened next |
|---|---|---|---|
| Example: Tue 7:10 a.m., 20 seconds | Rolled onto my right side in bed | Room spun, sick to my stomach, 7 | Lay still; it passed |
| Example: Sat 11 a.m., about 1 hour | Cereal aisle in a busy store | Floor seemed to tilt, queasy, 5 | Left early; rested at home |
Based on the questions in TBICoE guidance [1] and the Living Concussion Guidelines [3]. Print several copies and bring them to your visit.
Patterns to look for
After a week or two, read back through your entries. Look for the same trigger showing up again and again. Notice whether spells always end in under a minute, or whether they run for hours. Check for links to headache days or poor nights, since poor sleep can make balance symptoms worse [1].
Brief spinning tied to head position points toward BPPV. Spells lasting minutes to hours that follow neck movement point toward the neck [1].
A quick look at daily life
Clinicians may use a form called the Dizziness Handicap Inventory to see how much dizziness affects daily life [3]. It has 25 questions and dates from 1990 [6]. You answer yes, sometimes or no. Items ask whether a supermarket aisle or a sidewalk makes things worse and whether you cut back on travel. Others ask about chores like sweeping or putting dishes away [6]. Filling it out again later can show whether things are changing.
Getting ready for your evaluation
Canada’s guideline sets a one month mark. If balance or vision symptoms still limit you by then, it recommends referral to someone with special training in these systems [3]. A 2025 U.S. guideline for adults suggests considering a specialty referral when symptoms stay disabling past 30 days. It lists vestibular rehabilitation among the specialty options [7].
Primary care is usually the first stop. From there, the TBICoE fact sheet says you may be sent to an audiologist, an ear, nose and throat (ENT) doctor, a physical or occupational therapist, or a neurologist [2]. TBICoE guidance also suggests a TBI specialty clinic, where one exists, for symptoms that persist or severely limit you [1].
What the visit may include
The clinician should check your neck first. After that, a head positioning test can confirm BPPV [3]. Many clinicians use a short eye movement and balance screen called VOMS, which the Canadian guideline rates as valid and reliable [3]. Your clinician may also look for a drop in blood pressure when you stand, since that can cause lightheadedness [1].
Bring to your appointment
Checklist from Safety Behind the Wheel Foundation
- Your dizziness diary, with at least one week of entries.
- A list of all medicines and supplements you use, and when any of them last changed.
- Notes on your neck, such as pain, stiffness or whiplash from the crash.
- The daily tasks you have stopped or changed because of dizziness.
- Any falls or near falls, with dates and what you were doing.
- Other symptoms, such as headache, blurred vision, ringing ears or poor sleep.
- A family member or friend who has seen your spells, if that helps.
- Your written questions (see the list below).
A word about medicines
Some medicines list dizziness or lightheadedness as a side effect, including some pain relievers, muscle relaxants and medicines for anxiety [1]. TBICoE guidance says your clinician should ask about recent medicine changes [1]. Pills that quiet the balance system have been used for dizziness in the past. The Canadian guideline says current evidence does not support that approach [3], and TBICoE warns these drugs may worsen concussion symptoms and slow recovery [1]. Do not start, stop or change any medicine on your own. Bring your list and ask.
Daily tasks: safer ways to walk, shop, travel and keep house
Dizziness shows up in ordinary moments, from getting out of bed to bending over and yard work [6]. Use the table to spot your trouble areas and pick a safer way to do each task.
The aim is to lower your risk of a fall while you keep doing what you safely can. The Canadian guideline recommends gradual exposure to activities that raise symptoms only a little, no more than 2 points on a 10 point scale [3].
Comparison compiled by Safety Behind the Wheel Foundation
Daily tasks and safer ways to do them
| Task | What can make it harder | Safer ways to try |
|---|---|---|
| Getting out of bed | Standing up right away | Sit on the edge of the bed for a few minutes first |
| Walking at night | Dark rooms and halls | Lamp within reach of the bed; night lights on the path |
| Stairs | Looking down, carrying loads | Rails on both sides; nothing left on steps; lights at top and bottom |
| Bath or shower | Wet, slick surfaces | Grab bars by the tub and toilet; nonslip mat |
| Kitchen | Reaching high, bending low | Daily items at waist height so you need not climb; never stand on a chair |
| Chores | Bending, sweeping, quick turns | Hold something steady when you bend; short sessions with breaks |
| Grocery store | Long aisles, bright shelves, crowds | Quiet hours; a short list; stop and hold something steady during a spell |
| Escalators and elevators | Motion you cannot control | Hold the rail; choose whichever bothers you less |
| Car rides | Motion and passing scenery | Ride in the front seat; look at the horizon or close your eyes |
| Flights | Movement, crowds, long days | Sit over the wing; plan rest after you land |
Sources: TBICoE fact sheet [2]; CDC home fall prevention checklist [8]; CDC motion sickness advice for travelers [9]; Living Concussion Guidelines [3]. Ask your care team which changes fit you.
Walking and moving around the house
The TBICoE fact sheet advises holding on to something when you bend over or move suddenly [2]. A CDC checklist for preventing falls at home, written for older adults, adds more steps. Take up loose rugs or hold them down with tape or a nonslip backing, and keep floors and stairs clear [8]. Bending and reaching are common triggers, so move everyday items to shelves at about waist height [8].
Shopping
Stores ask a lot of your balance system. The Canadian guideline warns that glaring light and visually crowded settings can stir up symptoms [3]. TBICoE screening asks whether crowded or busy places leave you feeling sick or disoriented [1]. A few changes can help:
- Go early or late, when aisles are calmer.
- Write a short list in aisle order so you spend less time scanning shelves.
- If the shelves start to swim, stop, hold on to something that will not roll or slide, and sit down if you can.
- Use pickup or delivery on bad days and save store trips for better ones.
- Build up slowly, from a short trip to a small store toward a longer one, staying inside the 2 point limit [3].
Travel and getting around
Car rides, elevators and escalators can stir up motion sensitivity, and TBICoE screening asks about each one [1]. CDC advice for travelers with motion sickness suggests a front seat in a car or bus and a seat over the wing on a plane. Closing your eyes or looking at the horizon may help too [9]. It was written for travelers in general.
On longer trips, plan breaks and allow extra time. Bring a companion the first few times in case a spell hits.
Leave the driving to someone else for now
Do not drive while you feel dizzy. The Canadian guideline advises that people who still have concussion symptoms should not drive, and it names dizziness as a symptom that can affect driving [4]. It says to wait until your symptoms have settled enough for you to be safe on the road [4]. The TBICoE fact sheet also says to have someone else drive if dizziness or lightheadedness happens often [2]. Talk with your care team first, and check your state’s rules for drivers with medical conditions. This section’s article on returning to driving lists questions to ask.
Your daily tasks plan
Worksheet from Safety Behind the Wheel Foundation
My daily tasks plan
| Task | What happens when I try it | Safer way to try this week | How it went |
|---|---|---|---|
| Walking | |||
| Shopping | |||
| Travel | |||
| Household chores | |||
Fill in one change per task, try it for a week, then take the sheet with you to your next appointment. Built on the TBICoE fact sheet [2] and the CDC checklist [8].
What treatment can look like
Treatment depends on the cause. A 2020 guideline written for physical therapists by specialty groups within their national association covers four kinds of problems after a concussion. These involve the neck, the inner ear and eye movements, exertion and the body’s automatic controls, and control of movement [10]. A 2022 review adds that the main treatment for balance and vision problems after concussion is therapy, along with checking for other conditions [11].
For BPPV
BPPV is often treated in the office with a set of head and body position changes, known as a repositioning maneuver. The Canadian guideline gives this its top evidence rating [3]. If BPPV does not clear after one to three treatments, it suggests an ENT doctor or a clinician certified in vestibular rehabilitation [3]. The TBICoE fact sheet says to use these maneuvers only as your provider recommends [2].
For dizziness that limits daily life
Vestibular rehabilitation uses guided exercises to retrain the balance system. The Canadian guideline recommends it, at its strongest level, for dizziness that limits daily function [3]. The TBICoE fact sheet describes some of the exercise types. One trains your eyes to stay on a still target while your head moves. Another slowly trains your brain to tolerate the mixed signals coming from your inner ear [2].
Talk with your provider before you start [2]. Symptoms may rise for a short time during the exercises. If they do not settle within a minute, stop and try again the next day [2].
A 2022 review pooled small randomized trials of this therapy after concussion, in people aged 9 to 67. Scores on the Dizziness Handicap Inventory improved more with therapy, but the trials differed a lot, and the authors called for larger studies [12]. Sport concussion experts who met in Amsterdam in 2022 went further for athletes. If dizziness, neck pain or headaches are still present after 10 days, their consensus recommends therapy that treats the neck and balance system together [13].
Get emergency care right away
Certain warning signs after a blow to the head call for emergency help. Call 911 right away, or get a ride to an emergency department without delay, if any of these appear [5]:
- Head pain that grows steadily worse and does not let up.
- Weakness, numbness, decreased coordination, convulsions or seizures.
- Throwing up over and over.
- Slurred speech or unusual behavior.
- Pupils of two different sizes.
- Being unable to recognize people or places you know, or acting confused, agitated or restless.
- Blacking out, or being so drowsy that no one can rouse you.
Questions to ask your care team
Question checklist from Safety Behind the Wheel Foundation
- What type of dizziness do you think I have, and what points to it?
- Could my neck, my medicines, my blood pressure or migraine be playing a part?
- Should I be tested for BPPV, and who can do the repositioning treatment?
- Would vestibular rehabilitation help me, and can you refer me to someone trained in it?
- Which activities should I keep doing, and how much extra dizziness is okay during them?
- What home safety changes or walking supports should I use for now?
- When might it be safe to drive again, and how will we decide?
- If I am not better in a month, what is the next step?
Frequently asked questions
Is it normal to still feel dizzy weeks after a concussion?
Dizziness often clears in the first few weeks [1, 2]. For some people it lasts longer. The Canadian guideline recommends referral to someone trained in balance or vision problems when symptoms still limit you after a month [3].
Can I do balance exercises I find online?
Check with your provider first. The TBICoE fact sheet says to talk with your primary care provider before starting and to do repositioning maneuvers only as recommended [2]. The right exercises depend on the type of dizziness you have.
The bottom line
Recommendation from Safety Behind the Wheel Foundation
Dizziness after a concussion is common, and it often fades. When it lasts, a diary of what you were doing, what you felt and how long it lasted can help your care team find the cause [1, 3]. Bring the diary, your medicine list and your daily tasks plan to your visit, and ask whether vestibular rehabilitation fits your needs.
In the meantime, make your home safer, plan store trips and travel around your triggers, and let someone else drive [8, 4]. Check your state’s driving rules and talk with your own care team before you change medicines, start exercises or drive again.
Sources and further reading
- 1Traumatic Brain Injury Center of Excellence. Assessment and management of dizziness and visual disturbances following concussion/mild traumatic brain injury: guidance for the primary care manager. Revised January 2026. health.mil/…/Assessment-and-Management-of-Dizziness-and-Visual-Disturbances-Following-Concussion-Mild-Traumatic-Brain-Injury
- 2Traumatic Brain Injury Center of Excellence. Managing dizziness following concussion/mild traumatic brain injury. Fact sheet. Revised January 2026. health.mil/…/Head-Injury-and-Dizziness-Fact-Sheet
- 3Living Concussion Guidelines. Section 10: Vestibular (balance/dizziness) and vision dysfunction. Updated May 2023. concussionsontario.org/…/vestibular-balance-dizziness-vision-dysfunction
- 4Living Concussion Guidelines. Section 2: Initial management. Updated August 2022. concussionsontario.org/…/initial_management
- 5Centers for Disease Control and Prevention. Symptoms of Mild TBI and Concussion. Updated September 15, 2025. cdc.gov/…/signs-symptoms/index.html
- 6Jacobson GP, Newman CW. The development of the Dizziness Handicap Inventory. Archives of Otolaryngology Head and Neck Surgery. 1990;116:424-427. Form copy from the American Physical Therapy Association. apta.org/…/dizzinesshandicapinventory.pdf
- 7Silverberg ND, Lee K, Mikolić A, et al. Action Collaborative on Traumatic Brain Injury Care: adapted clinical practice guideline. Annals of Family Medicine. 2025;23(6):552-569. doi.org/10.1370/afm.250352
- 8Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Check for safety: a home fall prevention checklist for older adults (STEADI). 2017. cdc.gov/…/steadi_checkforsafety_brochure-print.pdf
- 9Centers for Disease Control and Prevention, Travelers’ Health. Motion sickness. Accessed October 2026. wwwnc.cdc.gov/travel/page/motion-sickness
- 10Quatman-Yates CC, Hunter-Giordano A, Shimamura KK, et al. Physical therapy evaluation and treatment after concussion/mild traumatic brain injury. Journal of Orthopaedic and Sports Physical Therapy. 2020;50(4):CPG1-CPG73. doi.org/10.2519/jospt.2020.0301
- 11Hac NEF, Gold DR. Neuro-visual and vestibular manifestations of concussion and mild TBI. Current Neurology and Neuroscience Reports. 2022;22:219-228. doi.org/10.1007/s11910-022-01184-9
- 12Galeno E, Pullano E, Mourad F, Galeoto G, Frontani F. Effectiveness of vestibular rehabilitation after concussion: a systematic review of randomised controlled trial. Healthcare (Basel). 2022;11(1):90. doi.org/10.3390/healthcare11010090
- 13Patricios JS, Schneider KJ, Dvorak J, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport, Amsterdam, October 2022. British Journal of Sports Medicine. 2023;57(11):695-711. doi.org/10.1136/bjsports-2023-106898
This article reflects the safety priorities of concussion recovery and road safety education. It offers general education, not medical advice for your situation. Causes of dizziness differ, so check official guidance and talk with your own care team before you start exercises, change medicines or return to driving. Reviewed October 2026.
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