Blured photo of a woman suffering from vertigo or dizziness or other health problem of brain or inner ear.

Dizziness After COVID: What it is and How to Treat it

COVID-19 has affected millions of people, and we now know the virus has long-lasting effects and lingering symptoms. “Long Haul” COVID is now recognized as a significant area of concern. Research in this area suggests as many as one in five people infected with the COVID-19 SARS Virus will have lingering symptoms, including dizziness and imbalance.  

It is essential to understand what may be causing symptoms post-COVID to benefit from available treatments. The good news is that Physical Therapists specializing in Vestibular Therapy can evaluate the cause of your post-COVID-related symptoms. Treatment focuses on decreasing dizziness, imbalance, and other related symptoms to allow for a return to pre-COVID levels of function.

 Post-COVID symptoms include: 

  • Dizziness or lightheadedness 
  • Fatigue 
  • Imbalance 
  • General weakness 
  • Brain Fog 
  • Visual disturbances and difficulty focusing while in motion 
  • Vertigo 
  • Poor concentration and decreased memory 
  • Decreased overall function 

How to treat dizziness after COVID

Physical Therapists specializing in vestibular therapy are healthcare providers that can evaluate and treat your dizziness post-COVID. Similar to treating dizziness after a concussion, the assessment includes administering different tests to evaluate the patient’s problems objectively. The therapist will screen the visual and vestibular systems to observe how well-controlled eye movements are. 

Testing includes: 

  • Sensation 
  • Gathering information about pain 
  • Muscle strength 
  • Extremity and spine range of motion 
  • Coordination 
  • Posture and balance 
  • Walking ability 

Cardiovascular screening includes: 

  • Assessment of heart rate 
  • Oxygen saturation 
  • Changes in blood pressure with positional changes 

Vestibular Physical Therapists can address and successfully treat gait and balance disorders, specifically dizziness, through exercises performed in the clinic. Patients are generally treated two to three times per week and given a detailed home exercise program in order to build back balance, muscle strength, and endurance, and address the possible cardiovascular and psychological factors which may be part of the lingering post-COVID symptoms. Patient education is provided at every step, and referrals are made based on evaluation findings to treat the complete patient.  

How long does dizziness last after COVID? 

“Long COVID” is now being researched and studied, and we are in the beginning phases of learning more about the condition. The length of time dizziness can last depends on many factors, including: 

  • Pre-COVID medical history 
  • Autoimmune history 
  • Cardiac history 
  • Length of hospitalization stay  
  • Amount of time spent on bed rest  

Timely treatment is important, the sooner a patient is evaluated for dizziness, imbalance, and functional deficits, the better. Balance retraining, vestibular rehab, and general strength and endurance training, including respiratory therapy, will help manage symptoms and speed up recovery.  

Is it possible to have lingering symptoms of COVID-19? 

Yes, below is a list of secondary conditions which may be directly linked to COVID, causing the above symptoms to remain long after the initial infection. 

Vestibular Neuritis/Labyrinthitis 

This term refers to inflammation of the vestibular nerve. It is caused by viral or bacterial infections entering the inner ear and causing inflammation or damage to the vestibular nerve in one or both ears. Ischemia, which is the lack of blood flow and delivery of oxygen, can also cause inflammation of the nerve. When this damage occurs, the vestibular nerves send messages to the brain that are no longer balanced between the right and left ear. People experience a sudden onset of vertigo and imbalance, which may be accompanied by nausea and vomiting. Symptoms of this inner ear disorder are severe and can last days. Dizziness and imbalance can occur for extended periods after the acute phase of vertigo has stopped. In cases of vestibular labyrinthitis, patients may also experience loss of hearing or ringing in the ears. 

Ototoxicity  

Certain medications can cause damage to the inner ear hair cells. Ototoxicity is ear poisoning that results from exposure to drugs or chemicals that damage the inner ear, often impairing hearing and balance and causing dizziness. Many chemicals can damage the inner ear, including over-the-counter drugs and prescription medications. Research is finding some medicines used to treat COVID can be harmful to the inner ear, and when coupled with prolonged bed rest, people report motion sensitivity and dizziness as a “Long COVID” symptom.

Central Processing Dysfunction  

The central nervous system brain is responsible for taking information from our sensory systems, such as the vestibular system, somatosensory system, and visual system. It uses the information to help us balance and navigate our environments. Any decreased blood flow or oxygen to the central nervous system can cause processing difficulties, and patients often feel off-balance and lightheaded. We know COVID can have immediate impacts on respiration and oxygen intake. Another known complication of COVID is blood clots. These COVID-related complications can cause decreased blood flow to the central nervous system and the vestibular organ.  

POTS (Postural Orthostatic Tachycardia Syndrome)  

This condition can influence involuntary nervous system functions, such as heart rate and blood pressure, usually upon standing from a reclining position. COVID can affect these autonomic functions causing dizziness and imbalance. Many POTS symptoms are thought to be related to inadequate control of blood flow, causing brain fog and dizziness. Dr. Chung from John Hopkin’s POTS program suspects that COVID may be associated with chronic inflammation in the autonomic nervous system, causing symptoms of dizziness and “brain fog.” 

Complications from prolonged bed rest  

The vestibular system needs stimulation regularly to stay healthy and strong. Lying in bed for long periods causes decreased effectiveness of the vestibular system. Muscle weakness, decreased coordination, blood pressure regulation issues, and extreme fatigue can cause balance and dizziness symptoms. People report fatigue, motion sensitivity, imbalance, and dizziness after prolonged bed rest. It is crucial to begin a guided course of Vestibular Therapy to improve function and re-introduce motion through gait and balance training. 

We’re here to help 

If you believe you are suffering from dizziness or other post-COVID systems, visiting a physical therapist can be life-changing. Request an appointment online or find the nearest clinic to schedule an evaluation with a physical therapist specializing in vestibular therapy.  


Article By: Robin Evans, PT, DPT, Vestibular Certified Therapist 

Vestibular Specialization Program Director 

Robin Evans has been a PT for over 20 years and is currently the director of Ivy’s Vestibular Specialization program. She received her Vestibular certification from Emory University in 2003 and has developed vestibular programs on Long Island, incorporating state-of-the-art diagnostic equipment (Frenzel Video System) into her daily care. She currently treats patients in Ivy Rehab Physical Therapy in Lynbrook, NY. 

The medical information contained herein is provided as an information resource only, and does not substitute professional medical advice or consultation with healthcare professionals. This information is not intended to be patient education, does not create any patient-provider relationship, and should not be used as a substitute for professional diagnosis, treatment or medical advice. Please consult with your healthcare provider before making any healthcare decisions or for guidance about a specific medical condition. If you think you have a medical emergency, call your doctor or 911 immediately. IvyRehab Network, Inc. disclaims any and all responsibility, and shall have no liability, for any damages, loss, injury or liability whatsoever suffered as a result of your reliance on the information contained herein.

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